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Mood and Behavior Changes (Psychiatric)



Irritability is a common and particularly difficult symptom of HD. Frequently, irritability is noticeable years before the physical symptoms of HD start. When someone acts irritable, it’s not obvious what the goal or desired outcome of the outburst is.  

Irritability in HD patients is different than anger or aggression.  It's characterized by: 

  • Brief outbursts of rage followed by a long period of calm.

  • Spontaneous and not planned.

  • A reaction to a seemingly meaningless trigger.

Sometimes, it’s easy to spot an episode of irritability before it occurs by looking for these clues:

  • Deliberately moving into your space.

  • Speaking loudly or quickly.

  • Making intense eye contact.

  • Asking repetitive questions or making constant comments.

  • Restlessness.

Common triggers of irritability include:

  • tired

  • pain

  • hunger

  • thirst

  • change in routine

  • medication issues

  • grief

  • stress around holidays or other special events

  • changes in the lives of important family members

Strategies for Avoiding and Calming Irritability 

Several things you can say to someone who is irritable and unspoken cues you can use to calm the situation.   

  • Don't fight back or argue.

  • Give positive reassurance.

  • Give the person space and don't touch him or her.

  • Let the irritable person do most of the talking while you listen.

  • Make the environment as calm and safe as possible - slowing down or stopping the car, taking kids to another room, or leaving a restaurant are some examples of environmental control.

  • Manage your emotions and stay calm.

  • Repeat what you hear the person say so you're sure you understand the concern or problem.

  • Use "I" messages and statements instead of "you" messages and statements.

  • Use a soft tone of voice.

  • Use non-threatening body language (relaxed stance, arms at your side instead of crossed).

The person with HD who is experiencing irritability is typically upset or embarrassed after the outburst.  Untreated irritability can evolve into aggression.  Luckily, irritability is one of the easiest symptoms to treat.  Start by consulting a doctor. If you're more comfortable, you can speak with a doctor alone and request confidentiality.