Irritated and angry cat, hissingIrritability, an agitation that may result from provocation, illness, or seemingly no reason at all, may be simply an expression of normal annoyance, but it may also indicate a mental health or medical condition. When experiencing consistent irritability that causes stress and interferes with the ability to sleep, work, eat, or maintain good relationships with others, or irritation that may be inappropriate for or out of proportion to a particular situation, it may be helpful to speak to a therapist.

Causes of Chronic Irritability

In itself, irritability is not a mental health condition. Most people feel irritable from time to time, and some people may become frustrated more easily than others as a result of irritability. Even if there appears to be no source behind the irritability, there generally is a cause, such as dissatisfaction with one's life or relationship difficulties. Irritability can also be a symptom of withdrawal from drugs or alcohol.

Irritability is a symptom of many mental health conditions, and chronic irritability may be indicative of an underlying health condition, poor coping skills, or negligent self-care. Common causes of chronic irritability include:

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    Physical conditions such as flu, menopause, polycystic ovary syndrome, hyperthyroidism, toothaches, and ear infection.
  • Mental health conditions such as stress, anxiety, depression, bipolar (both during the manic cycle or a depressive episode), schizophrenia, and autism. Irritability occurs as a symptom of depression most often in teenagers and adolescents. In children, an irritable mood may be linked to oppositional and defiant behavior.
  • Inadequate self-care, such as not sleeping enough, not eating well, or not taking time to enjoy hobbies and spend time with loved ones.
  • Chronic stress or poor stress-management skills.
  • Attention deficit hyperactivity, which can make mundane tasks frustrating.

Effects of Irritability

Irritability often leads to a short temper and may cause excessive frustration with others. Excessive irritability may cause a more extreme reaction to outside stressors than would normally be experienced. Irritability might also be directed at unrelated individuals, especially in times of depression, anxiety, or stress or when the feeling seems to have no direct cause.

Many people may prefer to avoid an irritable person, and frequent irritability can interfere with friendships and romantic relationships and may also lead to trouble in the workplace. Children might become fearful around irritable parents, and irritability may also affect relationships between other family members.

Coping with chronic irritability might also cause significant stress, especially when the irritability is internalized and not directed outward at others.

Overcoming Irritability

Self-awareness can be an important tactic to combat irritability. Some people become irritable after hours or days of stress and anxiety. But maintaining awareness of emotions can help stop irritability before it becomes overwhelming or unavoidable. Contemplating feelings, talking about them, and gaining control over them can help reduce the frequency of irritability. Recognizing physical warning signs of irritability—muscle tension, shallow breathing, and increased sweating—may be beneficial.

When feeling irritable, it may be helpful to avoid or walk away from provocative situations rather than attempt to respond. This may prevent outbursts or comments that might be regretted at a later time.

Time may be a necessary factor in overcoming irritability. While attempting to calm emotions, it may be helpful to exercise or otherwise move the body, avoid interactions that might lead to further irritation, and try to find a mood-lifting activity or something to laugh at. Studies show that laughter is generally an effective way to reduce stress and tension.

Therapy for Irritability

Therapy for irritability focuses on discovering the underlying cause, which may be an outside factor or a mental health condition, addressing the issue, and establishing coping skills. Any number of types of therapy are likely to be effective in treating irritability and its underlying causes.

Cognitive behavioral techniques, for example, which can help reframe thoughts to improve behavior, appear to be popular among people affected by irritability. In addition, learning effective stress management skills and techniques such as meditation and mindfulness as well as exploring helpful outlets for stress, anxiety, and frustration might all be aspects of therapy to treat irritability. Sometimes irritability can be the result of deep feelings of grief or anger: These feelings may be unconsciously felt, and therapy can help uncover and treat the effects of these emotions, thus reducing or relieving irritability.

In the case of an underlying mental health condition such as bipolar or depression, medication along with therapy might also help to relieve irritability as well as other symptoms.

Case Examples

  • Irritability in work and relationships: Rhona, 49, enters therapy because she is often irritable at work, and her relationships with her coworkers are suffering. In therapy, she attributes her moodiness to menopause. The therapist validates this possibility but also explores Rhona’s level of satisfaction in her job and life in general. Rhona admits she is lonely and sometimes depressed, and as she begins to get in touch with some feelings of grief and sadness, her irritability diminishes. She decides in therapy to attempt to make friends outside her workplace and enrolls in a cooking class and joins a book club in order to do so. Rhona still experiences depression and continues in therapy for a few months in order to work through it, but her irritability does not return.
  • Husband irritable with wife and children: Paolo, 34, seeks therapy after his wife insists upon it, as he has been very irritable with her and their two young children for no apparent reason. Paolo cannot identify any particular triggers for his irritability; he admits he is usually short-tempered and easily annoyed with his family, but that he does not know why. He even reports feeling irritable with the therapist’s questions. A complete history reveals that Paolo has experienced mood swings from time to time, and a psychiatric evaluation indicates that Paolo suffers from bipolar and appears to be entering a manic phase. A low dosage of mood stabilizer remedies the situation in the short term, and over the next several months, Paolo and his wife attend therapy sessions together to learn about bipolar and develop new coping skills to manage Paolo's moods as they arise.

References:

  1. Kahn, A. (n.d.). Irritability: Causes, Symptoms & Diagnosis. Retrieved from http://www.healthline.com/symptom/irritable-mood.
  2. Kennard, J. (2010, April 25). Coping With Irritability and Anger. Retrieved from http://www.healthcentral.com/bipolar/c/7712/110122/irritability-anger.
  3. Kuriansky, J. (2013, November 22). Irritable, Annoyed, On Edge? How to Ease Up Before You Blow Up. Retrieved from http://bottomlinepersonal.com/irritable-annoyed-on-edge-how-to-ease-up-before-you-blow-up.
  4. O'Connor, R. (1997). Undoing depression: What therapy doesn't teach you and medication can't give you. Boston, MA: Little, Brown.
  5. Stress management: Improve your sense of humor. (2013, July 23). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456?pg=2.