Dysphoria (A 3 point guide)

Dysphoria is a state of generalized unhappiness, restlessness, dissatisfaction or frustration, and while not a mental health condition itself it can be a symptom of a variety of actual mental health disorders.

What is Dysphoria?

Dysphoria is the opposite of euphoria. It comes from a Greek word meaning ‘hard to bear’.

Although it is a psychological state, often accompanying a mental health condition, it usually manifests as a mood which is most often just fleeting.

In more serious cases it can remain present in the long-term, in which case there are strong indications of depression, mania or bipolar disorder. 

People usually think of gender dysphoria when they hear the word dysphoria.

However, dysphoria is also a hallmark of drug addiction: when people who are addicted to a drug such as cocaine or heroin, they feel dysphoria when they are not using it.

To relieve these negative emotions, addicts begin to crave the drug and lose control over their intake.

Symptoms of dysphoria during drug withdrawal include depression and anxiety. 

What are the signs and symptoms of Dysphoria?

The following behaviors typify dysphoria symptoms, although note that these are also symptomatic of a number of actual mental health disorders:

·      sadness

·      apathy

·      fatigue

·      worry

·      uneasiness

·      lack of satisfaction with oneself or life.

What are the different types of Dysphoria?

Gender Dysphoria: One of the best known types is gender dysphoria, sometimes known as gender incongruence.

This is when a person’s gender identity differs from the gender biologically assigned to them at birth.

This has replaced the earlier diagnosis of Gender Identity Disorder (GID).

For example, some people have the physical anatomy of a man, but identify themselves as a woman, while others may not feel they are definitely one or the other sex. 

If a person transitions, or at least begins to live as their true gender, the condition of gender dysphoria could begin to resolve.

Transition is when someone aligns their physical characteristics with their gender identity.

As this can be, and often is, a complex process it can take up to several years and can involve surgery or hormone treatments.

Some individuals do transition with neither surgery nor hormone treatments.

The first signs of gender dysphoria can appear when a child is very young. For example, a child may refuse to wear typical boys’ or girls’ clothes, or find it uncomfortable taking part in typical boys’ or girls’ games.

In a lot of cases this is just part of the confusion of growing up and it passes in time.

However, for those people with gender dysphoria it remains and moves on into adulthood

Adults with this problem can feel trapped inside the ‘wrong’ body.

In some cases people will go through with conforming to societal expectations, like a man marrying a woman and having a family, even though he feels he should be a woman.  

Is there any treatment for gender dysphoria?

Usually an in-depth assessment can determine whether gender dysphoria is present.

These can include the following avenues of discussion:

·      is there a clear mismatch between biological sex and gender identity?

·      Is there a strong desire to change physical characteristics as a result of such a mismatch?

·      how is the client coping with any difficulties of a possible gender mismatch?

·      How have the feelings and behaviors of the client developed over time?

·      What support do they have from friends and family?

If the assessment of the client or a child reveals they are experiencing gender dysphoria, a medical professional will assist in creating an individual treatment plan, since all cases are different.

The treatment will aim to reduce or remove the distressing feelings caused by a mismatch between biological sex and gender identity.

Some people may be advised to dress and live as their preferred gender, others may have hormones prescribed or even surgery to change appearance radically. 

What is the cause of gender dysphoria?

This can be hormonal when the fetus is still in the womb, either through excess hormones in the mother’s system via medication, or the fetus may have insensitivity to certain hormones.

There are two very rare conditions which can cause this situation.

The first is congenital adrenal hyperplasia (CAH), where a high level of male hormones enter a female foetus causing the genitals to become more male in appearance and, in some cases, the female baby may be thought to be biologically male when she is born.

The second is intersex conditions which cause babies to be born with the genitalia of both sexes (or ambiguous genitalia).

Parents are recommended to wait until the child is ready to choose their own gender identity before any surgery or other intense treatment is carried out.

Some other types of dysphoria are rejection sensitive dysphoria, post-coital dysphoria and premenstrual dysphoric disorder. 

Rejection sensitive dysphoria is connected with attention deficit hyperactivity disorder (ADHD).

ADHD sufferers can be very sensitive to what other people think or say about them.

They get very upset if they perceive that someone has shunned or criticized them, even if it is not true.

They can get easily embarrassed, set high standards for themselves they can’t always meet, have low self-esteem and feel like a failure.

Postcoital dysphoria is also called postcoital tristesse (French for sadness) or the post-sex blues.

It brings feelings of deep sadness and possibly restless agitation after consensual sex, even if the event was enjoyable and loving.

Sometimes people become tearful or depressed after an orgasm.

Premenstrual dysphoric disorder is similar to, but more serious than, premenstrual syndrome (PMS). It can cause severe anxiety or depression a week or two before your period starts, meaning the sufferer spends up to half the year in this state.

