Dysphoria

In various life situations, each person reacts to stimuli in his own way and, according to his reaction, expresses emotions that characterize his attitude to what is happening. In long-term stressful situations, diseases of the central nervous system, affective experiences intensify and can reach pathological heights. Dysphoria is one of the types of emotional disorders in psychology with an unmotivated, clearly depressed mood, characterized by tense gloom, gloom, and all-encompassing discontent. This condition is directly opposite to euphoria. They both relate to disorders with increased emotionality. A person's sensitivity is exacerbated, he is capable of a sudden explosion of anger and aggressive behavior, the strength of which is incomparable with external stimuli, and often directed against himself.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ]

Epidemiology

The prevalence of dysphoria is very wide. It can be caused by many reasons, ranging from banal overwork to organic psychosyndrome.

Statistics highlight only certain types of dysphoria, for example, premenstrual dysphoric disorder is observed in 5-8% of women of childbearing age, with patients aged 25-35 being most susceptible to it.

According to US medical statistics, one in a hundred women wants to change their gender to male. One in four hundred men wants to become a woman. Approximately 4% of the planet's population exhibits behavior typical of the opposite sex. However, it is unknown which of them experiences dissatisfaction on this basis reaching the heights of dysphoria.

Dysphoria is observed in many epileptics of different ages, more often in male patients, and correlates with an increase in the frequency of seizures.

[ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ]

Causes dysphorias

Painful dissatisfaction combined with a melancholy, depressed mood, anger breaking through, malicious antics directed both at others and at oneself, can develop against the background of many mental disorders - neuroses, psychopathies, depressions, phobias and more serious mental illnesses - schizophrenia, epilepsy. In the latter, dysphoria can be observed in the prodrome of a seizure and after its completion, as well as instead of it.

Unmotivated irritability and anger are characteristic of withdrawal syndrome in alcoholics and drug addicts.

A dysphoric state is observed in the structure of organic brain lesions of various origins (trauma, intoxication, tumor, hypoxia, hemorrhage).

Decompensated diabetes mellitus and thyroid dysfunction can also cause the development of this condition.

Monthly hormonal fluctuations in some women of fertile age can cause a pathological response of the central nervous system in the form of the development of dysphoric disorder.

Dissatisfaction with one's gender identity, sexual failure, chronic pain, insomnia or stress, long-term anxiety, heredity, obesity, general health, and certain personality traits are risk factors for developing dysphoria.

The pathogenesis of painful mood decline is triggered by many of the above-described reasons, and more often by their combination. At the current level, the neurobiological vulnerability of the brain to hormonal fluctuations has been proven - the development of dysphoric disorder in the premenstrual period or against the background of a surplus (deficiency) of thyroid hormones; metabolic disorders, in particular, hypoglycemia; intoxications. Many causal factors can affect the chemical interaction of neurotransmitters with receptor proteins on the presynaptic and postsynaptic membranes, changing their concentration in the synapses.

Mood and behavior are affected by a disturbance in dopamine transmission. Weakening of norepinephrine activity leads to the formation of a melancholy mood, a disorder of the sleep-wake cycle. A decrease in serotonin levels, an imbalance of neuropeptides, in particular endorphins, and other substances cause a pathological response from the central nervous system in the form of a sharp decrease in mood while maintaining motor activity and explosive emotional tension.

The role of heredity in the pathogenesis of mental illnesses has also been established. In addition, certain personality traits (increased anxiety, suspiciousness), tendencies to somatic diseases, such as diabetes, drug addiction, alcoholism, other antisocial behavior, and even the occurrence of premenstrual dysphoria, are passed on by inheritance.

Hereditary aspects are also involved in the development of gender identity. The brains of men and women have neuroanatomical differences, which affects the psychological characteristics and behavior of individuals of different sexes. Gene mutations in gender dysphoria, or more precisely those responsible for atypical gender identity and the dissatisfaction associated with it, have not yet been studied much, but research proves that they do occur.

In general, the mechanism of development of dysphoria in any mental disorders and organic pathologies is under study; the possibilities of lifetime neuroimaging, advances in neurobiology and genetics have not yet revealed all the secrets of the interaction of brain structures.

