Irritability in Adults: What it Means and How to Manage it
Irritability has long been seen as a sign of emotional imbalance. It is a state of increased sensitivity to frustration, often leading to quick annoyance, impatience, or anger over seemingly small things.
While occasional irritability is part of the normal human experience, ongoing irritability is often due to an underlying issue that should be addressed.
Persistent irritability is seen as a core symptom in many mental health and neurological disorders, including depression, anxiety, and bipolar disorder. Studies estimate that up to 15–20% of adults experience persistent irritability that interferes with their daily life.1
On this page, you’ll learn what irritability is, why it develops, how it impacts daily life, and how to manage it.
What Is Adult Irritability?
Irritability is the tendency to feel annoyed and easily angered in response to things that would not bother most people. For someone who is irritable a lot of the time, the threshold for “losing patience” is much lower.
Psychologists describe irritability as a combination of mood and behavior. What a person feels from the inside (tense, restless) is what they express through intense behaviors noticeable to those around them.
Doctors treat adult irritability as an important emotional sign because it is a common symptom in many mental health diagnoses (depression, anxiety, attention deficit hyperactivity disorder, and personality disorders). It also tends to be a predictor of relationship problems and functional difficulties at work and home.
The experience of irritability also involves the body. Changes in thought and mood come with physical sensations like muscle tension, faster heartbeat, clenched jaw, or restlessness.
Types of Irritability
Irritability can be divided into two main types: phasic and tonic irritability.2 Let’s break down what each of these means in simple terms.
Phasic Irritability
Phasic irritability refers to sudden, short-lived bursts of frustration. These are your mood “flare-ups,” i.e., quick, intense reactions that rise and fall rapidly. These outbursts are usually followed by a return to baseline mood.
Phasic irritability tends to be noticeable to others because it involves visible emotional expression through raised voice, angry tone, or sharp gestures.
Tonic Irritability
Tonic irritability, in contrast, is the steady, background sense of being easily annoyed when nothing specific has gone wrong. It’s more of a persistent emotional tone than a sudden outburst.
A person with tonic irritability wakes up already feeling tense and finds themselves constantly frustrated by small things. They also describe a low-grade anger that never disappears. It makes daily interactions difficult and can contribute to chronic stress.
How Is Irritability Different From Anger?
Irritability is best understood as a state of emotional sensitivity. Anger, on the other hand, is a stronger emotional response that results after a specific trigger or perceived wrongdoing.3
From a psychological point of view, irritability is considered a mood state, while anger is an emotion. Research on emotional regulation shows that irritability involves ongoing activity in brain areas that detect threats, while anger is a stronger but shorter burst of activity aimed at defense or confrontation.
When you’re irritable, your behaviors are slightly more toned down than during anger. Someone who is irritable easily may sigh, complain, withdraw, or show visible impatience that builds slowly across the day. Anger is louder and more expressive.
Common Causes of Irritability
There’s no single cause of irritability. Several different factors can contribute to it, such as:
Stress and Anxiety
Stress is one of the most common triggers of irritability. During times of stress, the body and mind enter a state of alertness. This reaction, known as the “stress response,” is controlled by the hypothalamic–pituitary–adrenal (HPA) axis, a system that releases stress hormones.
Stress hormones, cortisol and adrenaline, prepare the body to deal with the stressor, but when stress becomes persistent, the system stays switched on for too long. Over time, the constant activation wears down a person’s emotional control and makes them more prone to irritability.
Evidence suggests that people with consistently high cortisol levels – such as those who are highly stressed or anxious – tend to have greater emotional volatility and irritability.4 People with anxiety also tend to pay more attention to things they see as threatening. The bias toward seeing danger and negativity more readily makes small annoyances feel bigger.
In a study of adolescents, those who were more sensitive to anxiety tended to be more irritable – mainly because they focused more on things they saw as threatening.5
Depression
Depression is a mental health condition with symptoms of persistent sadness and loss of pleasure in activities of interest. Irritability is one of the core symptoms of depression.
When depression is more severe, irritability tends to be more intense. For example, in one large U.S. study, around 40% of outpatients with major depressive disorder said they were irritable more than half of the time in the week before entering treatment.6
Some of the same genetic risk factors that increase the chance of depression also increase the chance of having irritability. In adolescent studies, researchers find high genetic correlation (meaning many shared genes) between irritability and depression.7
Research also shows that irritability in early life can predict future depressive episodes in adulthood.8 If someone is irritable for a long stretch, that seems to increase the risk of developing full depression later.
It’s important to note that people struggling with irritability linked to depression are more at risk of attempting suicide and having past suicide attempts. If you’re struggling with irritability and depression and need immediate support, contact us or SAMHSA’s Disaster Distress helpline at 1-800-985-5990.
Lack of Sleep
Sleep helps the parts of the brain that regulate emotions, especially the prefrontal cortex, to rest and reset.
Studies using brain imaging show that after sleep deprivation, the amygdala (which responds to threat and emotional stimuli) becomes more reactive, while its connection to the prefrontal cortex becomes less strong.
