Depression

“You Can Be a Real Bitch” – Depression and Irritability

Depression and irritability - cartoon image of a person getting angry

Irritability can definitely be an issue sometimes because of my depression.  I seem to lose access to all of my more mature self, and revert to what may have worked best when I was five years old.  This can have a major impact on my behaviour, and sometimes I have let fly with yelling, screaming, and swearing.  This has occurred most often when I’ve been hospitalized, and has been directed at nurses and doctors whom I perceived as making things more difficult for me.  One of my former community psychiatrists once told me “you can be a real bitch when you’re not well”.

Several years after my first hospitalization, I learned that one of the diagnoses on the discharge summary was borderline personality traits.  Subsequent psychiatrists have disagreed with that diagnosis, as that set of maladaptive coping mechanisms only makes an appearance when I am ill, as opposed to personality disorders involving traits that are consistent over time.  It begs the question, though – to what extent do our coping strategies and behaviour when ill reflect (or not reflect) our core selves?

I’m not generally an irritable person, so when irritability rears its head due to my depression, I’m not sure if things are suddenly bothering me that I never would have noticed, or if I’m just more disinhibited about expressing irritation about things that I would normally just brush off.  In other words, is something new happening, or is there just an amplification of what’s already there?  While in the end, it probably doesn’t make much practical difference, it’s worth considering in terms of self-identity.

Is my mental illness part of me or is it something that happens to me, a monster on my back that I have to carry around?  I have always tended to lean toward the latter view, because I don’t think my illness should define me.  Perhaps it’s also in part because I don’t wantmy core self to be responsible for my bad behaviour.  Then again, no one is responsible for my actions but me, although the options I have to choose from seem to be very much influenced by my illness.

The perspective that I’ve sort of settled on is that we all have our inner caveman brain, including bits like the amygdala, and in times of stress and difficulty, that’s what gets activated.  Our prefrontal cortex, the most evolutionarily advanced part of our brain, is what generates our most adaptive coping mechanisms.  In personality disorders, factors such as trauma can impair the development over time of these sorts of adaptive coping mechanisms.  In conditions like mood disorders, our ability to access our adaptive coping mechanisms seems to be impaired in the acute illness phase, leaving us to default to what caveman brain can provide us.

So am I a bitch, or is it my illness?  In the end, probably some of both.

You can find more posts on depression on the blog index.

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46 thoughts on ““You Can Be a Real Bitch” – Depression and Irritability”

  1. I struggle with this SO much! The girls at work tell me I have a great resting bitch face and it’s usually because I am just annoyed, for various reasons. Other days, I really don’t know what I am feeling but I want to be left alone. It’s kinda like an indifference. It is ironic too, because before my brain surgery, I never really noticed it much. Now, I am far more aware. And of course, others love to make me aware.

  2. I have asked myself this frequently, and not only towards moments of negativity, i have asked myself questions like ” are my achievements really still valid if they were only induced by hypomania and i may not be that much of a creative hard working person normally? and this is where everything stops making sense, i think looking at it all with kindness and self acceptance is the best we can do!

  3. Ugh…I don’t like it but sometimes the bitchiness I feel kinda sneaks in. I try not to be this way, but sometimes I’m a complete bitch. I know it’s depression and I always feel guilty for it, but it happens.

  4. I get irritable when I’m depressed, although it manifests more as sarcasm and withdrawal rather than screaming and shouting.

    I think my autism symptoms get worse when depressed, which may be one reason the doctors were unwilling to diagnose as autism, as those symptoms should be constant since childhood. I think it’s more likely that I have masking and coping strategies that are hard to hold on to when I’m very depressed and anxious.

  5. That last full paragraph is scientific genius. It makes a lot of sense!!

    I’ve been struggling with this, too–the fear that I have an evil side that takes over when I’m extremely paranoid. I start fearing, what if that side of me is the real Meg? And that’s kind of scary. I almost sense we separate from our higher selves and enter into our baser selves whenever we’re stressed or struggling or unhappy. It’s disturbing for sure!!

  6. Interesting. I’ve always been quick to anger (not that I express it to people that often IRL), but also quick to laugh and dive into silly little joys. When I’m depressed, I tend to do neither and just stare into space…

  7. This is such an apt post for me today. I revert to a complete childlike state when I’m suffering. Today was an absolute prime example. I am the queen of the tantrum, tears, stamping feet, poor me .. blah blah. My counsellor asked me when I felt at my lowest and most agitated what age did I feel. I immediately replied, about 10. He talked to me about acknowledging that child when she appears. Giving her the love and attention she is needing. Quite frankly, she’s a little horror and I’m not keen on encouraging the awful behaviour. It only happens when I’m ill or I’m heading that way. I can recognise it’s happening now. I’m just not sure if I’m able to stop it.