[ 15 ], [ 16 ], [ 17 ], [ 18 ]

Symptoms dysphorias

The first signs that attract attention are expressed in the fact that the subject's emotional state is clearly negative. Moreover, there are no visible reasons for this or they do not correspond to the gloomy, dissatisfied facial expression, caustic and stinging remarks, rude answers to questions, and irritation often goes off the scale and spills out into a surge of unmotivated aggression.

A person may be sullenly silent, but tension is felt in everything. Dysphoria refers to disorders with increased emotionality, the patient does not have motor and speech inhibition, which is characteristic of typical depression. He easily switches from sullen silence to abuse, threats, brutal behavior and even illegal actions in the form of a sudden attack or self-harm.

A bad mood attack occurs without any apparent reason, often right in the morning. The expression: "got up on the wrong side of the bed" is exactly about this: total discontent, grumbling, pickiness combined with hypersensitivity and touchiness, easily turning into acute bitterness characterize the dysphoria syndrome, as some users call it, although in psychiatry this condition is not classified as a syndrome.

Sometimes, if there has been a previous negative stressful situation, those around you may feel that this is a natural reaction to events, however, repeated and fairly frequent reactions of this type, sometimes without any apparent reason, should make you think about the presence of a mental disorder.

Episodes of dysphoria occur suddenly, lasting for two or three days, sometimes for several weeks (this is already a clear pathology). The attacks of bad mood stop just as unexpectedly as they arise.

If the condition drags on, vegetative symptoms join the very bad mood: blood pressure surges, tremors of the limbs, headaches, increased heart rate, worsening sleep and appetite.

Euphoria and dysphoria are two diametrically opposed emotional disorders. The euphoric state consists of good nature, a serene and carefree mental state and is accompanied by pleasant somatic symptoms. The toxic effects of opiates are associated with the emergence of a state of peace and satisfaction, a feeling of blissful warmth spreading in waves from the lower abdomen up to the neck. Opiate euphoria causes lightness in the head, a feeling of joy and jubilation. The surrounding world is perceived as bright, people are kind and friendly. Then the sensations smooth out and acquire features of satisfaction, sweet languor, benevolent laziness - a state of nirvana.

Caffeine, cocaine, and lysergic euphoria are more combined with feelings of a clear mind and intellectual uplift.

Alcohol intoxication, barbiturate poisoning makes the subject smug, boastful, self-assured and disinhibited. However, no real increase in mental and physical productivity is actually observed in artificially induced euphoric states.

Sometimes dysphoric disorder can be accompanied by inadequate enthusiasm, logorrhea, exaltation and delusional statements about one's own greatness, somewhat reminiscent of euphoria, however, there is no smell of complacency.

Dysphoria in children is observed less frequently, however, it can develop for the same reasons as in adults. More often, attacks of bad mood with increased irritability affect children-epileptics, oligophrenics, future excitable psychopaths-epileptoids.

The condition may develop against the background of a severe infectious disease. Domestic violence against a child or a situation where the child witnesses violent actions becomes an additional risk factor for the development of dysphoric disorder.

More and more children and teenagers in the world, according to Western research, are dissatisfied with their gender identity and complain of imaginary physical defects. Experts believe that if a child has dysphoria that is not related to mental retardation, trauma, or epilepsy, his parents also need psychotherapeutic help.

Mild dysphoria looks and is perceived by others as a very bad mood - a person grumbles in the morning, is dissatisfied with everything, sarcastically criticizes family members, finds fault with trifles, but is very offended by criticism addressed to him. The patient may flare up, quarrel, slam the door. Such attacks usually last for several hours, then suddenly pass.

With a longer course (up to several days), the condition reaches a more severe stage. Vegetative symptoms join the manifestations of bad mood and irritability, the person behaves too inadequately, the emotional state is unstable, his consciousness is narrowed, reduced or there is no critical attitude towards his behavior. Sometimes after the end of the dysphoric episode, the patient remembers what happened very fragmentarily. The state of severe dysphoria can pose a danger to the health and life of the person himself and his environment.

[ 19 ], [ 20 ], [ 21 ]

Forms

Experts distinguish certain types of this mood disorder that are quite common and therefore attract close attention. For example, in the latest, fifth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-5, such nosological units as "gender dysphoria" instead of gender identity disorder appeared, emphasizing precisely the deep dissatisfaction with one's sexual status at the level of psychological distress, as well as premenstrual dysphoric disorder.

