Dysphoria

Dysphoria (from Greek: δύσφορος (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, particularly in cases of gender dysphoria. Common reactions to dysphoria include emotional distress or indifference. 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" in preference to "gender identity disorder". DSM-5 introduces the term "gender incongruence" as a better identifying and less stigmatising term.^[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
• Stress
• Adjustment disorder with depressed mood
• Anxiety disorders such as post-traumatic stress disorder
• 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^[4]
• Chronic pain^[5]

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,^[6] μ-opioid receptor antagonists such as naltrexone and nalmefene,^[7] and antipsychotics like haloperidol and chlorpromazine (via blockade of dopamine receptors),^[8] 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.^[9]

See also

• Comedown (drugs)

Notes

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.
2. Abbess, John F. "Glossary of terms in the field of psychiatry and neurology". Retrieved 2006-11-18.
3. Borderline personality disorder
4. 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.
5. 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.
6. 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.
7. Joyce H. Lowinson (2005). Substance Abuse: A Comprehensive Textbook. Lippincott Williams & Wilkins. pp. 648–. ISBN 978-0-7817-3474-5.
8. 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.
9. Thompson, Stephen. "First Listen: Against Me!, 'Transgender Dysphoria Blues'" NPR. NPR, 12 Jan. 2014. Web. 27 May 2014

References

• Abbess, John F. "Glossary of terms in the field of psychiatry and neurology". Retrieved 2006-11-18.
• "Dysphoria." Alleydog.com Psychology Glossary.
• Metcalf, Matthew; Coop, Andrew (2005). "Kappa Opioid Antagonists: Past Successes and Future Prospects". The AAPS Journal. American Association of Pharmaceutical Scientists. 7 (3): E704–E722. doi:10.1208/aapsj070371. ISSN 1522-1059. PMC 2751273. PMID 16353947. Retrieved 2006-11-19.
• Read, Kimberly (2006). "What is dysphoria?". Your Guide to Bipolar Disorder. About.com. Retrieved 2006-11-19.