  8. I relate, so very much, to this post. It’s comforting to read the thoughts in my own head on someone else’s blog… especially when they’re written so beautifully.

    Learning about my disease (for me it’s Borderline Personality Disorder, complicated by severe Post-Traumatic Stress Disorder) has only helped me to recognize the symptoms… controlling them is a much harder feat.

    With the aforementioned knowledge, I am able to see the onset of dark symptomatic behavior easier than I once did; but control is still a wildly varying, sometimes quite elusive factor. Even when I do manage to “control” myself, the feelings that cause the maladjusted behaviors dance around in my head with pitchforks and torches… demanding recompense in blood. And those lil’ bastards can be hard to ignore.

    I take some comfort in the fact that I have a disease to blame when things go awry; but the other side of that coin is the guilt associated with a lack of control over that disease. The best I can do is to acknowledge that the “bitch” in me evolved out of a need for protection against forces I had no ability to defend myself against.

    When she does rear her ugly, harpy head, I do my best to explain (albeit, after I’ve raged) that she was provoked by triggers too deeply embedded in my psyche to see before the fighting starts… sadly, it’s not always enough. But in the end, it’s all I’ve got.

    1. Luckily it doesn’t come up for me that often, but the lack of control piece is hard. I can feel it when it comes on, but that doesn’t help me control it. And then apologizing is all there is, and hope that it’s enough.

  9. It’s very normalizing to us to read so many people talk about various parts of their selves. This meets our need for connectedness.

    We believe our academic achievements were fueled by OCD and hypervigilance. We do not want to fuel that combination again because it takes a toll. Was that us? Yes. Did we also shame our Younger Child and yell and be intimidating? Yes. Was it due to our upbringing and trauma? Yes. And for Younger Child, all that may matter is that we fucked up. It’s not a child’s job to care why their parent fucks up. Truth is that all parents fuck up. Maybe it’s how much we—the children aged into adults—can mourn and repair that might dictate any future relationship with parents.

    We can’t blame our parents and not be accountable to Younger Child. We will try to understand, accept both. We have little relationship with parents because we are vulnerable to triggers. We just wait for them to die, which does not feel pleasant.

    1. I agree, all parents do fuck up at some time or another. And then it’s up on parents to choose to be accountable and work on doing better next time. Or they can choose not to be accountable and not work on doing better.

  10. Oh yes, I can be a bitch too! I get so irritated, over nothing. Well, nothing, when I am in *that* mood no-one is safe. Especially my neighbors with their loud voices and children!! Deep inside I’m just jealous because they can do all fun things and I can’t. That is what gets me every time. I struggle to accept every aspect of depression thrown at me and sometimes I can’t cope with the joy or abilities of others.
    And I *know* that it’s not nice but it needs to get out. I feel a little better afterwards because I realize that I’m really unwell but I also need to cope with the guilt of being a bitch.

      1. I know, that would be great. I feel like screaming must be involved and maybe some throwing with objects. I tried exercise, I did not work.

  11. I’m a major bitch when I’m triggered. I am trying to notice the body sensations that come with it. But I’ve snapped at people many times and feel really bad about it.

  12. Me too. But my inner ‘bitch’ pops out all the time, as opposed to being just when I’m really stressed out about being in hospital (for whatever reason). The one time I was institutionalize (as opposed to being in hospital for major surgery), I was too scared to even say much at all. The fear of being in that place never left me either.

  13. I don’t believe my irritability is the result of my depression as I see it in other members of my family who don’t have depression so I assume it’s genetic.

  14. When I am in a depressed state I tend to isolate and hunker down and not talk to the people around me. My depressed me is not particularly irritable so much as isolated, I do have mixed mood bipolar when manifests itself in very persistent anxiety. I think my anxious self is my irritable self. When I am anxious, there is no family activity that seems fun and no outing that I find I might enjoy. When I am anxious I am so not fun (at all) to be around — that may present as being irritable.

  15. When I am not feeling like myself, I am more bitchy. I tend to over worry about small things and I can’t relax. I don’t think straight and try to calm down when I feel like this. I just keep lashing out.

    I don’t think my anxiety and depression is a part of me but I don’t feel normal without it.

  16. This is exactly how I try to think about PMS. It’s not so much that being hormonal makes me a different person, it’s more that my tolerance for things that would normally only irk me goes wayyyyy down. It just amplifies opinions and feelings that I already have. That’s not to say that we shouldn’t try to control our bitchy moments, but it’s helpful to have an explanation, whether that’s PMS or depression or what have you. Easier to be kind to ourselves that way.

    I don’t find that my depression makes me terribly irritable, although that’s probably because I’m rather hard on myself for having feelings at all, and just stuff them away in a dark corner.

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