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Tuesday, April 13, 1999Can you please eat somewhere else?
A researcher says irritability should be treated as a specific disorder
If you have ever found your gorge rising at the rustling noise of someone reading a newspaper, or if you have ever become extremely annoyed by the way someone chews her food, you have likely experienced irritability.
While many people would recognize irritability in themselves as a distinct phenomenon, the medical community has tended to lump a more severe state of irritability in with other disorders such as depression and anxiety. But Leslie Born, a researcher and therapist at the Women's Health Concerns Clinic -- an outpatient psychiatric clinic at McMaster University in Hamilton, Ont. -- thinks irritability should be looked at as a separate and distinct state.
"There is a small group of us who believe that the time has come to resurrect irritability as a distinct phenomenon . . . If we can measure irritability and distinguish it from other phenomena, then we can talk about it all we want," said Born last week at a McMaster lunchtime lecture called Resurrecting Irritability.
Born said she became interested in irritability while working with women at the clinic. She found that many of the women made comments such as, "The dog is breathing too loud," and "I feel like a volcano and anything sets me off."
When Born prepared a questionnaire for these women, she discovered that many of them used words such as "rage" and "explosive" to describe their states. They didn't want to touch anyone or be touched and they reported being incredibly sensitive to sounds. One woman complained that her husband ate his sandwich too loudly.
"This is irritability that is severe enough to disrupt lives and warrant treatment. We can all get irritable without enough to eat, or not enough sleep, or from a hangover. But in some women it's severe enough to disrupt their lives. It's Jekyll-and-Hyde severe -- people on the street wouldn't normally see this," said Born.
Such serious irritability certainly affects relationships and, Born points out, no one has looked at the effect on children with a severely irritable parent.
When Born tried to find current research on the topic, she discovered that there was almost no recent material. She refers to her work as the "resurrection" of irritability because her review of the literature (as far back as Plato) revealed that irritability was once thought to be a bodily problem, not a psychological one. Until the 18th century, it was considered an innate nervous force. "It was the property of the muscle fibre of our hearts, body muscles, diaphragms, and intestines," said Born.
By the 19th century, irritability came to be seen as a mental disturbance. But for most of this century, the topic has been largely left untouched. "The best answer I can offer is that it fell out of fashion," said Born.
Looking at irritability on its own, apart from other mental disturbances, should allow researchers to find effective treatment for those who suffer severe symptoms.
"We're concerned about resolving the symptom and then finding the cause and working our way back . . . It has been determined that medication given for depression like Prozac or Zoloft is successful in treating irritability, but it is used in a way that is very different from depression. It's used in very low doses and it has an almost immediate effect," said Born.
Some women have expressed a serious need to spend a little time alone, so Born and her colleagues have even recommended a scream room. "It's a place to be alone and have a good yell if necessary," she laughs, and points out that it provides only temporary relief. "Irritability isn't something that disperses with an outlet, so if they explode at a spouse or a child, it's not going to help overall."
Given that she works in a women's health clinic, Born will have to limit her research to women for now. She is hoping that her work will spark similar studies in how irritability affects men.
She has asked male friends informally if they would ever describe themselves as irritable. "They just give me this look," she said. "Guys don't call themselves irritable; they might say cranky, or hostile, or aggressive." But figuring out if they are actually talking about the same feeling is a whole other research project.
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