EpistemisDysphoria
Specialty: Psychiatry.
Why it occurs
- Borderline personality disorder (BPD, core symptom of emptiness and reactivity)
- Bipolar disorder (mixed episode or transition phase)
- Premenstrual dysphoric disorder (PMDS)
- Substance withdrawal (opioids, nicotine, alcohol, benzodiazepines)
- Attention deficit hyperactivity disorder (ADHD) in adults (emotional dysregulation)
- Temporal lobe epilepsy (interictal dysphoria)
Initial workup
Daily recording of symptoms and mood; impulse control scales (Barratt Impulsiveness Scale - BIS-11); gynecological hormonal analysis; urine drug screening.
red flags
Extreme dysphoria that triggers crises of explosive anger with physical aggression towards third parties or impulsive self-harming behaviors (cutting) to "relieve" internal discomfort.
Standard management
- Fluoxetine or Sertraline — SSRIs, of choice for dysphoria in the context of PMPS or BPD
- Valproic acid or Topiramate — affect modulators and impulsivity control
- Quetiapine at low doses — anxiolytic and nocturnal affective regulator effect
- Clonidine — to mitigate autonomic dysphoria in opioid withdrawal syndrome
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4