Gender dysphoria

Every year, the number of people seeking treatment at clinics for gender reassignment is growing worldwide, as people feel that their inner self does not correspond to their outer appearance. Currently, Western psychiatry recognizes sexual incongruence as a congenital defect, although there are still many debates about this. In addition to the presence of certain and still unidentified genes responsible for sexual identification, scientists are considering the endocrine theory, suggesting that pathological processes occur in the hypothalamus nuclei and other structures of the brain, disrupting the transmission, conduction and regulation of neuroimpulses.

Social theory blames everything on the impact of some unfavorable factors on the psyche, and in most cases, these factors are present in the child’s life from early childhood.

In addition, the term "sexual" has been replaced by "gender" because the concept of sex is not applicable to people with disorders of sexual development. Sex implies the presence of clear biological characteristics of sexual identity. In reality, there are a number of patients with ambiguous sexual characteristics. The term "gender" is more general and reflects social and psychological identification as a person of a certain sex.

“Gender dysphoria” emphasizes, first of all, as a clinical problem, an emotional disorder, a discrepancy between experiences and sensations and the determined gender.

Symptoms of gender dysphoria often manifest in childhood – the child begins to behave like a representative of the opposite sex, dress in markedly inappropriate clothes, and demands to change his or her name. However, such a violation of self-perception does not always persist into adulthood.

Gender dysphoria is more common in women than in men. Among those wishing to change their gender to the opposite one, there are four times more representatives of the fair sex (at least in the USA).

Individuals with cross-gender behavior are classified using the Benjamin scale, which helps to determine the severity of symptoms and determine the direction of assistance.

Pseudo-transvestites are people who are known to cross-dress and have various sexual preferences, but do not flaunt their features, often doing so out of curiosity, to get acute sexual sensations and new interesting experiences. In fact, their sexual self-identification clearly corresponds to their biological one. They often start a traditional family, do not plan to change anything in their lives and do not consider the possibility of hormone therapy or sex reassignment surgery.

Transvestite fetishists identify themselves exclusively with their gender. In their sexual life, they often prefer heterosexual contacts; bisexuality is possible, but rare. They regularly wear clothing for the opposite sex, they can wear underwear all the time, and they can also call themselves by both male and female names. The goal is to achieve sexual arousal. There is no talk of any kind of treatment. Sometimes behavior correction is recommended through psychotherapy sessions.

True transvestites are defined in cases where sexual self-identification based on biological characteristics is difficult, and they recognize their gender with great reservations. In a mild degree, people try to wear all items of clothing of the opposite sex as often as possible and copy their behavior and lifestyle. Sexual orientation is directly related to the clothes a person wears (psychologically heterosexual). During periods of cross-dressing, feeling like a representative of the opposite sex, they choose a partner of the same biological sex. They do not actively seek a sex change operation, but they do not reject the idea itself. Psychotherapeutic treatment usually does not help in such cases; sometimes hormonal treatment is useful.

A more severe form is non-op transsexualism. Gender self-identification causes difficulties, however, the person does not show any activity in the matter of surgical gender reassignment, although a certain interest in this is visible. Uses any opportunity to change clothes and lead the lifestyle of a person of the opposite sex. However, he does not experience complete satisfaction with this, complaining that this is not enough. Such people often have a reduced sexual desire, they are mainly bisexual. In this case, hormone therapy is indicated, which helps to adapt in society. The choice of gender role often occurs under the influence of external factors.

True transsexuals with moderate disorders have no doubts about their sexual identity as the opposite sex. In sex, they choose partners of their biological sex with a heterosexual orientation, imagining classic sexual contact between a man and a woman. They constantly wear clothes and lead the lifestyle of representatives of the opposite sex, however, this does not bring them satisfaction. Hormonal treatment is not effective, although they do not refuse it either. They actively seek surgical intervention for gender reassignment. They are distinguished by more positive thinking than the next group.

Severe transsexualism is expressed in complete rejection of one's biological sexual characteristics, even to the point of committing suicide. It is in this group that severe transgender dysphoria develops. Social and sexual behavior is similar to the previous group. It is they who, for vital indications, need surgical correction of gender followed by hormone therapy.

