Dysphoria

Dysphoria (from Template:Lang-el (dysphoros), δυσ-, difficult, and φέρειν, to bear) is a profound state of unease or dissatisfaction. In a psychiatric context, dysphoria may accompany depression, anxiety, or agitation. It can also refer to a state of not being comfortable in one's current body. Examples include Body Dysmorphic Disorder, where people are repulsed by their own appearance, such as a crooked nose or uneven smile; apotemnophilia, referring to those who wish to believe they should be amputees and sometimes follow through with surgical procedures; and gender dysphoria, or people who feel they are not the gender they were assigned at birth, and may undergo similarly accommodating surgery to satisfy their feelings. Common reactions to dysphoria include emotional distress; in some cases, even physical distress. The opposite state of mind is known as euphoria.

In psychiatry

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 or bipolar disorder as well as the dysphoric symptoms themselves.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes specific dysphoria in the obsessive–compulsive spectrum.

Gender dysphoria

Gender dysphoria is discomfort, unhappiness, or distress due to one's gender or physical sex. The current edition (DSM-5) of the Diagnostic and Statistical Manual of Mental Disorders uses the term "gender dysphoria" where it previously referred to "gender identity disorder", making it clear that they no longer consider the gender identity to be disordered, but rather the emotional state of distress which results from the gender identity.^[1]

Related conditions

The following conditions may include dysphoria as a symptom:

Major depressive disorder (unipolar) and dysthymia
Bipolar disorder^[2] and cyclothymia
Borderline personality disorder^[3]
Premenstrual syndrome
Premenstrual dysphoric disorder
Dysphoric milk ejection reflex
Stress
Adjustment disorder with depressed mood
Anxiety disorders such as post-traumatic stress disorder
Dysphoric rumination^[4]
Dissociative disorders such as dissociative identity disorder, dissociative amnesia, and depersonalization disorder.
Attention Deficit Hyperactivity Disorder
Mixed anxiety-depressive disorder
Gender dysphoria, sometimes referred to as "gender identity disorder" (note that use of the latter term and its identification with gender dysphoria is controversial)
Personality disorders such as borderline personality disorder, dependent personality disorder and antisocial personality disorder
Substance withdrawal
Body dysmorphic disorder
Akathisia
Hypoglycemia
Schizophrenia
Sexual dysfunction
Body integrity identity disorder
Insomnia^[5]
Chronic pain^[6]

Drug-induced (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,^[7] μ-opioid receptor antagonists such as naltrexone and nalmefene,^[8] and antipsychotics like haloperidol and chlorpromazine (via blockade of dopamine receptors),^[9] among others. Depressogenic and/or anxiogenic drugs may also be associated with dysphoria.

In popular culture

Against Me! released the album Transgender Dysphoria Blues in which the lead singer Laura Jane Grace shares her experiences of gender dysphoria.^[10]

Shane Neilson released a book of poetry entitled Dysphoria (The Porcupine's Quill, 2017) in which he explores the experience of dysphoria.^[11]