In a study, staying awake for 35 hours raised amygdala reactivity by over 60%, compared to well-rested people, and reduced regulatory connections to the prefrontal cortex.9 Even with mild to moderate partial sleep deprivation, people became more impulsive, and their positive mood dropped after just one night of shorter sleep.
In another study of adults aged 19–74, researchers found that poorer sleep quality was directly associated with higher irritability.10
Medical and Hormonal Factors
Many medical reasons make a person more irritable than usual. In these cases, treating the underlying medical condition can fix or reduce the dips in mood. Here are some considerations:
- The thyroid gland makes hormones that control your energy levels and body functions. If the thyroid makes too much hormone, you feel anxious, nervous, jittery, have a faster heartbeat, and become easily irritated.
- Hormonal fluctuations in women around menstrual cycles, pregnancy, postpartum, perimenopause, or menopause have a huge impact on irritability. Before a period, for example, many women experience premenstrual syndrome (PMS), where irritability is a key symptom.11
- Diseases that affect hormone-producing glands change the levels of many hormones. For example, Cushing’s disease (hyperactive adrenal gland causing too much cortisol) can lead to irritability.
- After a head injury, many people experience changes in mood and behavior. A study of 196 adults hospitalized after head injury found that 35% reported irritability even one year later.12
Medication Side Effects
Many medications can trigger irritability as a side effect. Below are some common categories of medications known to increase irritability:13
- Corticosteroids
- Stimulants like methylphenidate, amphetamine, and modafinil (often used for ADHD)
- Antidepressants such as SSRIs, SNRIs, bupropion, and MAOIs
- Hormonal medications, including oral contraceptives, hormone replacement therapy, and anabolic steroids
- Thyroid medications
- Caffeine, if consumed in large amounts
- Sudden withdrawal from anti-anxiety drugs like benzodiazepines
The Impact of Irritability on Daily Life
Irritability has a measurable impact on almost every domain of daily functioning. Here’s how it affects people:
- Relationships. Persistent irritability in relationships can disrupt communication and emotional connection. Individuals with high irritability scores report more frequent conflicts. They also tend to have lower relationship satisfaction and decreased emotional intimacy. The impact is similar on all kinds of relationships.
- Work and productivity. Irritability can directly affect a person’s job performance. People high in irritability tend to be more reactive to workplace stressors, and that can promote counterproductive behaviors like missing deadlines, snapping at colleagues, and reacting hastily. According to a Work in America survey, workers admit irritability or anger with co-workers is associated with lower productivity.14
- Self-esteem. Habitual irritability often leads to regret and self‐criticism after outbursts. Over time, repeated emotional conflicts can produce negative self-views. This internalized distress may gradually increase a person’s vulnerability to depressive symptoms.
Impact on mental health. The connection between irritability and mental health is well established. Persistent irritability is a recognized symptom in many diagnoses and a risk marker for major depressive disorder and generalized anxiety disorder. In a large U.S. survey, higher irritability was also associated with suicidal thoughts.15
Managing Irritability in Adults
The management of irritability has two phases: the in-the-moment phase, where you try to reduce the severity of an outburst, and a long-term phase to reduce the number of outbursts.
Coping With Irritability in the Moment
When you feel irritation rising, try to distract yourself for a moment.
Slowing the breath and deeply inhaling through the nose and exhaling slowly calms your body. It lowers your heart rate and the activation in the nervous system that fuels irritability.
Also, step away briefly from whatever is triggering you. Do something concrete and sensory, like walking, stretching, shaking out tension, or a short physical movement to shift your body state.
Similarly, shift the focus of your mind to music or to writing something down. This is known as avoidance-oriented coping, and it’s been found to reduce the immediate negative effect of irritability.16
These moment-of-irritation strategies won’t always stop every reaction, but they can help to reduce the intensity of your outbursts.
Long-Term Anger Management Techniques
Anger management techniques for the tonic type of irritability require more sustained efforts.
One of the strongest predictors of lower irritability is the use of approach-oriented coping, which involves actively identifying your stressors and managing them instead of suppressing them.
For example, if you feel irritated every evening after work because household chores keep piling up, try taking a step back to see what actually causes you the stress. Then, make a plan to fix it, e.g., delegate some tasks and finish others during short breaks. Over a few days, the irritation will likely fade because the source of stress is being managed, not bottled up.
Avoidant behaviors, on the other hand, make irritability worse. Ignoring your stressors keeps the nervous system in a state of chronic activation.
A healthy routine is also helpful for long-term irritability management. Set time for regular physical exercise to regulate your mood-related neurotransmitters and improve tolerance to frustration. Also, consider forming a consistent sleep routine to recharge your body.
Professional Help and Treatment Options for Irritability
Irritability responds best to a combined approach of active lifestyle changes paired with structured professional help.
Behavioral Therapy for Irritability
Behavioral therapy is the most well-researched treatment for chronic irritability and anger.17
Cognitive behavioral therapy (CBT), in particular, helps people identify the thought patterns that turn frustration into irritation. You also learn to recognize your triggers and how to prevent aggressive reactions to those triggers.
Other structured methods, such as dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT), also show strong evidence for improving emotional control. Biofeedback and relaxation-based therapies are also used together with these approaches.
