What Is Dysphoria, And How Do I Know If I Have It?
By: Jennifer Conerly
Updated April 23, 2021
Everyone gets blue occasionally, but how can you tell the difference between a bad mood and a more serious condition? With the increase in mental health awareness, many might become confused about their feelings and seek help. If you have been feeling depressed lately, there is a name for what you are feeling: dysphoria.
What Is Dysphoria?
The word "dysphoria" comes from the word dysphoros, which is Greek for "hard to bear." This condition is both a short-term or long-term general feeling of unhappiness or frustration. Most commonly, dysphoria is described as a bad mood. However, prolonged bouts of dysphoria indicate a more serious issue. While dysphoria isn't a psychological condition itself, it can be a symptom of other mental health disorders.
Dysphoria and depression can go hand-in-hand: the sadness of dysphoria can be a symptom of chronic depression. Those with dysphoria can also be more likely to have an anxiety disorder. This condition affects about 5% of the population, with research showing most of them being adult women between 25 and 44 years old.
Dysphoria Vs. Dysmorphia: What's The Difference?
Most people confuse dysphoria with another condition, dysmorphia. While dysphoria includes general feelings of unhappiness, dysmorphia - or Body Dysmorphic Disorder - is a separate psychological condition. BDD occurs when someone believes that one or multiple parts of their body are deformed. They may avoid social situations and extreme measures (such as cosmetic surgery) to correct their perceived flaws. Dysphoria and dysmorphia can be associated with negative feelings, but BDD typically fixates the human body.
Dysphoria Causes: Medical And Environmental Factors
There are many causes for temporary and permanent dysphoric states. While it can be associated with several mental disorders, these moods may also come from one's environment or experiences. If you are feeling stressed in your work or personal life, dysphoric states can follow. Those with substance abuse issues may also report feelings of dysphoria. Addicts who attempt to quit using their drug of choice - whether alcohol, tobacco, or illicit drugs - may experience dysphoria symptoms when considering or trying to stop using.
Other events, such as losing a loved one or family tensions, can also trigger dysphoria. Many people also experience this psychological state immediately after any significant life change, such as graduating from college or going through a breakup. Dysphoria can also be very common in people who experience chronic health conditions or an undiagnosed illness. Enduring constant doctors' visits and health screenings can lead to frustration, a characteristic of dysphoria.
Dysphoria can look and feel like someone is unhappy all the time. Dysphoria symptoms can include:
- Feeling sad
- Feeling anxious
- Constant exhaustion and fatigue
- Irregular sleeping behaviors (sleeping too much or not enough)
- Loss of appetite
- Taking no joy or enjoyment in your everyday life
- Feeling frustrated with every aspect of your life
- Showing symptoms of constant emotional distress, such as crying
- Anxiety or a negative outlook about future events
Dysphoric Mood In Other Health Conditions
Even though dysphoria is not a standalone diagnosis, it can lend its name to various mental health conditions. Dysphoric feelings of unhappiness and anxiety can be a common element in all of these diagnoses.
If you enter the term "dysphoria" into any search engine, most of the results will describe a condition known as gender dysphoria. Formerly Gender Identity Disorder, the American Psychiatry Association's handbook, the Diagnostic and Statistical Manual of Mental Disorders - nicknamed the DSM-5 - defines gender dysphoria as feelings of sadness or anxiety in people who do not identify with their born gender for at least six months. Gender dysmorphia symptoms can include a sense of distress that interferes with daily activities, such as work, home, or social commitments. Their communities and loved ones may often shun people with gender dysphoria. In many cases, people may publicly assign their gender as the one they were born with, not the one they identify with.
Gender dysphoria can be present in both children and adults, but it can be presented differently at different age levels. Children with gender dysmorphia may be uncomfortable with their primary sex characteristics, and they may often state their desire to grow up to be the gender with which they identify. They may want to wear the clothing and use the mannerisms of their identified gender, possibly resisting their parents' or the public's attempts to curb this behavior. The distress that those with gender dysphoria feel can lead to anxiety and depression in children and adults.
Gender Dysphoria Treatment
The DSM-5's listing of gender dysphoria comes with its own set of complications. Some claim the identification provides much-needed attention and resources for those who are transgender and nonbinary. Others object to its presence in the manual, claiming that it contributes to the stigma that transgender people endure every day.
Research suggests that the most effective gender dysphoria treatment is a transition to the person's identified gender. People with gender dysphoria may begin a lengthy process to live the gender they identify, such as hormone treatments, changes to physical appearance, and surgery.
However, gender dysphoria may not just disappear as soon as someone transitions. People with gender dysphoria can experience frustration and anxiety when others do not recognize their identified gender in both public and private settings. Their family relationships may also become strained if their loved ones do not support their decision to live as their identified gender. These dysphoric feelings can linger in certain individuals, and they may seek therapy to cope with their emotions.
Rejection Sensitive Dysphoria
Associated with ADHD, Rejection Sensitive Dysphoria is a state of extreme depression or anxiety someone feels when they think someone rejects, minimizes, or does not recognize their efforts. Although most people with ADHD are typically extremely sensitive to what others think of them, Rejection Sensitive Dysphoria occurs when someone fears these feelings of inadequacy so much that they may avoid contact with others.
