Irritability is defined as reacting strongly to stimuli that aren't worthy of that reaction. Characteristics include being easily annoyed & outbursts of rage.
8 most common cause(s)
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Irritability symptoms
For most of us, "irritability" is a negative trait and refers to a person who is overreacting to normal life. People we consider irritable react very strongly to minor inconveniences or what they consider inconveniences. Likewise, sometimes specific systems can be irritable, such as an "irritable bowel," where the intestinal tract is overreacting to stress, foods, medicines, germs, or other stimuli.
Its also common to have a bad day and experience irritability yourself from time to time. However, were going to discuss symptoms of recurrent or constant irritability.
Common characteristics of irritability
If you're experiencing irritability, it can likely be described by:
- Feeling easily annoyed
- Being quick to anger
- Aggression, even when it's uncalled for
- Having a short fuse
- Outbursts of rage: Verbal and sometimes physical abuse of others is likely. Infants and young children may be hard to soothe.
Duration of irritability symptoms
Irritability may be temporary or persistent, depending on the underlying cause.
- Temporary: Inconsolability in infants may often fade as they get older, though sometimes this persists into childhood and may be an early indicator of mood disorders in adulthood.
- Persistent: Irritability tends to be a chronic condition in adults unless an underlying cause is addressed.
Who is most often affected by irritability
The following individuals are more likely to be affected by irritability.
- Infants: Especially those born to drug-addicted mothers.
- Anyone with chronic pain: From disease, injury, or emotional causes
- Older people: Especially those with health problems and/or psychological issues
- People withdrawing from drugs and medications
Is irritability serious?
Irritability may vary in severity.
- Less serious: Occasionally feeling frustrated with daily life, or simply "having a bad day," is completely normal. Being angry is also a normal emotion.
- More serious: Frequent irritability that is accompanied by verbal outbursts, raging, breaking objects, or even violence toward other people is a sign of physical and/or psychological illness. This is serious and needs attention.
Irritability causes
Many conditions can have irritability as a symptom. These can involve solely a physical or psychological cause, or sometimes a combination of the two.
Physical causes
Irritability may be due to physical causes, such as the following:
- Chronic pain from injury
- Chronic illness
- Medications and withdrawal
- Drug use or withdrawal: Especially of alcohol and opiates
- Infants born to drug-addicted mothers
Psychological causes
Psychological causes of irritability may be due the following:
- Depression
- Anxiety
- Isolation
- Relationship conflicts
This list does not constitute medical advice and may not accurately represent what you have.
Seasonal affective disorder
Seasonal affective disorder is mood disorder marked by seasonal onset. While summertime sadness is possible, the vast majority of seasonal affective disorder begins in the winter and resolves by summer.
You should visit your primary care physician to confirm the diagnosis. Your physician may discuss treatment options such as light therapy, antidepressants, and/or talk therapy.
Rarity: Rare
Top Symptoms: fatigue, loss of appetite, difficulty concentrating, weight gain, sleep disturbance
Urgency: Primary care doctor
Premenstrual syndrome
Premenstrual syndrome, or PMS, refers to a set of symptoms experienced by some women just before the start of a menstrual period.
The exact cause of PMS is uncertain, but changing hormone levels are always involved. Ongoing depression will make the symptoms worse and may be connected to low levels of the brain chemical serotonin, which influences mood, food cravings, and sleep patterns.
Symptoms include irritability, mood swings, insomnia, difficulty concentrating, weight gain, fluid retention, bloating, abdominal discomfort, food cravings, and breast tenderness.
PMS normally fades within a day or two of start of the menstrual period. If the symptoms are interfering with activities of daily living, a medical provider may be able to help. Some symptoms can be treated for improved quality of life.
Diagnosis is made through patient history.
Treatment primarily involves making lifestyle improvements in diet, exercise, and stress management. Nonsteroidal anti-inflammatory drugs can address the physical discomfort, and diuretics will help with fluid retention. Hormone-based contraceptives can regulate the cycle and ease symptoms. In some cases, antidepressants are helpful.
Premenstrual dysphoric disorder
Premenstrual dysphoric disorder (PMDD) describes a set of severe, debilitating symptoms that appear seven to ten days before a woman's menstrual period begins.
It may be caused by an abnormal reaction to the natural female hormone changes, creating a deficiency in the mood-regulating brain chemical serotonin.
Risk factors include a personal or family history of PMDD, postpartum depression, and/or general depression, as well as cigarette smoking.
Physical symptoms include headaches, abdominal pain and bloating, back pain, and breast tenderness. Psychological symptoms include severe depression, anxiety, and irritability.
Because symptoms tend to get worse over time, medical help should be sought so that quality of life can be improved.
If symptoms persist for a year or more, a diagnosis of PMDD may be made.
Treatment includes improving the diet, adding vitamin and mineral supplements, and getting regular exercise.
Birth control pills to regulate the menstrual cycle may be prescribed, along with anti-inflammatory medicines such as ibuprofen. Antidepressants in the selective serotonin reuptake inhibitor class (SSRI) are helpful in some cases.
