Dana, sorry to hear that the dysphoria came back so strong. I'm just over 6 months into E/Spiro and while I can't say that my dysphoria came back fully, it's definitely there in the background. Especially if I encounter some trigger. It also seems to cycle up and down. What I don't have is the long periods of dark hopelessness. It did take me some time to get used to it and perhaps it will take a bit longer for you too. My therapist has been great at helping me navigate the changes. For me, therapy alone wouldn't be able to do what E does, for sure, but E by itself can't solve all of my problems. I think your dysphoria may lighten again and especially if you have some other help.