Irritability Overview
Irritability is a common emotion, in which an individual may feel less tolerant of certain things than usual. Many factors can cause or contribute to irritability, including life stress, a lack of sleep, and hormonal changes.
When a person feels irritable, small things that would not usually bother them can make them feel annoyed or agitated. The resulting tension can make a person more sensitive to stressful situations.
Extreme irritability, or feeling irritable for an extended period, can sometimes indicate an underlying condition, such as an infection or diabetes
. It may also be a sign of a mental health condition, such as anxiety or depression.
People may experience the following symptoms along with increased irritability:
- A rapid heartbeat
- Confusion or difficulty concentrating
- Excessive sweating
- Fast or shallow breathing
Anxiety
Feelings of anxiety often arise in response to stressful situations in life, such as problems at work, preparing for an important exam, or going through significant life changes. This type of anxiety usually goes away once the stressful situation passes.
However, anxiety may linger or worsen over time and can severely affect a person’s daily activities, work performance, and personal relationships.
If a person has excessive anxiety or worry that lasts for 6 months or longer, they may have generalized anxiety disorder (GAD), which affects up to 20% of adults in the U.S. each year.
The symptoms of GAD can occur in other types of anxiety disorder and may include:
- A rapid heart rate (arrhythmia)
- Difficulty concentrating or making decisions
- Irritability
- Shallow breathing
- Muscle tension
- Problems falling asleep or staying asleep
Patients may also experience panic attacks. A panic attack refers to a period of intense fear that develops with little to no warning and peaks within minutes. The exact triggers vary from person to person, and they may not always be apparent.
Individuals who experience panic attacks may find themselves worrying about when the next attack will occur. They might go out of their way to avoid situations, places, or behaviors that could trigger an attack. Thinking about triggers and panic attacks can make a person feel overwhelmed and irritable.
Depression
Depression affects nearly 16 million adults in the United States. It can manifest in a wide range of symptoms and often causes persistent sadness, fatigue, and irritability.
One of the early signs of depression or a depression relapse is stronger feelings of irritability.
Irritability is more likely to be one of the symptoms of depression in men than in women, and it often occurs alongside aggressive feelings, risk-taking, and substance abuse.
The National Institute of Mental Health state that people may have depression if they experience any of the following symptoms for 2 or more weeks:
- Digestive problems
- Concentration or memory problems
- Feelings of guilt, worthlessness, or hopelessness
- Loss of interest in once pleasurable activities
- Headaches
- Fatigue
- Sudden changes in appetite or weight
Not everyone experiences every symptom of depression. Symptoms can vary in severity and duration.
Irritability in Children
Young children go through phases of appearing more or less irritable. These phases are a normal part of development.
Children often seem irritable if they have a viral or bacterial infection. This irritability will usually go away when they feel better.
In other cases, irritability in children and adolescents can indicate a mood or behavior disorder, such as:
- Anxiety disorder
- Depression
- Attention Deficit Disorder (ADHD)
- Oppositional defiant disorder (ODD)
Mood and behavior disorders are relatively common. According to a 2019 study on mood and behavior disorders in children aged 3–17 years:
- 7.4% have a behavior or conduct disorder
- 7.1% have anxiety
- 3.2% have depression
Irritability in Older Adults
The causes of irritability in older adults are the same as those in younger adults, although there is an increased likelihood of mood swings, depression, and irritability having an association with physical pain, isolation, loneliness, or an underlying medical condition.
The National Institute on Aging list mood changes, personality changes, and increased agitation as early signs of Alzheimer’s disease, the most common form of dementia.
Hormonal Imbalance
Hormonal imbalances can cause various physical and psychological symptoms, including irritability. High levels of stress, poor nutrition, and inadequate sleep can influence people’s hormones.
Other possible causes of hormonal imbalance include:
- Diabetes
- Hyperthyroidism
- Menopause
- Polycystic ovary syndrome (PCOS)
Low levels of testosterone or high levels of estrogen can cause irritability in males.
Life stress
Going through a stressful period can make a person feel more irritable than usual.
When someone experiences a stressful life event, which may tie in with work, school, trauma, or grief they may find it more difficult to manage their emotions and can become overwhelmed. They may feel less tolerant of the people around them.
Feeling overwhelmed by life stress is normal, but prolonged periods of stress can lead to emotional exhaustion. Recognizing the early signs of stress and taking steps to relieve this feeling can help people avoid burnout.
