What Causes Agitation?

Agitation is a sense of inner tension and restlessness. When it happens, you may get annoyed easily or feel like you need to move around. It’s a normal emotion. But it’s more likely to show up when you’re under a lot of stress. It can also happen if you use drugs or withdraw from alcohol.

But sometimes, a medical condition can cause agitation. It’s pretty common to feel unsettled if you have hormone problems or a psychological condition like schizophrenia, bipolar disorder, or dementia. Rarely, it may be caused by a brain tumor. That’s why it’s important to talk to your doctor if you get agitated, especially if you feel like it’s for no reason.

Common symptoms of agitation include:

  • An uneasy feeling
  • An urge to move, maybe with no purpose
  • Crankiness
  • Little patience
  • Nervousness
  • Stubborn behavior (often toward caregivers)
  • Too much excitement

You may act angry or violent at the same time. But agitation isn’t the same as aggression. It’s also different than akathisia. That’s a movement disorder often caused by antipsychotic medication.

It’s normal to get worried if you or a loved one is agitated a lot. But your doctor can help you find and treat the cause. That’s the best way to feel better.

Here are some of the most common causes of agitation:

Schizophrenia

You may not be able to control your emotions or actions. Schizophrenia can also make it hard to tell what’s real. That can make you feel troubled. You may or may not be able to manage your agitation. That’s why it’s important to talk to your doctor when you feel uneasy.

Other symptoms of schizophrenia include:

  • Difficulty finishing things
  • Memory or speech problems
  • Thoughts that don’t make sense

To treat your agitation, your doctor may give you:

  • Antipsychotics
  • Benzodiazepines (also called “benzos”)
  • Talk therapy
  • If nothing else works, physical restraint may be needed

You’ll need ongoing treatment for your schizophrenia. You may need a mix of:

  • Educational support
  • Family involvement
  • Help from your employer
  • Medication
  • Therapy

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Bipolar Disorder

This is also called manic-depressive disorder. It can cause strong swings in your emotions and energy levels. Your mood can cycle between good and bad feelings. Or you can have both at the same time.

If bipolar disorder causes your agitation, you might also have:

Manic episodes. During these “up” periods, you may have:

  • A lot of energy
  • Inflated sense of what you can do
  • Little need for sleep
  • Really fast thoughts

Depressive episodes. During these “down” periods, you could have:

With both mania and depression, these things are possible:

Treatment for your agitation may include:

  • Medication
  • Other mood stabilizers
  • Psychotherapy, like cognitive behavioral therapy (CBT)

Like with schizophrenia, you may need to go to the hospital if your agitation is really bad. And you’ll need ongoing treatment to control your symptoms.

Alzheimer’s Disease and Dementia

That’s a decline in your ability to think, behave, or recall things. You may get frustrated and not be able to control your feelings. It’s more common in older people. But it’s not a typical part of aging.

One of the main symptoms of dementia is memory loss. But you could also have trouble finding the right words or paying attention. You may not be able to do things for yourself, like eat or get dressed.

Alzheimer’s disease is the most common cause of dementia in older people. And if you’re caring for someone with Alzheimer’s, they probably have a reason for feeling agitated. You should find out if they also have:

  • A bad interaction with medicine
  • A feeling of loneliness or depression
  • Constipation
  • Pain
  • Sensitivity to sounds or crowds
  • Trouble with any kind of change

If you or a loved one has Alzheimer’s or dementia, treatment for agitation may include:

Antipsychotics are not approved to treat dementia-related agitation. These drugs raise the odds of death in older people.

In some cases, dementia-like symptoms can be reversed. That can happen if you have a brain infection, take certain medicines, or have other health problems. That’s why it’s important to talk to your doctor about any new memory or mood problems.

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Autism

You may get upset if you have trouble communicating. That can happen if you have autism spectrum disorder (ASD). It’s a sensory and behavior disorder that shows up when you’re young. It can make social situations hard. You may feel like you need to repeat certain behaviors to calm down. But that might not always work.

