DYSPHORIA: DEFINITION, ASSOCIATED DISORDERS AND TREATMENT - PSYCHOLOGY - 2024

The dysphoria is a psychological state of dissatisfaction, frustration, discomfort or concern. It is usually a state of mind and is usually a consequence of certain mental conditions. This means that a person may experience dysphoria at certain times while not at others.

This state involves a wide variety of situations that may or may not be pathological. We all experience dysphoria at some point in our lives and it can be a response to negative everyday events. It is important to mention that dysphoria is a symptom, not a diagnostic entity.

Dysphoria that is strongly related to mental health problems is that long-lasting that is maintained over time. This is what happens, for example, in bipolar disorder, in anxiety, in chronic pain or in depression. The one that is related to emotional disorders is a risk factor for suicide.

However, other environmental problems can also cause dysphoria, such as stressful situations, problems in relationships or grieving situations (death of a loved one, loss of a partner, etc.).

Dysphoria can also be caused by health problems or nutritional deficiencies. Thus, it has been observed in people with hypoglycemia or chronic diseases.

Conditions associated with dysphoria

Depressive disorders

There are many types of depression, some more serious than others; however, all are accompanied by dysphoria. In fact, all depressive states involve dysphoria, although this also accompanies other situations that are not depressive disorders.

For example, major depression lasts for more than two weeks and is characterized by a depressed mood or loss of interest most of the day. While persistent depressive disorder or dysthymia is chronic, lasting more than two years.

However, depressive states can also be induced by other substances or medications, such as drugs or other drugs. This is described in the section on Drug-Induced Dysphoria below.

Cyclothymia

Cyclothymia or cyclothymic disorder is a mood disorder in which emotional ups and downs occur in a very short time. In these periods the person oscillates from euphoria to dysphoria, although it is not as intense as occurs in bipolar disorder.

Between these episodes the person may feel good and stable.

Bipolar disorder

Also called premenstrual dysphoric disorder, it is the one that occurs in women before the start of menstruation. A week before it arrives, women may experience strong affective lability, that is, mood swings, in which they are suddenly sad or an intense sensitivity to rejection.

There may also be strong irritability or anger, depressed mood, feelings of hopelessness, tension or anxiety.

Personality disorders

These disorders are very stable patterns of behavior and ways of thinking. Some personality disorders do not present with dysphoria, such as schizotypal personality disorder. Although others are accompanied by dysphoria that is directly caused by the disorder itself.

One of them is borderline personality disorder. It is characterized by a strong pattern of instability in all aspects of the person's life. For example, in interpersonal relationships, in self-perception, in affections, etc.

It is usually accompanied by a chronic feeling of emptiness, intense impulsiveness, and trouble controlling anger. In addition, these people experience strong emotional instability due to sudden changes in mood. This leads to intense episodes of dysphoria or irritability that usually last a few hours.

Another disorder that causes dysphoria is avoidant personality disorder. It is a dominant pattern of social inhibition, fear of negative appraisal, feelings of incompetence, and feelings of lack of adaptation.

All these fears cause the person to avoid many situations and reject opportunities that can be beneficial. As a consequence, she is in a continuing state of dysphoria.

Lastly, dysphoria is also present in dependent personality disorder. In this case, the person needs, in an excessive way, to be cared for with an intense fear of separation. Thus, they develop submissive behavior and extreme attachment to other people.

They tend to feel uncomfortable or helpless when they are alone and when they end a close relationship they urgently seek another. To gain the approval of others, you may do things that you dislike. For all these reasons, these people develop dissatisfaction or dysphoria that is usually permanent due to the continuous fear of abandonment.

Abstinence syndrome

There are many substances that, if abused, can cause withdrawal symptoms. This is characterized by unpleasant symptoms opposite to those of the substance or drug used in the past.

This happens with alcohol, marijuana, cocaine, heroin, nicotine… And even with substances such as caffeine or some psychotropic drugs. Normally, this syndrome is accompanied by dysphoria, low mood and irritability, since the substances of abuse usually produce euphoria and well-being.

Body dysmorphic disorder

This disorder is characterized by significant dysphoria that arises from dissatisfaction with one's own body. These people worry about one or more flaws or imperfections in their physical appearance that are not really relevant or are hardly noticeable.

This concern creates significant discomfort and the person may spend a great deal of time trying to cover or monitor such blemishes.

Schizophrenia

It is a mental illness that stands out for a significant disconnection with reality. These individuals may suffer so-called positive symptoms (hallucinations or delusions).

However, dysphoria would correspond to negative symptoms consisting of depression, cognitive impairment, lack of interest, social isolation, lack of emotional response, etc.

Gender dysphoria

It can occur in both children and adults. It is characterized by strong dissatisfaction with the sex assigned to her. That is, he feels a strong incongruity between the sex he feels or expresses and the one assigned to him.

This dysphoria lasts for more than six months and is accompanied by fantasies about belonging to the other sex, preferences for wearing typical clothes of the opposite sex, and a marked discomfort with one's sexual anatomy.

