September 3, 2002

• Dysphoria…

  
  

  This artical can be found at: Dysphoria – Frequently Asked Questions . I thought I would share it here.

  
  

  Dysphoria is a word that turns up often in the literature and in dicussions relating to bipolar disorder. However, the exact meaning of the word seems to be rather vague, and its use is often confusing. Lucie shared, “I went with my daughter to her pdoc [psychiatrist] on Tuesday and started talking about her dysphoria. The pdoc stopped me and asked me what I meant by dysphoria. I said that I understood dysphoria to be mania in the form of agitation, anger, etc. She said no, that is just mania. But I thought that mania came in a couple of forms – euphoric where you feel ‘on top of the world’ in one form or another and dysphoric where you are filled with rage, energy, agitation, rapid speech, etc. What’s going on?” Poetprose responded, “Yeah, I get confused about dysphoria too. I thought it meant a crashing low depression” (from our forums).

  
  

  The dictionary definition of dysphoria is actually very straightforward – a state of feeling unwell or unhappy. However, that could describe anything from PMS to raging flu to crying because your goldfish died! Many medical dictionaries define dysphoria simply as anxiety. But these definitions just do not describe properly the way dysphoria applies to the moods associated with bipolar disorder cycles. As shown by the dicussion above, many use dysphoria to define manic episodes while others associate it with depressive episodes. The truth is, it is actually quite valid as a description for either mania OR depression.
  

  Dysphoric mania, as presented in the Merck Manual, is “prominent depressive symptoms superimposed on manic psychosis.” Symptoms include:
  

  
  

  
  
  • crying
    
  • curtailed sleep
    
  • racing thoughts
    
  • grandiosity
    
  • psychomotor restlessness
    
  • suicidal ideation
    
  • persecutory delusions
    
  • auditory hallucinations
    
  • indecisiveness
    
  • confusion

  
  

  In everyday English, the complex terms above include – trouble sleeping, racing thoughts, grandiosity, mental and/or physical agitation, thoughts of suicide, feeling persecuted for no reason, hearing things, and having trouble making decisions (along with others).
  

  Dysphoric depression, more commonly referred to as a mixed episode, consists of “intrusions of hypomanic symptoms or hyperthymic traits into a retarded major depressive episode” (Merck). Basically, this means that characteristics of hypomania or overactivity occur during a depression that in general has the patient sluggish or listless. Symptoms include:
  

  
  

  
  
  • irritability
    
  • pressured speech against a background of retardation
    
  • extreme fatigue
    
  • guilty ruminations
    
  • free-floating anxiety
    
  • panic attacks
    
  • intractable insomnia
    
  • increased libido
    
  • histrionic appearance with expressions of depressive suffering

  
  

  Once again putting this into more common terms, these symptoms include: being easily angered, pressured speech in spite of slowed thinking, being overtired, dwelling on guilt feelings, being anxious in general (for no specific reason), serious difficulty in sleeping, extra sex drive, and being melodramatic about feeling depressed.
  

  Important Note: When associated with either mania or depression, dysphoria is linked with a greatly increased risk for suicide and should always be brought to the attention of a medical professional.
  

  Another condition recently included in the dysphoria spectrum is PMDD – Premenstrual Dysphoric Disorder. It is characterized by severe monthly mood swings along with other common symptoms of PMS. The mood swings can include irritability to rage to homicidal feelings, and severe depression to hopelessness to suicidal thoughts and urges. PMDD is a very serious condition and should be treated by a doctor. Please see the excellent Premenstrual Dysphoric Disorder Resource linked in the sidebar above.

  • 7:23 pm
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