Medication for Irritability
Medications are needed to manage irritability when it stems from an underlying mental health cause or medical condition.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are prescribed for people with major depressive disorder or anxiety.
If irritability is part of bipolar disorder, mood stabilizers like lithium or valproate may be used. Management of hormonal causes of irritability also requires medications.
Medication, however, should always be prescribed and monitored by a qualified professional who can adjust doses and track side effects.
Get Emotional Health Support for Irritability at Mission Connection
If you’ve been struggling with constant irritability that feels out of your control, Mission Connection is here to help you.
Our team offers comprehensive outpatient mental health and irritability care with flexible scheduling and personalized support that meets you where you are.
We combine individual therapy, daily group sessions, and psychiatric care to create an irritable mood treatment plan that truly works for you.
You will learn to recognize your triggers and regulate your emotions through proven, evidence-based methods like CBT, DBT, mindfulness, and experiential therapies.
References
- Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review. Journal of the American Academy of Child & Adolescent Psychiatry. 2016;55(7):556-570. doi:https://doi.org/10.1016/j.jaac.2016.04.014
- Saatchi B, Olshansky EF, Fortier MA. Irritability: A concept analysis. International Journal of Mental Health Nursing. 2023;32(5):1193-1210. doi:https://doi.org/10.1111/inm.13140
- Gröndal M, Ask K, Winblad S. The distinction between irritability and anger and their associations with impulsivity and subjective wellbeing. Scientific Reports. 2023;13(1). doi:https://doi.org/10.1038/s41598-023-37557-4
- Wirth MM, Scherer SM, Hoks RM, Abercrombie HC. The effect of cortisol on emotional responses depends on order of cortisol and placebo administration in a within-subject design. Psychoneuroendocrinology. 2011;36(7):945-954. doi:https://doi.org/10.1016/j.psyneuen.2010.11.010
- Abend R, de Voogd L, Salemink E, et al. Association between attention bias to threat and anxiety symptoms in children and adolescents. Depression and Anxiety. 2017;35(3):229-238. doi:https://doi.org/10.1002/da.22706
- Perlis RH, Fraguas R, Fava M, et al. Prevalence and clinical correlates of irritability in major depressive disorder: a preliminary report from the Sequenced Treatment Alternatives to Relieve Depression study. The Journal of clinical psychiatry. 2005;66(2):159-166; quiz 147, 273-4. https://pubmed.ncbi.nlm.nih.gov/15705000/
- Jung K, Yoon J, Ahn Y, et al. Leveraging genetic overlap between irritability and psychiatric disorders to identify genetic variants of major psychiatric disorders. Experimental & Molecular Medicine. 2023;55(6):1193-1202. doi:https://doi.org/10.1038/s12276-023-01005-0
- Vidal-Ribas P, Stringaris A. How and Why Are Irritability and Depression Linked? Child and Adolescent Psychiatric Clinics of North America. 2021;30(2):401-414. doi:https://doi.org/10.1016/j.chc.2020.10.009
- Killgore WDS. Self-Reported Sleep Correlates with Prefrontal-Amygdala Functional Connectivity and Emotional Functioning. Sleep. 2013;36(11):1597-1608. doi:https://doi.org/10.5665/sleep.3106
- Whiting C, Nellia Bellaert, Deveney C, Tseng WL. Associations between sleep quality and irritability: Testing the mediating role of emotion regulation. Personality and Individual Differences. 2023;213:112322-112322. doi:https://doi.org/10.1016/j.paid.2023.112322
- Yeşildere Sağlam H, Basar F. The relationship between premenstrual syndrome and anger. Pakistan Journal of Medical Sciences. 2019;35(2). doi:https://doi.org/10.12669/pjms.35.2.232
- Kim SH, Manes F, Kosier T, Baruah S, Robinson RG. Irritability following traumatic brain injury. The Journal of nervous and mental disease. 1999;187(6):327-335. doi:https://doi.org/10.1097/00005053-199906000-00001
- Casagrande Tango R. Psychiatric side effects of medications prescribed in internal medicine. Psychiatric Disorders in Somatic Medicine. 2003;5(2):155-165. doi:https://doi.org/10.31887/dcns.2003.5.2/rcasagrandetango
- American Psychological Association. 2023 Work in America Survey. Apa.org. Published 2023. https://www.apa.org/pubs/reports/work-in-america/2023-workplace-health-well-being
- Perlis RH, Ata Uslu, Schulman J, et al. Prevalence and correlates of irritability among U.S. adults. Neuropsychopharmacology. Published online August 24, 2024. doi:https://doi.org/10.1038/s41386-024-01959-3
- Holahan CJ, Moos RH, Holahan CK, Brennan PL, Schutte KK. Stress Generation, Avoidance Coping, and Depressive Symptoms: A 10-Year Model. Journal of Consulting and Clinical Psychology. 2005;73(4):658-666. doi:https://doi.org/10.1037/0022-006x.73.4.658
- Sukhodolsky DG, Smith SD, McCauley SA, Ibrahim K, Piasecka JB. Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology. 2016;26(1):58-64. doi:https://doi.org/10.1089/cap.2015.0120