Irritability is defined as a state of extreme or marked sensitivity to criticism or insult from internal or external sources. It typically comes about as a result of stress and is characteristically found in a number of psychiatric disorders.

     It is important to understand that irritability is often ignored or overlooked because people think or are told they are just being overly sensitive. In actuality irritability can be a symptom of a psychiatric disorder for which treatment should be sought.

     Irritability often leads to anger and sometimes extreme anger. The person is said to have “a short fuse” and can lash out at those whom he or she believes are criticizing him or her.

     Irritability can be a symptom of several psychiatric disorders. They include:

• Major depressive disorder
• Adjustment disorder with anxiety
• Bipolar disorder, especially in a manic or hypomanic state
• Intermittent explosive disorder
• Attention deficit disorder
• Personality disorders, especially borderline personality and narcissistic character disorder

     Major depressive disorder can include people who have symptoms of anger and irritability as well as depression. Again, this disorder is well treated with medication and therapy.

     In adjustment disorder a person experiences some stress related to his outside life, whether it is work, home, or family. Irritability can be prominent.

     Bipolar disorder is characterized by mood swings. The range frequency varies from anger to depression. People often think that mood swings generally involve going from being grandiose and happy to being depressed and sad; however, in my experience the scope is more often from anger and irritability to sadness. (Note: Bipolar disorder is frequently misdiagnosed as a form of character disorder, which may or may not be present as well and is best treated with therapy and medication. Irritability is a psychophysiological response to the mental disorder.)

     Intermittent explosive disorder is as the name suggests. It is best treated with medication.

     Attention deficit disorder is also characterized by difficulty focusing and concentrating and extremely noticeable irritability coupled with inability to stay on task.

     Borderline personality disorder is characterized by rejection sensitivity, that is to say being hurt by someone saying something or doing something they do not like, and becoming unhappy and angry very, very quickly.

     I will cover narcissism in the next blog.