Rarity: Common
Top Symptoms: fatigue, stomach bloating, anxiety, depressed mood, abdominal cramps (stomach cramps)
Symptoms that always occur with premenstrual dysphoric disorder:impaired social or occupational functioning, symptoms of depression, anxiety and emotional lability
Symptoms that never occur with premenstrual dysphoric disorder:constant sadness, disapearance of periods for over a year
Urgency: Primary care doctor
Post-concussion syndrome
Concussion symptoms tend to last for a few days to weeks. Sometimes, symptoms are long term, lingering for several months or even years. This is known as post-concussion syndrome (PCS). Some of the most common PCS symptoms include headaches and confusion. Memory problems and difficulty concentrating may also occur.
You should consider visiting a medical professional in the next two weeks to discuss your symptoms. A doctor can evaluate PCS with a review of your symptoms and an MRI. Once diagnosed, treatment depends on your specific symptoms but often focuses on letting the brain rest and recuperate. You may be asked to temporarily stop sports and exercise until you are cleared to return.
Obstructive sleep apnea
Sleep apnea means "sleeping without breathing." It means the person briefly stops breathing during sleep and then abruptly wakes up due to lack of oxygen.
In obstructive sleep apnea, the airway becomes relaxed and collapses during sleep. In central sleep apnea, the part of the brain which controls breathing may fail to send out signals during sleep. In both cases, breathing is cut off and the patient is forced to wake up – sometimes hundreds of times per night.
Older, overweight people are most susceptible, as is anyone with enlarged tonsils.
Symptoms include loud snoring; constant rousing during sleep; and constant daytime sleepiness.
Ongoing sleep apnea leads to very poor sleep quality with little REM sleep. This is very stressful and can lead to high blood pressure, stroke, and heart arrhythmias. The daytime drowsiness can lead to car accidents.
Diagnosis is made through physical examination and a sleep study.
Treatment consists of lifestyle changes and usually a CPAP (Continuous Positive Airway Pressure) machine, which allows the patient to experience much better sleep almost immediately.
Insomnia disorder
Insomnia disorder means being unable to fall asleep, or to stay asleep long enough to get the normal seven to eight hours of sleep per night.
Common causes are pain; sleep apnea; depression; stress and worry over life events; circadian rhythm disorders such as jet lag; aging; and certain medications.
Many medical conditions, such as diabetes and heart disease, cause poor sleep. Women who are pregnant or menopausal may experience insomnia due to hormone shifts.
Symptoms include waking up during the night; feeling tired in the morning; daytime sleepiness and irritability; and increased errors and accidents through inability to concentrate.
Diagnosis is made through physical examination, patient history, and sometimes testing at a sleep study center.
Treatment consists of addressing underlying medical conditions, along with managing stress and checking all medications and supplements.
Improving "sleep hygiene" means establishing a routine of lying down in a dark room at the same time each night, with no television, computer, or phone. Avoiding food and caffeine before bedtime will prevent heartburn and wakefulness while trying to sleep.
Depression
Moderate depression, also called dysthymia or dysthymic disorder, is one of the three general forms of : mild, moderate, or severe. About half of all people suffering from have the moderate form.
The causes of any depression are not known for sure. Some may be situational, such as grief or other difficult life events. Others may be due to physiological causes such as chemical or hormonal imbalances.
Symptoms include loss of interest in normal activities; neglect of activities of daily living; and loss of productivity, though the person will continue going through the motions of attending work or school.
If not treated, moderate depression can worsen into major depression.
Diagnosis begins with physical examination and blood tests to rule out any physical causes. A mental health professional will talk to the patient to learn about any difficult situational factors.
Treatment may or may not involve antidepressant medication, since antidepressants generally work best for severe depression. Psychotherapy, exercise, relaxation techniques, and lifestyle improvements are usually tried first for moderate depression, and are often very effective.
Rarity: Common
Top Symptoms: fatigue, depressed mood, headache, anxiety, irritability
Symptoms that always occur with depression: depressed mood
Urgency: Primary care doctor
Symptoms of menopause
Menopause is the name for the natural process by which the menstrual cycle (period) stops happening in a woman. Usually, the process is gradual (takes months or years) and occurs from the age of 45 to 55 years. Menopause is officially diagnosed once a woman stops having a period for 12 months continuously. A woman with menopause will notice a decrease in the number and regularity of her periods until they completely stop. In addition, she may notice a number of symptoms that occur as a result of decreased estrogen levels, such as hot flashes, changes in mood, sleep problems, vaginal dryness, changes in libido, and changes in sexual function. Certain medications exist that can decrease these symptoms.
Rarity: Common
Top Symptoms: fatigue, delay in or irregular periods, vaginal discharge, anxiety, trouble sleeping
Symptoms that always occur with symptoms of menopause: delay in or irregular periods
Urgency: Self-treatment
Mild chronic depression (dysthymia)
Mild chronic depression is also called dysthymia, dysthymic disorder, or persistent depressive disorder. It is a long-term, low-grade depression that may last for years and periodically swings from mild to severe, but never really lifts.
