Irritability: Causes

What causes irritability?

Irritability can be associated with psychiatric conditions, substance abuse, withdrawal, medication side effects, or chronic medical conditions.

Irritability is common with medications, substances, and medical conditions that affect the central nervous system. It can also be associated with conditions that can deprive the brain of nutrients and oxygen, or a variety of other diseases that affect how well one feels.

Psychiatric causes of irritability

Irritability may be caused by psychiatric conditions including:

• Anxiety disorders
• Bipolar disorder
• Delusional disorders
• Depression
• Drug, alcohol or tobacco withdrawal
• Premenstrual dysphoric disorder
• Schizoid personality disorder (disorder characterized by detachment and isolation)
• Schizophrenia
• Schizotypal personality disorder (disorder characterized by a need for isolation, odd beliefs, and disordered thinking)
• Substance abuse

Neurological causes of irritability

Irritability can also be caused by conditions of the nervous system including:

• Brain tumors
• Dementia
• Head injury
• Stroke

Other causes of irritability

Irritability can have other causes including:

• Cardiovascular disease
• Chronic fatigue syndrome
• Chronic pain
• Hyperthyroidism (overactive thyroid)
• Lung disease
• Medication side effects
• Other acute or chronic illnesses

Serious or life-threatening causes of irritability

In some cases, irritability may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

• Acute delirium (sudden onset of mental status changes due to illness or toxicity)
• Alcohol poisoning or drug overdose
• Brain abscess
• Encephalitis (inflammation and swelling of the brain due to a viral infection or other causes)
• Hydrocephalus (fluid buildup in the brain)
• Meningitis (infection or inflammation of the sac around the brain and spinal cord)
• Sepsis (life-threatening bacterial blood infection)
• Stroke
• Traumatic brain injury

Questions for diagnosing the cause of irritability

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your irritability including:

• How long have you felt irritable?
• Can you describe your irritability?
• Did any stressful events occur before your irritability developed?
• Does anything make you more or less irritable?
• Do you have any other symptoms?
• Do you have any other psychiatric or medical problems?
• What medications are you taking?
• Do you drink any alcohol?
• Are you using any illicit drugs?

What are the potential complications of irritability?

Because irritability can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Brain damage, memory loss, attention difficulties, and impaired judgment
• Coma
• Difficulties at work, in school, in social environments, and with relationships
• Drug and alcohol use and abuse
• Drug overdose or alcohol poisoning
• Increased risk of injury
• Self-harm
• Suicide or violence

References:

Stress. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/stress.html. Accessed May 29, 2011.

Anxiety. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/anxiety.html. Accessed May 29, 2011.

Anxiety disorders. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed May 29, 2011.