The discrepancy between external sexual characteristics (body) and the internal sense of one's own gender is also called body dysphoria, mainly associated with the desire to change gender. However, mood disorders can occur with any manifestations of dysmorphophobia. A person can be overly concerned about any part of their body, want to change it, get upset to such an extent that their ability to work, self-care and other social responsibilities is impaired. Such mental pathologies are found among men and women equally, manifesting in adolescence or youth, there is a risk of suicide due to the inability to change the imaginary defect.

Another continuation of body dysphoria is species dysphoria. A person is also dissatisfied with his body, feels like he belongs to another species of creatures, sometimes mythical - for example, a dragon, sometimes real, often predators - a wolf, a leopard. Patients feel the presence of phantom body parts (wings, clawed paws, tail), are upset by the lack of fur or mane. Species dysphoria essentially includes gender dysphoria: a woman in a man's body is a special case. Nevertheless, people with species dysphoria are aware of their biological belonging, although they are not satisfied with it to the heights of dysphoric disorder.

Premenstrual dysphoria

Approximately a quarter of menstruating women experience a pronounced regular decline in mood, the appearance of despondency, irritability in the late luteal phase (the week before menstruation), and with the onset of menstruation these symptoms weaken, and after - disappear. No more than a third of the specified cohort of patients experience premenstrual syndrome in a very severe form. Modern medicine considers it a complex psychoneuroendocrine disorder, which reduces the quality of life of a woman in certain periods.

Moreover, it is not even necessary to observe the symptoms described below every menstrual cycle, however, most of them should be accompanied by at least five signs. Among them, the presence of at least one of the first four is required.

Such an authoritative organization as the American Psychiatric Association has identified the following main symptoms:

• depressed gloomy mood, focusing attention only on negative events, a feeling of hopelessness or one’s own insignificance (“one just gives up”);
• anxiety, worry, increased emotionality to the point of constant agitation;
• instability of emotional state: sudden tearfulness, hyper-touchiness;
• outbursts of anger, spiteful behavior, conflict.

In addition, there may be additional complaints about the inability to concentrate on any activity, distracted attention, lack of strength and energy, rapid fatigue, a constant desire to lie down, changes in appetite or food preferences, sleep disturbances (difficulty falling asleep or pathological sleepiness), a subjective feeling of inability to control one's actions, orient oneself in a situation, and a lack of criticism of one's actions.

The presence of some somatic symptoms is assumed: swelling and/or tenderness of the mammary glands, abdominal pain, flatulence, migraine, arthralgia, myalgia, weight gain, swelling of the extremities.

Risk factors for the development of premenstrual dysphoria include heredity (close female relatives have suffered from it), excess weight, chronic somatic pathologies, physical (sexual) abuse, and a history of depressive episodes.

The mechanism of development of premenstrual syndrome and its most severe form, dysphoria, is still under study.

The following forms are distinguished:

• neuropsychiatric, in which affective symptoms predominate, and, at a young age - depressive episodes, and at a more mature age - pronounced dysphoria;
• edematous - the name speaks for itself, in addition, there is weakness, increased irritability, sweating and itchy skin;
• cephalgic - with a predominance of hypersensitivity to sounds (headache), to smells (nausea, vomiting, dizziness), cardialgia, paresthesia of the extremities, hyperhidrosis;
• crisis - panic states or sympathoadrenal attacks (a more severe stage of the decompensated first three forms);
• atypical – cyclic allergic or hyperthermic reactions, uncontrollable vomiting, etc.

Premenstrual dysphoric disorder presupposes the absence of other mental disorders (although they may have been present in the past). Symptoms should appear only in the late luteal phase and disappear completely after menstruation.

Postcoital dysphoria

Not only women, but also men experience a bad mood, feelings of emptiness and dissatisfaction after sex, the quality of which the individual usually has no complaints about.

This is expressed in different ways. Women feel sadness, inexplicable melancholy, some cry violently.

Men want to be left alone for a while, not touched, not talked to, otherwise they feel very irritated. Sometimes the stronger sex is sad to tears too.

Research and surveys have shown that approximately one fifth of the population experiences this condition after sex from time to time, and approximately 4% of men and women experience a permanent decrease in mood.

The reasons for this phenomenon are unknown, one hypothesis suggests that the depressed mood after lovemaking is associated with a decrease in dopamine levels during intercourse. Then the body restores balance for some time, this takes from a quarter of an hour to three hours, during which melancholy, displeasure, tearfulness, and irritability appear.

Twin studies have also been conducted, which do not rule out a hereditary predisposition.