In order for dysphoria to decrease in this case, the individual can be assisted in making the transition to a life with the desired sex. This process can be long and complicated, and there are societies and cultures that reject it.

However, this is something that cannot be changed, as the person feels that they have been born in the wrong body. The best option is to fulfill the wishes of the individual.

Adjustment disorder

In adjustment disorder, the dysphoria would be caused by identifiable stressors that could have occurred about three months before the discomfort. It differs from depression in that in the latter there are no recognizable external events that cause dysphoria.

However, in adjustment disorder, the discomfort is disproportionate to the negative event, it produces a significant deterioration in the person's functioning, and the symptoms do not represent normal grief.

Anxiety disorder

Anxiety is a cognitive, physiological and behavioral reaction of the organism towards a stimulus or situation that is evaluated as dangerous. Actually, these reactions are disproportionate compared to the real danger of the stimulus.

There are many types of anxiety and they all cause dysphoria. The most notable are the generalized anxiety disorder in which the person has a constant fear of terrible things happening and perceives the world as dangerous.

Whereas, in post-traumatic stress disorder, the patient, after experiencing an objectively traumatic event, such as wars, natural catastrophes, accidents, assaults, robberies, etc., the person avoids all situations that remind him of these events.

The victim may not remember some details of the event, become emotionally over-activated, or have nightmares about the event.

There is also strong dysphoria in separation anxiety disorder, in certain phobias, in social anxiety, in panic disorder, and even in obsessive compulsive disorder. In fact, in the latter, patients try to eliminate their dysphoria through behavioral or mental rituals.

Anxiety can also be induced by drugs, drugs, or physical illness.

Sexual dysfunctions

Sexuality is a very important part of people's intimacy. It is a way to express ourselves and feel good with others and with ourselves. Therefore, sexual dysfunctions can cause intense dysphoria.

In addition, this is accompanied by the difficulty that many feel in recognizing this problem and seeking help.

In men, dysphoria can be caused by erectile dysfunction, premature ejaculation, or delayed ejaculation disorder. While in women, vaginismus, pain during penetration or anorgasmia are more common.

Insomnia

The sleep disorder that generates the most dysphoria is insomnia. People who suffer from it have problems initiating and maintaining sleep, and perceive that they have not had enough sleep or have not rested.

During the day, these individuals will feel fatigued and experience problems with concentration, memory, attention, irritability and, of course, dysphoria.

Chronic pain

Chronic pain can be experienced, even if there is no actual injury. It lasts more than six months and can cause significant disability in a person's life.

Pain affects the psychological plane of people, since it is always unpleasant. It is usually accompanied by feelings of stress, sadness, irritability, helplessness, frustration, etc.

Duel

Not surprisingly, a depressed mood or decreased interest or pleasure occurs as a direct consequence of another medical problem.

This occurs with hypoglycemia, hypothyroidism, multiple sclerosis, HIV, vitamin deficiencies (such as vitamin B12 or folate), etc.

Drug-induced dysphoria

There are drugs that can chemically cause a state of dysphoria. For example, those substances that are kappa opioid receptor agonists, such as nalbuphine, butorphanol or pentazocine.

Another substance that stimulates these receptors is salvinorin A, which is the active component of the hallucinogenic plant sage. Dysphoria may also occur through μ-opioid receptor (MOR) antagonists such as nalmefene or naltrexone.

Some antipsychotics can also make you feel unwell and sad, such as chlorpromazine or haloperidol. This occurs mainly by blocking dopamine receptors.

For this reason, on many occasions, patients with psychotic illnesses are prescribed antidepressants in addition to antipsychotics.

Treatment

People who experience long-term dysphoria may be at risk of committing suicide. It is important to go to psychotherapy or other health professionals who can help you as soon as possible.

Whether it is a pathological condition or stressful life events, such as grief, psychological assistance will be essential to reduce dysphoria, developing strategies to prevent and manage it in the future.

It is common for people with dysphoria to seek mental health care, especially when they are intense feelings.

Thanks to psychotherapy, the causes or conditions that have caused the dysphoria will be identified, then these negative feelings will be worked on by changing thoughts and behaviors.

Depending on the cause of the dysphoria and its severity, medication can sometimes be used in combination with psychotherapy.

Dysphoria may be due to a physical health condition (such as endocrine disturbances). In this case, it is important to control and monitor physical conditions. Perhaps in this way the dysphoria disappears.

It is important to note that in many cases changes in lifestyle can contribute to improving mood. For example, exercise, spend more time with family and friends, change your diet, establish different routines, work on hobbies, etc.

The therapist can be of great help in identifying the positive changes that could be made in the lifestyle of each patient, with the goal of reducing or eliminating dysphoria.

References

1. American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).
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3. Dysphoria. (sf). Retrieved on March 23, 2017, from Wikipedia: en.wikipedia.org.
4. Dysphoria. (2016, April 18). Retrieved from GoodTherapy: goodtherapy.org.
5. What Is Dysphoria in Bipolar Disorder? (sf). Retrieved on March 23, 2017, from Verywell: verywell.com.