What is the treatment for Dysphoria?

Dysphoria is a symptom, not a diagnosis in its own right.

People often seek psychological help for the symptoms of dysphoria, but very similar symptoms can manifest in several mental health disorders.

Following a full medical assessment, if dysphoria is detected, the underlying causes are carefully examined.

Depending on the severity and the conditions causing it, medication could be used in conjunction with psychotherapy.

An underlying physical health condition could be causing symptoms and that may require medical treatment. 

Sometimes, lifestyle changes, engaging in hobbies, dietary adjustments or change of routine can also help.

In this blog article, we discussed what dysphoria is, what the causes and symptoms are, and how it is commonly treated.

We also distinguished between gender dysphoria and other types of dysphoria. 

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

Frequently asked questions (FAQs) about dysphoria: 

1.    What does it feel like to have dysphoria?

Dysphoria is a feeling of dissatisfaction, anxiety and restlessness.

Severe forms, such as gender or premenstrual dysphoria can result in extreme distress, anxiety and depression.

2.    What is a dysphoric mood?

This can involve sadness, numbness, a feeling of heaviness or anger and mood swings.

There is often a loss of interest or pleasure in usual activities.

3.    Is dysphoria a depression?

It is a profound state of unease or dissatisfaction.

It can accompany depression, anxiety or agitation and restlessness.

4.    What causes dysphoria?

Dysphoria is a mental state that is often caused by, or accompanies, a mental health disorder.

Stress, grief, relationship tensions and/or other environmental problems can also cause dysphoria.

5.    Is dysphoria a choice?

  No, dysphoria is not a choice. 

6.    How is dysphoria treated?

Talking therapy such as psychological therapy, CBT and other forms of mental attention.

For gender dysphoria or other more specific forms there are other treatment approaches.

7.    What is gender dysphoria?

When a person experiences dysphoric symptoms because there is a mismatch between their biological sex, in other words the sex organs they were born with, and their psychological gender identity.

For example, some people may have the anatomy of a man, but identify strongly as a woman. 

8.    How do you get diagnosed with gender dysphoria?

A person must have been exhibiting symptoms for at least six months.

In children, this can include consistently saying they are really a girl, even though they have male sex organs, or vice versa.

9.    Can gender dysphoria go away?

Most children diagnosed with gender dysphoria move on from their symptoms when they reach puberty.

With or without therapeutic intervention the majority grow up to identify as gay, lesbian or bisexual.

If the dysphoria persists into puberty it is most likely permanent.

10.                  How can an individual tolerate gender dysphoria without gender reassignment?

Not everyone with gender dysphoria opts to undergo gender reassignment.

For one, gender reassignment involving surgery is extremely expensive and typically not covered by most health insurance.

Also, as major surgery, some people prefer not to undertake this willingly.

Some people are satisfied with just taking hormones, and still others are happy with neither surgery nor medication, but just prefer to dress and present their identity gender in public.

Want to learn more about dysphoria? Try these books!

Rejection Sensitivity Dysphoria. Cognitive therapy of anxiety disorders Journal and Notebook

The left pages of the diary are a weekly planner. With the page split into the days of the week.

This allows you to plan when and where you are going to take some of the stress out of social occasions.

The right pages a Cognitive therapy anxiety management template, which allows you to identify issues and how to best deal with them.

Blue Is For Boys?: A Case Analysis Reflection on Gender Dysphoria

Imagine you are an adult struggling internally with a wish to be the opposite gender. Now imagine you are only 5 years old!

The Relaxation and Stress Reduction Workbook

This helpful workbook gives step-by-step techniques for calming the mind and body in this overstimulated world.

It gives tips to help integrate healthy relaxation habits into everyday life no matter how busy you are.

This book also helps you explore what your stress triggers are and how to create a personal action plan to manage them.  

The Mindfulness Journal: Daily Practices, Writing Prompts, and Reflections for Living in the Present Moment

As described above, journaling is a great way to give yourself a stress release.

Whether you are dealing with mental health issues such as depression anxiety or general dysphoria, heartbreak, a problem at work, or any other life stressor, this journal is for you.

This Mindfulness Journal can easily be added into your daily routine and can serve as an outlet for stress-reduction that will help you appreciate every single day and moment.

It includes 365 daily writing prompts divided into 52 weekly mindfulness topics. The prompts are extremely unique, fun, and engaging, so you will never get bored while journaling.

Additionally, each prompt is on its own separate page, so you will have more than enough room for reflection and to write down all of your thoughts, big or small.

Although it is suggested to journal once a day, you can spend as much or as little time as you want on each prompt. 

References:

Dysphoria – goodtherapy.org – July 2019

When you don’t feel at home with your gender – WebMD – September 2018

Gender dysphoria – NHS UK – April 2019

Dysphoria. Science Direct. 2010. 

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