Dysphoria


Dysphoria is a profound state of unease or dissatisfaction. It is the semantic opposite of euphoria. In a psychiatric context, dysphoria may accompany depression, anxiety, or agitation.

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.

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:
"An unpleasant mood state, which can include feelings of depression, anxiety, discontent, irritability, and unhappiness."

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, butorphanol and pentazocine, μ-opioid receptor antagonists such as naltrexone and nalmefene, and antipsychotics like haloperidol and chlorpromazine, among others. Depressogenic and/or anxiogenic drugs may also be associated with dysphoria.
Intoxication or withdrawal syndromes 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 and features of dysphoria occur simultaneously. The coexistence of high mood and low mood makes this form particularly agonising and risky.

Organic dysphoria

In the context of neurological or internal illnesses, 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.

Premenstrual dysphoric disorder (PMDD)

Those affected experience pronounced mood swings with irritability, sadness and inner restlessness during the luteal phase. 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: