How to Recognize Irritation and Anxiety

February 16, 2012 Natasha Tracy

Irritation and anxiety can be symptoms of bipolar or side effects of medication - learn to recognize anxiety and irritation symptoms.

Self-harm is mentioned below.

When I was at university earning my degree I was a busy girl. I was attending school full-time, working three part-time jobs and skydiving on the side. There wasn’t a lot of time for dilly-dally.

And, of course, through this I was also getting treatment for bipolar disorder. This was at a time when treatment has started becoming successful but we were still tweaking things to try and get the most from the medication. As most lab rats know, this means upping the dose.

And, one day, I was at work and suddenly found myself needing to excuse myself to the lady’s room so I could slice open my ankle.


Irritation and Anxiety

Irritation, and I mean severe, rip-your-head-off irritation, is one of the least recognized symptoms of bipolar disorder and I believe it is closely related to anxiety, another symptom that is rarely talked about. We talk about being “up” or “down” but not what those words really mean.

And severe irritation or anxiety can happen either in a depressed or a manic/hypomanic state. This is recognized in the DSM by the official symptom “psychomotor agitation” which indicates:

“. . . unintentional and purposeless motions that stem from mental tension and anxiety of an individual. This includes pacing around a room, wringing one's hands, pulling off clothing and putting it back on and other similar actions. In more severe cases, the motions may become harmful to the individual, such as ripping, tearing or chewing at the skin around one's fingernails or lips to the point of bleeding.” ~Wikipedia

And for me, part of this is self-harm.

Recognizing Irritation and Anxiety

At the time I was fairly new to the bipolar diagnosis and I didn’t realize I was having a mood stemming both from my disorder and a medication side effect, all I knew was that I had to cut myself – now. It would have been helpful if someone had warned me about this possibility but warnings are difficult to give as every patient is different.

Nevertheless, irritation and anxiety are serious symptoms and can do serious damage to yourself and your relationships with others (and say, your job) so they are important to recognize. Anxiety is also highly correlated with suicide.

To recognize irritation and anxiety watch for situations that are out of place for you like:

  • Overly aggressive behavior
  • Extreme annoyance over small infractions
  • Abusive behavior
  • Wanting to isolate yourself
  • The feeling of “bugs crawling under your skin” (you’ll know it when you feel it)
  • The desire to perform repetitive actions for no reason
  • The desire to self-harm

Any of these should be reported to your doctor and certainly if you’re in danger of harming yourself or someone else they should be dealt with immediately. Do not wait to see if they go away. Waiting may be too late. And it’s much better to regret going to the doctor than to regret hurting yourself or someone else.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2012, February 16). How to Recognize Irritation and Anxiety, HealthyPlace. Retrieved on 2024, July 24 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Natasha is also unveiling a new book, Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder, mid-2024.

Find Natasha Tracy on her blog, Bipolar BurbleX, InstagramFacebook, and YouTube.

