Medicine:Dysphoria

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Dysphoria (from Script error: The function "iso_639_name" does not exist. δύσφορος (dúsphoros) 'grievous'; from δυσ- (dus-) 'bad, difficult', and φέρω (phérō) 'to bear') 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.[1]

In psychiatry

ICD-11

Dysphoria (MB24.7) 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:[2]

"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.[3] 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.[4]

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,[5] μ-opioid receptor antagonists such as naltrexone and nalmefene,[6] and antipsychotics like haloperidol and chlorpromazine (via blockade of dopamine receptors),[7] 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.[8] Those affected feel restless, irritable and dissatisfied - a main driver for relapses, as short-term relief from further substance intake is expected.[9]

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 mood and low mood makes this form particularly agonising and risky (increased suicidal tendencies).[10]

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).[11]

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.[12]

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.[13]

The following conditions may include dysphoria as a symptom:

References

  1. ↑ "Dysphoria definition | Psychology Glossary". https://www.alleydog.com/glossary/definition.php?term=Dysphoria. 
  2. ↑ "ICD-11 - MB24.7 Dysphoria". World Health Organization. January 2025. https://icd.who.int/browse/2025-01/mms/en#1979628747. 
  3. ↑ Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington: American psychiatric association. 2013. ISBN 978-0-89042-554-1. 
  4. ↑ "Borderline Personality Disorder - National Institute of Mental Health (NIMH)" (in en). https://www.nimh.nih.gov/health/topics/borderline-personality-disorder. 
  5. ↑ Lemke, Thomas L.; Williams, David A. (24 January 2012). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. pp. 682–683. ISBN 978-1-60913-345-0. https://books.google.com/books?id=Sd6ot9ul-bUC&pg=PA682. 
  6. ↑ Lowinson, Joyce H. (2005). Substance Abuse: A Comprehensive Textbook. Lippincott Williams & Wilkins. pp. 648–. ISBN 978-0-7817-3474-5. https://books.google.com/books?id=HtGb2wNsgn4C&pg=PA648. 
  7. ↑ 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. PMID 25164199. 
  8. ↑ Volkow, Nora D.; Morales, Marisela (August 2015). "The Brain on Drugs: From Reward to Addiction" (in en). Cell 162 (4): 712–725. doi:10.1016/j.cell.2015.07.046. PMID 26276628. https://linkinghub.elsevier.com/retrieve/pii/S0092867415009629. 
  9. ↑ Handelsman, Leonard; Aronson, Marvin J.; Ness, Robert; Cochrane, Kenneth J.; Kanof, Philip D. (January 1992). "The Dysphoria of Heroin Addiction" (in en). The American Journal of Drug and Alcohol Abuse 18 (3): 275–287. doi:10.3109/00952999209026067. ISSN 0095-2990. PMID 1329491. http://www.tandfonline.com/doi/full/10.3109/00952999209026067. 
  10. ↑ Swann, Alan C. (August 2013). "Activated Depression: Mixed Bipolar Disorder or Agitated Unipolar Depression?" (in en). Current Psychiatry Reports 15 (8). doi:10.1007/s11920-013-0376-1. ISSN 1523-3812. PMID 23881708. http://link.springer.com/10.1007/s11920-013-0376-1. 
  11. ↑ Patel, Beejal M.; Ghosh, Sanjukta S; Vora, Vaishal N.; Lakdawala, Bhaveshkumar M. (October 2023). "Organic Brain Disorders Manifesting as Psychiatric Symptoms" (in en). Annals of Indian Psychiatry 7 (4): 375–377. doi:10.4103/aip.aip_182_22. ISSN 2588-8366. 
  12. ↑ Sundström-Poromaa, Inger; Comasco, Erika (May 2023). "New Pharmacological Approaches to the Management of Premenstrual Dysphoric Disorder" (in en). CNS Drugs 37 (5): 371–379. doi:10.1007/s40263-023-01004-9. ISSN 1172-7047. PMID 37171547. 
  13. ↑ Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington: American psychiatric association. 2013. ISBN 978-0-89042-554-1. 
  14. ↑ Abbess, John F. "Glossary of terms in the field of psychiatry and neurology". http://www.abess.com/glossary.html. 
  15. ↑ 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. 
  16. ↑ Rosa RR, Bonnet MH (2000). "Reported chronic insomnia is independent of poor sleep as measured by electroencephalography". Psychosom Med 62 (4): 474–82. doi:10.1097/00006842-200007000-00004. PMID 10949091. 
  17. ↑ 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. 



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