Rejection Sensitive Dysphoria symptoms can include:
- Social anxiety
- Feelings of guilt for not fulfilling expectations
- Low self-esteem
- Feelings of intense anger or sadness when they think someone else is rejecting them
- Try to achieve goals that they cannot reach
- Tensions in relationships with partners, family, and friends
This condition is difficult to diagnose because it may also be present in other mental health conditions, such as bipolar disorder, social phobia, OCD, PTSD, and depression. Those with ADHD may have a heightened emotional state, leading to outbursts when they feel rejected.
Tardive dysphoria can occur when symptoms of chronic depression worsen while taking antidepressants. This condition has concerned psychiatrists since the 1960s. Mental health professionals are worried that these medications, which alter the neurotransmitters, are the parts of our brains responsible for sending chemical signals from one neuron to another. When our minds have too much exposure to these brain-altering drugs, the medications may stop working and increase depressive states.
The "post-sex blues"? You may not believe such a condition exists, considering all the health benefits associated with sex. It can be a great mood-booster: after we have an orgasm, our brains produce oxytocin, a chemical that makes us feel emotionally satisfied with our significant other. These positive vibes can last up to two days after sexual intercourse, but many people in fulfilling relationships report feeling sad or frustrated after sex with their partner. Research shows that over 30% of men and women admit to having post-coital dysphoria at least once.
Post-coital dysphoria is not the feelings of disgust or shame you feel after a regrettable encounter. This condition is limited to those in satisfying relationships. Even after having sex with someone you love, those with post-coital dysphoria can feel angry, sad, or anxious. Psychiatrists are still studying this new phenomenon, so there is limited information available on what causes it.
Premenstrual Dysphoric Disorder (PMDD)
Other than gender dysphoria, the most common example of dysphoria is Premenstrual Dysphoric Disorder (PMDD). A serious form of PMS, this psychological condition can affect your self-esteem and your mood. Of the 20-40% of women who report moderate or severe PMS, less than 10% experience PMDD. This condition can last about a week and a half, from the week before your expected start date until the middle of your period.
PMDD symptoms include:
- A heightened emotional state, including crying, irritability, and anxiety
- Severe mental symptoms, such as changes in mood, paranoia, poor self-esteem, and foggy memory
- Physical symptoms, such as muscle spasms, hot flashes, pain in the head or back, dizziness, changes in vision and coordination, heart palpitations, fluid retention, and skin reactions (such as acne or rashes)
For a diagnosis of PMDD, a woman must have at least five symptoms that are so severe that they impact her ability to lead a normal life or fulfill work, school, or personal commitments. Women with this condition often isolate themselves, avoid social situations, or encounter friends and loved ones. The symptoms of PMDD can also lead to an increase in depressive episodes and anxiety.
There is limited information on what causes PMDD, but physicians suggest a connection between family history, including depression, dysmenorrhea, and other conditions that affect mood. PMDD symptoms must alter a woman's professional and personal life for at least two menstrual cycles before a physician can evaluate her for the condition.
Mental health professionals and physicians urge women and their support systems need to take these symptoms seriously. It isn't just a bad period: PMDD is a severe medical condition that requires treatment.
Dysphoric mania is a condition that affects those diagnosed with bipolar disorder. It describes the state in which people with bipolar disorder have both depressive and manic states at the same time. Research suggests about 40% of people diagnosed with bipolar disorder have dysphoric mania. Since people with this condition can experience highs and lows, the symptoms may last longer than those with mixed characteristics.
Those with dysphoric mania may experience alternating symptoms, such as:
- Lengthy depressive episodes, characterized by severe feelings of sadness, apathy, loss of appetite and energy
- Manic symptoms, such as making impulsive decisions, increased confidence and narcissism, and constant flow of thoughts or ideas
Family history plays a significant role in bipolar disorder and dysphoric mania. Research suggests those who are related to someone with bipolar disorder - whether they present mixed states or not - are ten times more likely to have the condition, too. Lifestyle changes, such as a healthy diet, exercise, and avoiding coffee alcohol, can curb the severity of the dual states.
Dysphoria Test: When To Seek Help
Dysphoric moods are completely normal in certain stages of life. They usually come and go, only affecting you for a short period. In these cases, the short intervals of low moods typically do not indicate a more serious mental disorder.
When depressive moods last longer than two weeks, they can negatively affect your mental state. Dysphoria is associated with several mental health conditions, such as:
- Bipolar disorder
- Personality disorders in which someone's personality has characteristics that impair them from completing daily activities, such as Paranoid Personality Disorder, Borderline Personality Disorder, and Narcissistic Personality Disorder
- Anxiety disorders and dissociative disorders
- Adjustment disorders which keep people from processing life changes in a healthy way
- Schizoaffective Disorder (a specific condition that includes the mood changes of bipolar disorder with the psychosis present in schizophrenia)
However, feelings of dysphoria could be an underlying cause of a physical health condition. Your primary care doctor may run tests or evaluate you for any physical explanations for your dysphoria before recommending mental health treatment.
Both doctor and patient can work together to arrange a complete treatment plan. Dysphoria treatment strategies may include lifestyle changes, therapy, and other treatment options, which will help improve your quality of life. During your sessions, your mental health professional will help you identify what factors are causing your dysphoria and help you confront or eliminate these issues.
If your dysphoria is affecting your daily life, ReGain can help. Our licensed therapists are trained to help you on the road to better mental health.
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