The recommendations of specialists on the issue of postcoital dysphoria are as follows. If the worsening of mood after sex does not bother you, then you can live with it. If this worries you, contact a psychotherapist, in most cases he will be able to help.

You can contact a sexologist; sometimes the problem lies within his or her field of activity.

However, more serious causes are not excluded - diseases of the central nervous system, endocrine organs. Therefore, you should pay attention to your overall health and its changes.

Dysphoria in epilepsy

Emil Kraepelin noted that periodically occurring dysphoric episodes in epileptics are the most common mental disorder for this category of patients. They are often accompanied by vivid outbursts of rage, although they can occur without them.

Such disorders are classified depending on the time of their onset in relation to the epileptic seizure.

Prodromal dysphoria precedes an attack. Dysphoric disorder is characterized by depressed mood, gloom, and irritability. The condition develops several hours, and sometimes several days before an epileptic seizure, after which it regresses on its own. Relatives of the patient note that the patient's mood improves significantly after the seizure. Research confirms that in epileptics, prodromal dysphoria is characterized by more pronounced symptoms than in the interictal period. This is explained by the commonality of neurobiological processes that initiate a dysphoric episode and a seizure, i.e., a depressed mood is a subclinical manifestation of increasing seizure activity.

Postictal dysphoria (postictal) is an affect disorder lasting from several hours to several days. It is almost never found in isolation. It is typical for patients with interictal episodes of dysphoria and epileptic seizures with impaired consciousness originating from a focus in the temporal lobes of the right hemisphere. Postictal dysphoria is associated with neurobiological processes that suppress seizure activity.

Interictal (interictal) dysphoric episodes are often short-term (no more than two to three days) and tend to be self-limiting. Such conditions are typical for patients with refractory (resistant to therapy) epilepsy, especially with foci in the temporal region. Interictal dysphoria develops approximately two or more years after the manifestation of the disease. Its episodes are represented by various combinations of symptoms, the severity of which may vary in one patient. In patients with interictal dysphoria, psychopathological symptoms increase in the late luteal phase. It is this form of mental disorder in epileptics that is considered a serious risk factor for suicide attempts and the development of psychosis between attacks.

Dysphoric depression

An atypical form of chronic mood disorder that starts, in most cases, at a young age as a reaction to the action of constant negative factors (psychological and physical discomfort, serious illnesses, use of psychoactive substances), changes in habitual living conditions, or acute stress.

Against the background of depressed mood and pessimism, the patient does not exhibit psychomotor retardation, which is characteristic of classical depression; however, increased irritability, frequent outbursts of negative emotions and aggressive behavior that are not consistent with the circumstances in terms of the strength of expression are observed.

The patient finds fault with little things, is dissatisfied with everything and everyone - from the dinner served to the behavior of family members and even passers-by on the street. He is especially irritated and driven to a state of fury by the expression of joy and contentment on the faces of others, their successes and achievements. How dare they rejoice when he feels so bad! With typical depression, the patient does not care, he simply will not notice anything.

With dysphoric depression, a person often becomes the initiator of quarrels, scandals and fights, his irritation is characterized by pronounced intensity. In a fit of rage, he becomes dangerous, because he does not control his actions.

Outside of outbursts of anger, depressive features appear - inactivity and pessimism. The patient's ability to work decreases, he quickly gets tired and constantly feels empty and broken. The past years are perceived as fruitless, the patient feels disappointment and dissatisfaction with what has been achieved, dissatisfaction with himself, and the future in his perception also does not promise him anything good.

Problems with sleep, blood pressure, and heart begin. The person seeks oblivion and tries to relax with the help of alcohol and drugs, however, such methods increasingly aggravate the situation and are fraught with the commission of illegal actions and/or suicide attempts.

[ 22 ], [ 23 ], [ 24 ], [ 25 ]

Complications and consequences

Dysphoria is not the same as dysphoria. The functional state of dissatisfaction that occurs in healthy people is reversible, usually short-lived and not dangerous. Naturally, when a gloomy mood with irritability lasts for several hours, no one will have time to see a doctor.

But if such conditions tend to recur or drag on over time, affecting activity and work capacity, making communication difficult, it is worth persuading the person to see a doctor. Dysphoria can be caused by some disease that will require treatment.