The cause of is not certain. Heredity and brain chemistry may make it more difficult to cope with stressful life events. Dysthymia often begins early in life and may appear in childhood, especially among those with other mental health disorders.
Symptoms include feeling hopeless and inadequate; loss of interest in normal activities; trouble sleeping; irritability; and difficulty relating to others.
Long-term depression can seriously affect anyone's quality of life. If there is talk of suicide, it should be considered a medical emergency. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and blood testing to rule out any physical cause, and through psychological evaluation.
Treatment involves antidepressant medication and "talk therapy," as well as help with life management and coping skills.
Rarity: Uncommon
Top Symptoms: fatigue, depressed mood, irritability, difficulty concentrating, impaired social or occupational functioning
Symptoms that always occur with mild chronic depression (dysthymia): depressed mood
Symptoms that never occur with mild chronic depression (dysthymia): severe sadness
Urgency: Primary care doctor
Irritability treatments and relief
When it is an emergency
Seek immediate treatment in the emergency room or call 911 if:
- You feel severely depressed and are having thoughts of suicide
- You feel very angry and are having thoughts of harming others
- Someone you know is suicidal, homicidal, or threatened by someone else
When to see a doctor for irritability
You should schedule an appointment for chronic irritability, anger, and frustration. The most important part of dealing with irritability is finding the underlying cause.
Medical treatments for irritability
Your primary medical provider can refer you for treatment to the appropriate specialist for treatment of physical causes, such as the following.
- Testing: An internist can test for underlying illnesses.
- Chronic pain: A pain management specialist can treat cases of chronic pain.
- Nutrition: A nutritionist can advise about possible deficiencies.
- Addiction: A drug and alcohol specialist can help you treat addiction.
- Psychological treatments: You can also be referred for psychological causes of irritability. A psychiatrist treats cases of chemically based mental illness, such as bipolar disorder or schizophrenia. A psychologist can work with you to treat depression and anxiety. A counselor helps with any relationship issues you may be experiencing, including marriage and familial relationships.
At-home irritability treatments
Remedies for irritability that you can try at home include the following:
- General habit adjustments: Improvements in sleep, diet, and exercise can go a long way toward relieving stress.
- Make time to enjoy yourself: Making more time for friends and a normal social life can also help greatly in improving mood and easing depression, anxiety, and loneliness.
FAQs about irritability
Here are some frequently asked questions about irritability.
What are the common causes of irritability?
Irritability may be caused by many things. Most commonly, it is caused by emotional duress or stress. It can also be a sign of systemic physical illness or mental illness. Irritability is difficult to diagnose as individuals have different thresholds of irritability and/or expressions of being irritated.
Can anxiety cause anger and irritability?
Yes. Irritability is defined as an increased propensity toward anger and can be a manifestation of anxiety. When individuals experience something that makes them anxious or afraid, increased amount of stress hormones (e.g. cortisol) get excreted. These hormones activate a "flight or flight" system and cause an individual to respond with emotions such as anger or irritability.
Is irritability a sign of depression?
Irritability can be a sign of depression. Studies have found that individuals with clinically diagnosed depression have a higher level of stress hormones than those without depression. These stress hormones can cause an individual to more easily feel angry, anxious, and irritated. Medical professionals can use this observed increase in irritability as a marker of someone with depression.
When is irritability a sign of a more serious condition?
Irritability may be a sign of a more serious condition if it is accompanied by any of the following phenomena: a sudden change in personality, any non-characteristic or dangerous actions to one's self or others, other persistent physical symptoms, changes in senses (sight, smell, taste, touch, hearing) or changes in physical motion.
What type of behavior characterized irritability?
Irritability in children is characterized by an increased level of general hostility, or increased frequency of crying, fussing, hitting, biting, or kicking. In adults, irritability can manifest as increased level of hostility, decreased threshold for hostility, or increased propensity to worry.
Questions your doctor may ask about irritability
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Do you have trouble sleeping?
- Are you having difficulty concentrating or thinking through daily activities?
- Are you sleepy during the day?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
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- Mood-Related Disorders. Hazelden Publishing: Behavioral Health Evolution. Published 2016. BHEvolution Link.
- Leibenluft E, Stoddard J. The Developmental Psychopathology of Irritability. Development and Psychopathology. 2013;25(4 Pt 2):1473-1487. NCBI Link.
- Balbuena L, Bowen R, Baetz M, Marwaha S. Mood Instability and Irritability as Core Symptoms of Major Depression: An Exploration Using Rasch Analysis. Front Psychiatry. 2016;7:174. Frontiers Media Link.
- Mood Disorders. MentalHealth.gov. Updated August 22, 2017. MentalHealth.gov Link.
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- Fava M, Hwang I, Rush AJ, Sampson N, Walters EE, Kessler RC. The Importance of Irritability as a Symptom of Major Depressive Disorder: Results from the National Comorbidity Survey Replication. Molecular Psychiatry. 2009;15(8):856-867. NCBI Link.