March, 18 2017 at 5:39 am

I am so happy to see these posts. I was diagnosed with bipolar 1 in the year 2000. IPad many doctors that really took no interest in me they would listen for a few minutes and write me out a new drug dosage. I finally found a doctor willing to look outside the box I was in such a depressive state for over 10 years it was a depression I would not wish on my worst enemy. I finally told my doctor I'm done with these drugs. I have continued to be in the deepest depression in my life. This doctor was willing to look outside the box she took me off all the drugs and determined that the antidepressant I was on was exacerbating my depression. So we worked out a deal she looked into her database and natural supplements to deal with my depression , ie; 3000 milligrams for depression, 15 milligrams foliot for bipolar depression and one gram inositol for metabolic syndrome which I don't know what that is . Everything seems fine for about a year. I went from Total depression to feeling great and at peace, well that lasted close to a year. But in the last few months I hate being labeled with terminology under the bipolar umbrella it is said that I had Mania and extreme irritability, severe inappropriate crying Jags my emotions are all over the place.. I have become extremely pessimistic about everything in my life. My lack of patience showed up anywhere I couldn't control it I could feel it build up but I knew I was going to call somebody a bad name really soon. Like driving anywhere any I went I got irritated it's to the point where I can't control it and it's scary. I am barely hanging on by a string I can feel the irritation build up and I try to control it my fear is there will be one day I cannot control it. So I'm going to be seeing a psychiatrist in about a week or so I'm going to have to give in and work with her on maybe adding some more drugs. I am grateful that she was willing to look outside the box and try something different I really thought it would work because I was so done with the drugs they already put me on and none of them make me feel better. So I'm not sure what she's going to put me on now the only bipolar taking at this time is will now it's supposed to help with the mood swings I don't think it's working LOL. It's nice to have a form that I can express what's going on and read other people just like me and I am not alone. Hopefully I can look for something else and hope that it doesn't make me go back to being a zombie. I think half of the entertainment industry is bipolar energy is beyond human their minds are constantly busy they can't sit still. But somehow they manage to go with their careers which give them satisfaction and comfort . I am retired I am bored I sit around all day watch TV I have no place to go I have reached out to so many volunteer places so I can have something to do ,and because of recent developments in my hearing I had to get hearing aids which is turned my world upside down and it's made it much smaller because I cannot hear in a large group setting so therefore it is kind of pushed me down a bit and I don't know where to go and I'm desperately looking for something to do and hopes that it will shut off my brain and I won't talk to myself all day. I try to stay positive and push forward and hope that the next move or make me feel better. My question is when does it stop what's going to happen when I get older because my bipolar is so out of control is asincere fears. I wonder do I need you talk to yourself alot cuz I think sometimes I'm going crazy it's to the point or I find myself talking in public I'll just be standing there and I start talking it's not like I'm seeing people but I'm having a conversation I'm just expressing my feelings now I'm embarrassed. Alrighty then thank you all for your input

March, 28 2016 at 2:06 pm

I'm bipolar and autistic (aspergers high functioning) I never realized this is why I cut, pick my face, literally tear off my tie nails, and I'm always wanting to hit someone or something.

September, 15 2015 at 2:36 pm

I'm bipolar. I just hurt myself. I don't know what to do when I'm in stress. I like to read so thanks for your comments.

August, 21 2014 at 11:21 am

thanks so much
i've got the bugs right now
trying to figure it out
i'm diagmnosed w/bipolar 2
And last nite/today i'm having an asthma attack /panic attack/ bugs / you name it. maybe hypomania. /bought a few things on ebay. kept it to under $100 tho. trying to ride the horse without getting thrown. trying to calm myself. get it together. i start back to school next week.
oh hey. rereading this-yeah-it's definitely an episode-guess i better call.thought i could ride it out . . . really wanted to take care of it myself. should knoow better. i've been diagnosed for 20 + years-tho my sister says she thinks i've had bipolar disorder for 40 years-heygoes to show you can live a long life w/this stinkin disease. but it aint always easy. thanks for listening-gotta go make a phone call to the pdoc

Nora B
May, 20 2014 at 1:53 pm

I'm just catching the end of this thread. I had been stable since 1992 bipolar, after two severe manic episodes followed by depression.
Since menopause, I noticed extreme bouts of anger and irritability. Sometimes I have days where I am irritable about everything. I often try to subdue it with a couple glasses of wine. Started Prozac a month ago, and this seemed to temper the worst of the extreme irritability. But, I generall feel depressed and irritability comes and goes. First moments of awakening are always anxious, depressed.

Natasha Tracy
February, 25 2014 at 4:18 pm

Hi Rj,
Well, luckily, this site is full of help. Of course, you can check out the various sections of the site, under Communities (above) for information on all sorts of disorders.
For personal support, I recommend you check out the forum:
I hope that helps.
- Natasha Tracy

February, 25 2014 at 12:39 pm

Hello Natsha. I just signed up. Im looking for answers and Helpm alot of what ive read I go threw. Im a 41 old male & I am just jist doing well. I wish I could explain as well as all these others have maybe not this section. But others. Not sure how to use this for help. But I jave no support systemm I feel alone and crazy. Dont lnow who to trust it hasaffected everything. Have batteled it for uears worst. Ever. Been threw so much. With no job lost my wife some accidents been arrested for anger. Its very hatd and I reall want to try and feel better I could probally write alot more. Could you help me?

February, 24 2014 at 7:27 am

I don't think doctors directly ask about irritability but they usually do observe you and perhaps inquire about your relationships to see if it is a present issue. Personally, I think this is brilliant given we often have difficulty accurately and objectively analyzing our own mental state. Especially since our inappropriate level of irritability may feel justified at the time. I do think psychiatrists should explain symptoms more. Unfortunately, I think educating yourself is all you can do.

