Many mental health care professionals who believe in the DID diagnosis insist the main personality (for this patient, Nadine) is a borderline personality. Taken as one person and one identity, Nadine does come off as thoroughly borderline. Indeed, some who do not acknowledge the validity of the DID diagnosis claim that DID patients are really just severe borderlines. But clearly, even borderline patients who are very labile do not have emotions and behaviors that coalesce around strikingly different identities to the extent of many patients diagnosed with DID, including Nadine.

If someone with DID can ultimately be considered borderline, he or she must be seen as a very different kind of borderline-perhaps one with hysterical features severe enough to warrant the diagnosis of hystrionic personality disorder.

In the attempts to distinguish one mental disorder from another, a point is sometimes reached when the notion of diagnostic specificity itself is pushed to the limit. This may be the time to quit trying to fit a patient's symptoms to one set of diagnostic criteria or another so that the more fundamental question of why a patient's life is being lived as it is-i.e., the meaning of the pathological behavior-can be asked more directly and concretely.
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