Other symptoms of autism include:

  • Sensitivity to lights, noise, or crowds
  • Speech problems
  • Trouble making eye contact

You may need a personal approach for your symptoms. Your doctor could give you:

Stress

Life can be hard. And it’s normal to feel agitated if you’re stressed out. It may happen because of problems at home, work, or at school. Too much stress can make other health problems worse, like high blood pressure and diabetes.

Other common symptoms of mental stress include

Treatment to ease your stress will probably lift your mood. You may want to:

It may be hard to control your stress on your own. That’s when you should talk to your doctor. They may want you to try medication or therapy. And go to the hospital if you have chest pains or a hard time breathing. That may be a sign of something serious, like a heart attack.

Hypothyroidism

Agitation may be a sign of hypothyroidism. That’s when you don’t make enough thyroid hormone. Without this chemical, your brain and body don’t work very fast. It can happen if you get radiation treatment, have surgery on your thyroid, or you have an autoimmune condition, like Hashimoto’s thyroiditis.

Other symptoms of hypothyroidism include:

  • Attention or memory problems
  • Constipation
  • Depression or anxiety
  • Tiredness
  • Trouble staying warm

Treatment for your hypothyroidism should ease your agitation. Your doctor will give you medicine to bring your hormone levels back to normal.

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Menstrual Cycle

Hormone changes before your period can make you feel tense. But you may get really overwhelmed and agitated if you have premenstrual dysphoric disorder (PMDD). That’s a more serious form of premenstrual syndrome (PMS).

Some other symptoms of PMDD include:

Treatment for symptoms of PMDD may include:

It’s important to talk to your doctor if you have these symptoms every month. It may be a sign that your menstrual cycle is actually making another mood disorder worse.

When to Call a Doctor

If you feel agitated a lot and you don’t know why, talk to your doctor. They can give you tests to find out what’s going on.

And if you or a loved one is thinking about suicide or hurting yourself, tell someone right away. You can reach out to a friend, family member, or a health care professional. You can also go to the emergency room or call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) any time, day or night.

WebMD Medical Reference Reviewed by Jennifer Casarella on December 17, 2019

Sources

SOURCES:

BMC Psychiatry: “Characterizing the experience of agitation in patients with bipolar disorder and schizophrenia.”

Western Journal of Emergency Medicine: “The Psychopharmacology of Agitation: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Psychopharmacology Workgroup.”

Neuropsychiatric Disease and Treatment: Psychiatric symptoms in glioma patients: from diagnosis to management.”

Translational Psychiatry: “Dementia-related agitation: a review of non-pharmacological interventions and analysis of risks and benefits of pharmacotherapy.”

National Institute of Mental Health: “Schizophrenia,” “Bipolar Disorder,” “Autism Spectrum Disorder.”

Alzheimer’s Association: “Anxiety and Agitation.” 

Stanford Health Care: “Treatment Options for Dementia?”

National Institute on Aging: “What Is Dementia? Symptoms, Types, and Diagnosis,” “Coping with Agitation and Aggression in Alzheimer’s Disease,” “How Is Alzheimer’s Disease Treated?”

Applied Psychophysiology and Biofeedback: “The Effects of Hand Massage on Stress and Agitation Among People with Dementia in a Hospital Setting: A Pilot Study.”

Western Journal of Nursing Research: “Acupuncture and Acupressure for Dementia Behavioral and Psychological Symptoms: A Scoping Review.”

Journal of Child and Adolescent Psychopharmacology: “Atypical Antipsychotics for Irritability in Pediatric Autism: A Systematic Review of Network Meta-Analysis.”

Mayo Clinic: “Stress Management.”

Current Opinion in Endocrinology, Diabetes and Obesity: “Psychiatric and cognitive manifestations of hypothyroidism”

American Thyroid Association: “Hypothyroidism.”

Johns Hopkins Medicine: “Premenstrual Dysphoric Disorder (PMDD).”

UNC Center for Women’s Mood Disorders: “Menstrually Related Mood Disorders.”

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