Dysphoric feelings

The shift in emotion from the not unpleasant sense of intoxication that accompanied the first, accidental ingestion, and the distinctly noxious, exclusively dysphoric feelings of the second, intentional one is, without doubt, a dose dependent effect. Subsequent psychiatric studies revealed that whereas euphoria was common in the 2-13 mg range, dysphoria regularly replaced it at doses above 25 mg. 

Depression is one of the most common psychiatric disorders. It is characterized by feeling of intense sadness, helplessness, worthlessness, and impaired functioning. Those experiencing a major depressive episode exhibit physical and psychological symptoms, such as appetite disturbances, sleep disturbances, and loss of interest in job, family, and other activities usually enjoyed. A major depressive episode is a depressed or dysphoric (extreme or exaggerated sadness, anxiety, or unhappiness) mood that interferes with daily functioning and includes five or more of the symptoms listed in Display 31-1. 

An initial dysphoric response, demonstrated by a dislike of the medication or feeling worse, combined with anxiety or akathisia, is associated with a poor drug response, adverse effects, and nonadherence. 

First-time users frequently experience unpleasant, or dysphoric, effects that may include nausea and vomiting. The frequent user experiences a rush, or warm flushing feeling, in the skin and lower extremities that is often equated with sexual orgasm. This intense euphoria lasts... 

In patients receiving antidepressants for acute major depression, the initial therapeutic response is often delayed by several weeks. Patients with severe anxiety or insomnia may benefit from the concurrent, time-limited use of a benzodiazepine or short-acting hypnotic (Chapter 3). A patient may initially experience a return of energy and motivation while still having feelings of hopelessness and excessive guilt. Such patients may be at an increased risk for suicide because a return of energy in an extremely dysphoric individual may provide the impetus and means for an act of self-destruction. 

Premenstrual syndrome (PMS), as its name implies, is a constellation of symptoms which recur at monthly intervals during the seven to 10 days before the onset of menstrual bleeding and abate shortly after menstruation starts. The symptoms can be psychological, such as lowering of mood and irritability somatic, such as breast tenderness, feelings of bloatedness and signs of fluid retention behavioural, such as changes in food consumption and in appetite. If the symptoms are severe, the condition may qualify for the DSM-IV label of Premenstrual Dysphoric Disorder (PMDD). PMDD occurs in some 5% of normal women. 

Dysphoria or dysphoric— A feeling of discomfort or an unpleasant mood, such as sadness, anxiety, or irritability. 

One of the biggest problems for many clinical professionals who work with these clients is the lack of clarity and problems in semantics in defining what the term depression actually means. For many individuals, depression can mean feeling sad, blue, or down in the dumps, whereas for others there are clearly established criteria that reflect consistent patterns, signs, and symptoms relative to a mood disorder (Gitlin, 19%). Furthermore, some form of depression (also referred to as dysphoric mood) is present in virtually all mental health conditions. The only possible exceptions to this are clients who suffer from mania, certain forms of schizophrenia, or dementia (Gitlin, 1996). 

In contrast, drugs that block DA receptors generally produce bad feelings, i.e., dysphoric effects. Despite strong correlative findings, a causal relationship between DA and euphoria/dysphoria has not been established. 

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