Phobia Disorders
The term phobia describes an intense fear or aversion to a certain object, person, or situation.
Thinking about or having exposure to the phobic situation or item can make a person feel overwhelmed, panicky, and more irritable than usual.
People who have a phobia disorder may feel intense fear or anxiety about:
- Blood
- Flying
- Heights
- Needles
- Specific animals, such as dogs or snakes
- Being outside
- Social situations
Lack of Sleep
Not getting enough sleep, or sleep deprivation, can make a person feel irritable the next day. Children are especially likely to be unusually irritable or emotional if they have not had enough good quality sleep.
If a person feels tired all of the time or finds that sleeping does not make them feel refreshed, they may have a sleep disorder that causes them to wake up regularly at night, such as insomnia or sleep apnea.
The Centers for Disease Control and Prevention (CDC) state that one in three adults do not get enough sleep. They recommend that adults get at least 7 hours of sleep per night. Teenagers should get 8–10 hours per night, while babies may need up to 16 hours.
Getting enough good quality sleep is essential for health. It plays a role in boosting mental performance, concentration, and immune system function, and it also reduces the risk of heart disease and depression.
People can boost their quality of sleep by adopting the following practices to improve their sleep hygiene:
- Avoiding eating large meals and drinking caffeine and alcohol before bedtime
- Getting regular exercise
- Removing electronic devices, such as televisions, computers, and phones from the bedroom
- Sleeping in a dark, quiet room
- Trying to fall asleep and wake up at the same time every day, including at weekends
Low Blood Sugar
Having low blood sugar, called hypoglycemia, can affect a person’s physical and psychological health. Low blood sugar commonly affects people with diabetes as a result of them using insulin and other diabetes medications.
However, people with or without diabetes can experience temporary hypoglycemia if they have not eaten for several hours.
The symptoms of hypoglycemia include:
- A rapid heartbeat
- Difficulty concentrating
- Feeling dizzy or lightheaded
- Drowsiness
- Headaches
- irritability or nervousness
- Trembling
Hypoglycemia can also affect an individuals sleep. People can experience nightmares and excessive sweating throughout the night.
Premenstrual Syndrome
Premenstrual syndrome (PMS) is an example of a common hormonal imbalance that can result in mood swings and irritability.
PMS is very common, with over 90% of people reporting PMS symptoms in the week or fortnight before their period.
Other common symptoms of PMS include the following:
- Abdominal bloating
- Constipation or diarrhea
- Crying easily
- Food cravings
- Headaches
- Fatigue
- Low mood
- increased anxiety
- Tender or swollen breasts
If an individual experiences severe irritability, depression, or anxiety in the lead up to their period, they may have premenstrual dysphoric disorder (PMDD). This condition affects up to 5% of females of childbearing age. A doctor can provide information on treatment options for PMDD.
Treatment of Irritability
The treatment options for irritability vary depending on the underlying cause. Effectively treating the cause will relieve feelings of irritability and other related symptoms.
Medications, such as mood stabilizers and antidepressants, can help treat mood disorders. Professional counseling can help reduce mood-related symptoms, such as fear, worry, and irritability.
Treatments for hormonal imbalances include diet and lifestyle changes as well as hormone therapy.
Hormone therapy may not work for everyone, so it is best to consult a trained healthcare professional before starting hormone supplements.
Managing Irritability
People can manage their irritability in several different ways. Certain methods will work better for some people than others. It is up to the individual to find which coping mechanisms best suit their personality and lifestyle.
A few general tips for managing irritability include the following:
- Exercising regularly
- Eating a balanced diet rich in whole foods, such as fruits and vegetables, and low in processed foods
- Maintaining a regular sleep schedule
- Performing slow breathing techniques
- Meeting with a mental health practitioner or counselor
- Practicing meditation
- Speaking with trusted friends and family members
- Using a journal to keep track of mood changes and triggers
Summary
People can experience periods of irritability in response to stressful situations. Persistent irritability may indicate an underlying physical or psychological disorder, such as:
- Anxiety
- Depression
- Low blood sugar
- Hormonal imbalances
Children may appear irritable as a normal part of development. In other cases, irritability may be due to an infection, mood disorder, or behavior disorder, such as ADHD, depression, or anxiety.
Older adults may also experience frequent periods of irritability if they feel isolated or lonely. Neurodegenerative diseases, such as Alzheimer’s disease, can cause changes in a person’s mood or personality.
Patients can speak with a doctor or a trained mental health professional if they feel that they need help managing their irritability.
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