Notes

^ Fraser, L; Karasic, D; Meyer, W; Wylie, K (2010). "Recommendations for Revision of the DSM Diagnosis of Gender Identity Disorder in Adults". International Journal of Transgenderism. 12 (2): 80–85. doi:10.1080/15532739.2010.509202.
^ Abbess, John F. "Glossary of terms in the field of psychiatry and neurology". Archived from the original on 2007-07-18. Retrieved 2006-11-18. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^ Borderline personality disorder
^ Lyubomirsky, S.; Kasri, F.; Zehm, K. (2003). "Dysphoric rumination impairs concentration on academic tasks". Cognitive Therapy and Research. 27 (3): 309–330. doi:10.1023/A:1023918517378.
^ Rosa RR, Bonnet MH (2000). "Reported chronic insomnia is independent of poor sleep as measured by electroencephalography". Psychosom Med. 62 (4): 474–82. PMID 10949091.
^ Chapman CR, Gavrin J (June 1999). "Suffering: the contributions of persistent pain". Lancet. 353 (9171): 2233–7. doi:10.1016/S0140-6736(99)01308-2. PMID 10393002.
^ Thomas L. Lemke; David A. Williams (24 January 2012). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. pp. 682–683. ISBN 978-1-60913-345-0.
^ Joyce H. Lowinson (2005). Substance Abuse: A Comprehensive Textbook. Lippincott Williams & Wilkins. pp. 648–. ISBN 978-0-7817-3474-5.
^ Wu, Hanjing Emily; Okusaga, Olaoluwa O. (2014). "Antipsychotic Medication-Induced Dysphoria: Its Meaning, Association with Typical vs. Atypical Medications and Impact on Adherence". Psychiatric Quarterly. 86 (2): 199–205. doi:10.1007/s11126-014-9319-1. ISSN 0033-2720.
^ Thompson, Stephen. "First Listen: Against Me!, 'Transgender Dysphoria Blues'" NPR. NPR, 12 Jan. 2014. Web. 27 May 2014
^ "Dysphoria". The Porcupine's Quill.

References

Abbess, John F. "Glossary of terms in the field of psychiatry and neurology". Archived from the original on 2007-07-18. Retrieved 2006-11-18. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
"Dysphoria." Alleydog.com Psychology Glossary.
Metcalf, Matthew; Coop, Andrew (2005). "Kappa Opioid Antagonists: Past Successes and Future Prospects". The AAPS Journal. 7 (3). American Association of Pharmaceutical Scientists: E704–E722. doi:10.1208/aapsj070371. ISSN 1522-1059. PMC 2751273. PMID 16353947. Archived from the original on 2006-12-08. Retrieved 2006-11-19. {{cite journal}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
Read, Kimberly (2006). "What is dysphoria?". Your Guide to Bipolar Disorder. About.com. Retrieved 2006-11-19.

[recommendations-1] Fraser, L; Karasic, D; Meyer, W; Wylie, K (2010). "Recommendations for Revision of the DSM Diagnosis of Gender Identity Disorder in Adults". International Journal of Transgenderism. 12 (2): 80–85. doi:10.1080/15532739.2010.509202.

[read-2] Abbess, John F. "Glossary of terms in the field of psychiatry and neurology". Archived from the original on 2007-07-18. Retrieved 2006-11-18. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)

[3] Borderline personality disorder

[4] Lyubomirsky, S.; Kasri, F.; Zehm, K. (2003). "Dysphoric rumination impairs concentration on academic tasks". Cognitive Therapy and Research. 27 (3): 309–330. doi:10.1023/A:1023918517378.

[5] Rosa RR, Bonnet MH (2000). "Reported chronic insomnia is independent of poor sleep as measured by electroencephalography". Psychosom Med. 62 (4): 474–82. PMID 10949091.

[6] Chapman CR, Gavrin J (June 1999). "Suffering: the contributions of persistent pain". Lancet. 353 (9171): 2233–7. doi:10.1016/S0140-6736(99)01308-2. PMID 10393002.

[LemkeWilliams2012-7] Thomas L. Lemke; David A. Williams (24 January 2012). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. pp. 682–683. ISBN 978-1-60913-345-0.

[Lowinson2005-8] Joyce H. Lowinson (2005). Substance Abuse: A Comprehensive Textbook. Lippincott Williams & Wilkins. pp. 648–. ISBN 978-0-7817-3474-5.

[WuOkusaga2014-9] Wu, Hanjing Emily; Okusaga, Olaoluwa O. (2014). "Antipsychotic Medication-Induced Dysphoria: Its Meaning, Association with Typical vs. Atypical Medications and Impact on Adherence". Psychiatric Quarterly. 86 (2): 199–205. doi:10.1007/s11126-014-9319-1. ISSN 0033-2720.

[10] Thompson, Stephen. "First Listen: Against Me!, 'Transgender Dysphoria Blues'" NPR. NPR, 12 Jan. 2014. Web. 27 May 2014

[11] "Dysphoria". The Porcupine's Quill.

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