Q. My husband is always irritable. He gets upset at the smallest things and takes it out on whoever is around. He's always had a bit of a temper but it got worse after his fourth deployment. What could be causing this?
A. Irritability, or what some refer to as agitation, is common in people with and without psychiatric problems.
In either case, it's usually described as anger or extreme annoyance or frustration by the person or those around him.
And if left unchecked, it can wreak havoc in one's life.
Irritability is often an aspect of post-traumatic stress disorder. It's classified as a symptom of dysfunctional arousal and reactivity.
In extreme cases, it can lead to aggression and violence. And it's often the symptom reported by the veteran's spouse as being the most destructive to the relationship.
Depression is another possible cause of irritability. Over time, prolonged sadness, feelings of hopelessness and worthlessness, and loss of pleasure in life take a toll on the depressed person. In men, irritability is often the first sign that depression has set in.
The more common nonpsychiatric causes of irritability include lack of sleep, excessive caffeine intake, work and home stress, and a host of physical illnesses to include hypothyroidism, diabetes, allergies and the flu.
The cause of a person's irritability will determine the treatment. Some treatments are more straightforward than others. For example, in the case of sleep deprivation, the prescription is simply more sleep. In cases of excessive caffeine, just wait until the chemical leaves your system — and avoid additional intake for a while.
If thyroid disease or diabetes runs in the family, it's important to be checked out by a primary care provider. The irritability won't improve until the disease process is under control. In the case of allergies, an over-the-counter antihistamine like Benadryl or Claritin may do the trick. However, be aware that in some people, antihistamines can worsen irritability.
Psychiatric causes of irritability are trickier. In most cases, the underlying anxiety or depression needs to be treated before the irritability subsides.
But in some people, the irritability needs to be targeted specifically. This can be done with medication or talk therapy in which the person's negative thoughts are challenged or the person is taught calming strategies to manage intense feelings.
Regardless of the cause, evaluation by a health care provider is needed. What happens after that will be a joint decision between the individual and the provider.
Bret A. Moore, Psy.D., is a board-certified clinical psychologist who served two tours in Iraq. Email him at kevlarforthemind@militarytimes.com. This column is for informational purposes only and is not intended to convey specific psychological or medical guidance.
