Dysphoria and Dissociation
Alright, this post was spawned from someone asking me if I felt they were having dysphoria or dissociation episodes. So, I figured I’d break down what the two are and then get into the guts of what they really mean.
I think that is a pretty good definition, but I feel it left out an important piece. There are those people that experience dysphoria who express it as feeling nothingness or an emptiness which causes the dissatisfaction and restlessness. The dissatisfaction often arises from the questioning if they are real. After all, people feel. Right? Absence of feeling suggests an absence of humanity. The restlessness come from the desire to make change but without a sense of purpose. How does one make themselves feel more real? How do you make yourself feel at all?
The risk for suicide is very high when a person feels this way. Sometimes, dying seems like the only way to make the suffering end. And sometimes they are not intending to kill themselves. Self harm is one way to feel something. Pain is a feeling we can control, but it is a dangerous one to take on. Because like anything, it will require more and more stimulus to get the same job done. And you can only hurt yourself so much before you die.
Things become much more complicated when you begin to try to explain dysphoria in context of being present in another disorder. I think this is probably the single most complex symptom to explain and it becomes even more so when you need to sort out what is causing various presentations. I will tell you that most of the providers that I have worked with simply avoid this word. It lacks clarity and thus isn’t really useful.
This on first glance seems like a completely different animal, but there are points that it overlaps with dysphoria. The place it overlaps is with depersonalization. This is very similar to the sense of feeling unreal or feeling empty.
so, back to the original question. Which are you experiencing? Well, I’d say that it’s more likely dysphoria, but I cannot rule out a true dissociation episode. So, the final answer? I have no bloody idea! Really. To make this differential, we’d need to do some really hard digging and I’m not sure it’s that important. I really don’t think the labels matter as much as management of the symptoms…