A patient shows a heightened emotional reactivity. Before revealing the answer, decide what distinguishes irritability from affective incontinence.

Ask whether the patient retains voluntary control over the emotional display, or whether the display escalates beyond what they can control. Irritability is a persistently lowered threshold for annoyance, frustration, or anger, but the person still retains a meaningful degree of control over how they express it. Affective incontinence goes further: the display goes beyond irritability to a genuine loss of control over sudden laughing or crying, markedly disconnected from, or disproportionate to, the person's actual inner feeling at the time. The degree of voluntary control retained over the emotional expression is what separates the two, and affective incontinence's strong association with organic and neurological causes makes it a particularly important sign to prompt physical assessment.