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irritability in adults Definition Irritability is a state of being overly sensitive to stimulation. Adults who are irritable may easily become impatient or angry. What is going on in the body? When a person is irritable, he or she may be responding to something that causes pain, concern, fright, or discomfort. In some cases, a serious medical condition can cause irritability. What are the signs and symptoms of the condition? Symptoms of irritability depend on the cause. When a healthcare provider hears that someone is irritable, he or she may want to know: if there is a known cause how the person is behaving when it began how long it has been going on whether it is constant or comes and goes what the person's usual response to problems or pain is if anything makes it better or worse if it occurs only at certain times of the day if there are any other symptoms, such as fever, stomach upset, pain, injury, depression, sadness, or weight loss if there is any history of any other illnesses, conditions, allergies, or surgeries what medications the person takes Other questions may be asked about eating and sleeping habits, activity level, and any other concerns the person or the family has. What are the causes and risks of the condition? Mild irritability in adults is common. It can be due to the person being tired or overworked, having a bad day, or just dealing with long lines and traffic. However, adults may also become irritable from a number of medical conditions, including: injury or infections of any part the body addiction to or withdrawal from drugs, including alcohol, nicotine, or caffeine head injury or intracerebral hemorrhage, which is bleeding inside the brain increased intracranial pressure, which is increased pressure within the brain that can be caused by brain tumors or other conditions infections involving the brain, such as meningitis, an infection of the brain lining elder abuse cancer, such as a brain tumor reaction to medications or vaccines, such as a flu shot any serious illness, such as liver disease, chronic obstructive pulmonary disease, kidney disease, or heart disease emotional or mental disorders, such as anxiety disorders, schizophrenia, depression, abnormal grief, or post-traumatic stress disorder headaches, such as migraines or tension headaches autoimmune disorders, in which a person's immune system attacks his or her own body hormone imbalances, including premenstrual syndrome (PMS), diabetes, and hyperthyroidism poisoning from toxic substances, such as lead poisoning vitamin or mineral deficiencies, such as iron or folate deficiency any other new or chronic illness What can be done to prevent the condition? Avoiding people with colds and other infections may reduce the risk of irritability due to these causes. Many cases cannot be prevented, such as those due to cancer. How is the condition diagnosed? The healthcare provider begins the investigation of irritability with a history and physical exam. This may be all that is needed to make the diagnosis. In other cases, the healthcare provider may order tests such as: a complete blood count, or CBC, to detect infection or blood cancer x-ray tests, such as a chest x-ray, to help diagnose some infections and cancers thyroid function tests to check for abnormalities with the body's metabolism psychological testing to check for mental or psychological impairments What are the long-term effects of the condition? Long-term effects depend on the cause of the irritability. If an infection is the cause, antibiotics may cure the infection and there are usually no long-term effects. A person who has cancer or another serious condition may need lifelong treatment. What are the risks to others? Irritability is not contagious. If an infection is the cause, the infection may be contagious. What are the treatments for the condition? Treatment depends on the cause of the irritability. Infections are often treated with antibiotics. Treatment for autoimmune disorders may include medications to reduce inflammation and suppress the immune system. If a medication is causing the irritability, it may be stopped. T hose with cancer may need surgery, chemotherapy, or radiation therapy. Medications, such as antidepressants, are often used for mood problems, such as depression. What are the side effects of the treatments? Side effects depend on the treatments used for the irritability. For example, antibiotics can cause stomach upset, allergic reactions, and other effects. Surgery poses a risk of infection, bleeding, or allergic reaction to anesthesia. Chemotherapy can cause many side effects, such as stomach upset, hair loss, and weakness. What happens after treatment for the condition? In many cases, treatment "cures" the person of the irritability. Such a person may be fine and able to return to normal activities. In other cases, the cause cannot be cured and needs further treatment. How is the condition monitored? Someone with irritability from a mild illness or infection can often monitor his or her own symptoms at home. Any new or worsening symptoms should be reported to the healthcare provider. Other monitoring may be needed for the underlying cause. For example, a person with HIV or cancer may need repeated blood tests to monitor the condition.

Author: Eileen McLaughlin, RN, BSN Date Written: 07/31/00 Reviewer: Adam Brochert, MD Date Reviewed: 07/13/01 Potential conflict of interest information for reviewers available on request