December, 23 2012 at 7:46 pm

I was diagnosed with Bipolar 2 about a month ago after landing up in the hospital and have found it all a bit confusing. Especially since my 'high' is, for the most part, not such a great feeling. What I feel is exactly what you described above. The irritation that makes you feel like you're going to explode, feeling the intense need to punch someone in the face, the ants under your skin, the uncontrollable urge to hurt yourself just to make it all go away. I had a great week, and then yesterday I started feeling like described above. Like I'm starting to lose control. It's the first time I've felt like this since starting treatment and wasn't sure if it was part of my bipolar symtoms or me just beling stupid and making things up. So thanks for this article.

September, 24 2012 at 3:37 pm

Thank you soo much for sharing the part about ripping the skin away from your finger nails..I am bipolar ;manic and depressive with severy anxiety and irritatio,rapid speachn who restarted the right meds for me again but wondered why i teared the skin around my fingers as you posted about prior; terribly till the bled and so severe it bothered me while i did it but was something i couldnt control.also the feeling of bugs just started since they started a familiar med on me they used before and never caused a side effect so it might be a new symptom of my bipolar..Ty for sharing all

February, 24 2012 at 2:58 pm

My partner has a comment too: she's in a support group for significant others of people with bipolar, and says that one of the most common concerns partners have is bipolar irritability. It's very hard to live with.

February, 24 2012 at 2:45 pm

I've struggled a lot with irritability in both depressive and hypomanic/manic episodes, and it's something that's never been asked about, recognized, or considered by my mental health professionals. It's only in the last few years my partner and I have tackled it head on. I still have to continually insist to my psychiatrist that a drug that helps me with it (risperidone) is worth the side effects. She doesn't seem to understand that I'd rather have relationships than not.
Anyway, I was reminded of a time I was in the psych ward, very irritable for days. I was called into a clinical team meeting with half a dozen doctors, psych nurses, OT, etc. One said, "Why are you so irritable?" "Because I'm depressed!" I snapped. They still didn't understand. Sigh.
It really is up to individuals to understand the full impact of their condition, including a symptom like irritability which can so easily be mistaken for a personality trait. It isn't, and it can be controlled, but we have to realize why it exists first and treat it appropriately.
Thanks for writing this to bring attention to a symptom which is often overlooked but so important to quality of life.

Understanding Whitney Houston and Bobby Brown: Addictions and Relationships | Relationships and Mental Illness
February, 20 2012 at 8:55 pm

[...] paint for you.As someone struggling with bipolar, I’ve been driven to act out sexually and emotionally because I was afraid of not being perfect, of being the depressed, anxious person on the outside [...]

Natasha Tracy
February, 20 2012 at 7:55 am

Hi Cathy,
Happy to help.
- Natasha

Natasha Tracy
February, 20 2012 at 7:55 am

Hi Ash and Sheryl,
Happy I could help.
In my experience this isn't something that doctors ask about so it isn't something that patients know about. But knowledge is power, so hopefully this will help facilitate a change for you.
- Natasha

February, 18 2012 at 3:00 am

I'm going thru right now. I pick my nose till I bleed. Then wait a few hoursto do it again. You just helped me figure out that is my problem . Didn't realize why I did it .

February, 17 2012 at 8:15 am

Overly aggressive behavior is also sometimes caused by 'adrenaline system overreactivity'. Adrenaline system overreactivity can be treated with non-psychotropic drugs.
Overly aggressive behavior is sometimes misdiagnosed as a bipolar symptom, or misassociated with bipolar, autism and other disorders.

Cathy Sikorski
February, 17 2012 at 5:31 am

I have agitation at times and didn't understand that it was due to my having bipolar. It explains why I'm, at times, ready to scream and hit something over being agitated about something/someone. I'll have to tell my psychiatrist that I have agitation so we can deal with that symptom. Thanks for your input.

February, 16 2012 at 2:10 pm

Oh my gosh. I never thought about psychomotor agitation, but now my behaviour during hypomania makes a lot more sense. I pick at the skin on my face, and will occasionally cut myself (though I've worked hard to stop). I feel like I can't stop moving around. I've felt those "bugs" too. Great post!

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