Dysphoria as trans-diagnostic mood symptom and as lived experience. Lessons from prose, poetry and philosophy

Dysphoric mood appears among the symptoms of numerous psychopathological conditions, including major depressive disorder and dysthymia (APA, 2013), but also gender dysphoria, premenstrual syndrome, borderline personality disorder, prodromal schizophrenia, affective mixed states, paranoid psychoses (Starcevic, 2007). It is usually defined as an unpleasant mood state characterized by uneasiness, irritability, restlessness and despair. Dysphoria can vary in intensity and duration, ranging from mild feelings of malaise to profound emotional distress.

In spite of this broad spread across the spectrum of mental pathologies, it is not easy to find a valid characterisation of dysphoric mood that goes beyond its narrow operational definition. The main reason may be that patients, but also clinicians, often lack the words to provide a detailed description of this sometimes quasi-ineffable experience. Another reason why it is so difficult to give an accurate description of the dysphoric mood is that dysphoria, usually defined as a state of profound unease, dissatisfaction or discontentment, often involves a multitude of discordant feeling, thoughts and perceptions, and encompass contradictions within the realm of human experience. In essence, dysphoria is a multifaceted and dynamic phenomenon that reflects the inherent complexities of human existence and can give rise to ambiguous or paradoxical feelings – especially bodily feelings - that defy easy categorization or explanation. Persons experiencing dysphoria may find themselves torn between conflicting impulses, leading to inner turmoil and ambivalence (Stanghellini, 2016).

Dysphoria often involves complex narratives that resist simplistic descriptions and explanations. This paper aims to fill this gap by drawing on various sources, not only psychopathological research. For instance, images in visual arts may convey the feeling of dysphoria. Examples include images representing dimly lit spaces evoking feelings of emotional darkness, like Nocturne in Black and Gold - The Falling Rocket by James McNeill Whistler (1834–1903), depicting a moody atmosphere, vague wandering figures confused with a mass of foggy dark hues, semi-illuminated by a rain of golden sparks. Also, ‘realistic’ art representing solitary figures in empty spaces highlighting a sense of disconnection, like Edward Hoppers' (1882–1967) The nighthawks, a scene of profound solitude where in the dead of night the light which comes from the artificial illumination of the diner has nothing benign or salvific. The characters are victims of an incommunicability, in silence in front of a cup of coffee, not engaged in any particular activity but simply waiting for something indefinite, which perhaps could awaken them from their torpor. Something that, however, does not arrive.

Perhaps, the best illustrations of dysphoria are Francis Bacon's (1909–1992) unearthly atmospheres and disturbing images featuring distorted forms conveying the raw intensity and emotional upheaval of anguish and futility of existence. Yet, even at his most gruesome and disquieting, Bacon also ‘manages to inject a sense of exuberance and catharsis into his work’ (Hunter, 1989, p. 31). Bacon's paintings primary subject matter is the ‘body without organs’ (Deleuze, 2003), the body insofar as it is deformed by a plurality of invisible forces: a scream, the need to copulate, the flattening force of sleep. On one side, this power is a violent spasm that takes control of the body. It is experienced as an energy that takes the representation of oneself to pieces, reducing it to an assemblage of disordered emotions and drives. On the other side, however, it is also a power that expresses an encouraging vitality seducingly in touch with invigorating sensations. It is the glorification of a thrilled flesh, an intensive body vibrating at one with emotions, needs, desires.

In this paper, I will delve into descriptions of dysphoria found in literary, poetic and philosophical works, i.e. provided by people whose linguistic abilities allow them to build complex narratives of ‘what it feels like’ to be dysphoric. These rich explorations of dysphoric themes, using narrative techniques, vivid imagery, metaphor and symbolism, are able to convey the complex emotional state and existential dilemmas which characterize dysphoria. Dysphoria from this angle is not merely a clinical symptom but the starting point of a profound exploration of human experience, identity and the quest for meaning.

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