Prolonged pathological affective disorders without appropriate therapy lead to undesirable consequences. Lack of productive activity, conflict and anger can result in loss of job, family and social status, which is often aggravated by antisocial behavior, committing illegal acts or the decision to commit suicide.

[ 26 ], [ 27 ], [ 28 ], [ 29 ]

Diagnostics dysphorias

Dysphoria is diagnosed during a conversation with a psychiatrist, who will ask a series of questions and, if necessary, conduct a dysphoria test with the patient. Depending on the causal factor that caused the attack of pathological gloom and irritability, the topic of testing will be chosen (test for psychopathy, gender dysphoria, etc.).

Tests and instrumental diagnostics may be necessary if the doctor suspects that the cause of dysphoria lies in a chronic disorder of the general health. In this case, the treatment will be carried out by specialists of the corresponding profile.

[ 30 ]

Differential diagnosis

Differential diagnostics are carried out between the diseases that provoked the dysphoric disorder and their absence. For example, a person suffering from gender dysphoria, dissatisfied with his body and requiring a sex change operation, first of all, must be mentally healthy. A schizophrenic who imagines himself a transsexual will require a completely different treatment.

Species dysphoria is differentiated from lycanthropy; a woman complaining of premenstrual dysphoric disorder should also not suffer from epilepsy or schizophrenia. Postcoital dysphoria is also diagnosed in completely healthy people.

Dysphoria is distinguished in epileptics, people with organic brain damage as a result of diseases, injuries, operations, alcoholism and drug addiction. This is necessary in order to choose the right tactics for treating mental disorders.

[ 31 ], [ 32 ], [ 33 ], [ 34 ], [ 35 ], [ 36 ]

Treatment dysphorias

How to deal with dysphoria? This condition occurs and passes suddenly, often within a few hours even in epileptics. If this is a one-time situation, then treatment is not required. Frequent or prolonged attacks of pathologically depressed states with easily arising affects require diagnosis and treatment by a specialist.

If the cause of dysphoric disorder is diabetes mellitus or thyroid dysfunction, the patient will be treated by an endocrinologist, and when a compensated state is achieved, the symptoms of dysphoria will disappear.

Standards for the treatment of mood disorders in patients with epilepsy have not yet been developed. Such patients are treated symptomatically. Sometimes it is enough to adjust the antiepileptic therapy regimen; some patients, in particular those with dysphoria, are prescribed antiepileptic drugs in combination with antidepressants.

In the treatment of dysphoric disorders, psychotherapy, autogenic training, meditation, breathing exercises, yoga, and qigong are widely used. Such practices are very helpful in cases of postcoital and post-stress dysphoria, when the disorder occurs in a sensitive, but practically healthy person.

Women diagnosed with premenstrual dysphoria are prescribed medications to alleviate the condition and stop the prevailing symptoms. These may be analgesics, herbal sedatives, and sleeping pills. In more severe cases, hormonal correction with progesterone-based medications may be prescribed. In cases of severe psychotic reactions, the doctor may prescribe antidepressants or tranquilizers.

True transsexuals can only be helped by surgery with hormonal therapy. At least, this is the chosen way of help at the moment. Although more and more sex change operations are being performed, it is not always the case that a person finds himself after the operation and gets rid of suffering. More and more scientists are voicing their opinion that when the soul and body suffer, the soul should be treated, and not the body reshaped, as is done now.

[ 37 ], [ 38 ], [ 39 ]

Prevention

Prevention of dysphoric disorders should begin even before the birth of the child. Healthy parents, a normal pregnancy, natural childbirth without complications are the key to the appearance of a healthy child, who should be raised by a healthy and friendly family without pathological interactions between its members, and then - a healthy society. How realistic is this? At least, we should strive for this.

In adulthood, clear goals and objectives, positivism, the ability not only to work but also to rest, and commitment to a healthy lifestyle significantly reduce the risk of developing painful affects.

[ 40 ], [ 41 ], [ 42 ], [ 43 ]

Forecast

Mild forms of dysphoria often go away on their own; sometimes sessions with a psychotherapist can help relieve the condition.

If dysphoria is complicated by alcoholism or drug addiction, the prognosis is less rosy.

When this condition develops against the background of diseases, the prognosis depends entirely on the disease. Modern medicine has a large arsenal of means of assistance in almost any case of dysphoric disorder.

[ 44 ], [ 45 ]