Intense states of distress and unease increase the risk of
suicide, as well as being unpleasant in themselves. Relieving dysphoria is therefore a priority of psychiatric treatment. One may treat underlying causes such as
depression (especially
dysthymia or
major depressive disorder) or
bipolar disorder as well as the dysphoric symptoms themselves.
ICD-11 Dysphoria () was included as a separate diagnosis in the
ICD-11, which came into force in 2022. It can be found under the category "Mental or behavioural symptoms, signs or clinical findings". It is defined as follows:
Possible manifestations Dysphoria is a key component of several health conditions that can have an intense negative impact on a person's quality of life.
Borderline personality disorder (BPD) Extreme
mood swings, chronic feelings of
emptiness and rapid
irritability are typical. Between intense
fear of abandonment and
impulsive behaviour, sufferers experience a lasting dysphoria that can manifest itself in outbursts of anger,
self-harm or relationship dysfunction.
Drug-induced dysphoria (dysphoriants) Some
drugs can produce dysphoria, including
κ-opioid receptor agonists like
salvinorin A (the active constituent of the
hallucinogenic plant
Salvia divinorum),
butorphanol and
pentazocine,
μ-opioid receptor antagonists such as
naltrexone and
nalmefene, and
antipsychotics like
haloperidol and
chlorpromazine (via blockade of
dopamine receptors), among others.
Depressogenic and/or
anxiogenic drugs may also be associated with dysphoria.
Intoxication or
withdrawal syndromes (e.g.
alcohol or
opiate withdrawal) often result in severe, persistent dysphoria. Those affected feel restless, irritable and
dissatisfied - a main driver for
relapses, as short-term relief from further substance intake is expected.
Gender dysphoria (GD) Gender dysphoria is discomfort, unhappiness, or distress due to the
primary and
secondary sex characteristics of one's
sex assigned at birth. The current edition of the
Diagnostic and Statistical Manual of Mental Disorders,
DSM-5, uses the term "gender dysphoria" where it previously referred to "gender identity disorder."
Mixed affective state (dysphoric mania) In
bipolar disorders, an episode can occur in which symptoms of
mania (e.g. racing thoughts, pressurised speech) and features of dysphoria (e.g. irritability, anger, dissatisfaction) occur simultaneously. The coexistence of high energy and low mood makes this form particularly
agonising and risky (increased
suicidal tendencies).
Organic dysphoria In the context of
neurological or internal illnesses (e.g.
traumatic brain injury,
dementia,
metabolic disorders), dysphoria can occur primarily for organic reasons. For example: The damage or dysfunction in certain areas of the
brain leads to chronic bad mood and
irritability without there being an underlying primary mental illness (
Organic brain syndrome).
Premenstrual dysphoric disorder (PMDD) Those affected experience pronounced
mood swings with
irritability,
sadness and inner restlessness during the
luteal phase (one to two weeks before the onset of menstruation). The symptoms are so severe that they put a significant strain on everyday life and interpersonal relationships - typical of a dysphoric mood disorder that is closely linked to the hormonal cycle.
Post-traumatic stress disorder (PTSD) A central feature is the persistent experience of
fear,
anger,
inner restlessness and
irritability. These dysphoric states are caused by the re-experiencing of the
traumatic event and the associated emotional overexcitement, which severely restricts everyday life.
Other related conditions The following conditions may also include dysphoria as a symptom: •
Major depressive disorder (unipolar) and
dysthymia •
Bipolar disorder and
cyclothymia •
Premenstrual syndrome •
Dysphoric milk ejection reflex •
Stress •
Adjustment disorder with depressed mood •
Anxiety disorders • Dysphoric
rumination •
Dissociative disorders such as
dissociative identity disorder,
dissociative amnesia and
depersonalization-derealization disorder. •
Attention deficit hyperactivity disorder •
Mixed anxiety-depressive disorder •
Personality disorders such as
dependent personality disorder,
histrionic personality disorder, and
antisocial personality disorder •
Body dysmorphic disorder •
Akathisia •
Schizophrenia •
Sexual dysfunction •
Body integrity dysphoria •
Insomnia •
Chronic pain •
Disease == References ==