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Re: Is Dysphoria an Actual Diagnosis?

Posted by tex1 on April 26, 2002, at 3:40:20

In reply to Is Dysphoria an Actual Diagnosis? , posted by Leighwit on April 25, 2002, at 12:18:02

> Is dysphoria a diagnosis separate and distinct from major depression?
>
> In Wednesday's Chicago Tribune there was an article ("Depression Can Leave Blind Spot for Support") which states: "... but when it comes to suffering from depression and dysphoria (a combination of anxiety, depression and irritability), ...."
>
> I searched through past threads, but can find nothing that actually defines dysphoria ~ or addresses it as a particular condition.
>
> Anxiety, depression, and irritability, however, is so much more specific than "major" recurrent clinical depression.
>
> I have a hard time determining whether the anxiety and irritability are part of depression or entirely side effects of Wellbutrin. When I mention those symptoms, I'm always prescribed something to target them as side effects of the WB. Xanax, for example.
>
> It's a vicious cycle. If I mention the primary symptoms of despair and lethargy (as in can't take a shower or get off the couch without planning it for three hours) I get a script for an AD that has energizing characteristics. I can't gain any weight (due to Type 1 Juvenile-onset diabetes) and virtually every SSRI, particularly Celexa caused weight gain in my case, so I've been on Wellbutrin a lot (off and on with and without SSRIs, Serzone, Norpramin/Desiprimine, Effexor and Reboxetine) over the past ten years.
>
> If I mention irritability or anxiety to my current pDoc, she wants to prescribe Xanax on top of the WB.
>
> I think dysphoria sounds much more "specific" to what I've had for ten years than does major depression alone. I feel like saying to the Pdoc: "I have a dysphoria and can't gain any weight. I'd prefer not to loose my memory or my IQ in the treatment process. What do you prescribe for that?"
>
> Can anyone relate?

Dear friend,
it sounds like you've had the same reaction that I've had many, many times. See all AD are *stimulating*. Wellbutrin is much more stimulating than any other AD since it works on both dopamine and noradrenaline. I'm not surprised that your pdoc prescribed to you some benzos. As you've said, sometimes it's a vicious cycle. Pull up or down, this is what psychiatric drugs tend to make. Always. The only exception maybe is lithium that simply flatten the mood.The point is that some people (usually very sensitive to meds) develope a "antidepressant induced dysphoria". The only way to get out of it is to take a benzo, or, better, to reduce the dose of the AD.
I remember when I was taking Efexor XR that I happen to have dramatic mood shifts, was irritable without a reason and even broke up with some friends because of this. This is not good. What I did was simply to reduce the dose to 50 mg/die instead of 75 XR. It worked pretty much. But remember that AD induced dyspohria is bad enough to let you make things you never wanted to.

Tex



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URL: http://www.dr-bob.org/babble/20020425/msgs/104187.html