Huntington’s disease is a rare autosomal dominant disease with an estimated incidence of approximately 4-6.1/100,000 people within the United States. Often recognized for its progressive motor symptoms and cognitive decline, its psychiatric symptoms can be underrepresented. It is only within the past few years that we have come to appreciate the range and prevalence of neuropsychiatric symptoms that plague patients with chronic degenerative disease. Still, some patients’ neuropsychiatric symptoms may be misinterpreted as part of other psychiatric conditions. Specifically, prodromal phase symptoms such as agitation, impulsivity, depression, and more may present similarly to purely psychiatric disorders. This may complicate patient’s clinical picture consequently leading to delays in diagnosis and in treatment. Such delays can worsen prognosis and a patient’s quality of life. Here, we describe a multifaceted case of a patient who exhibited striking psychiatric symptoms as her primary presentation. This case helps highlight the importance of recognizing psychiatric symptoms including irritability, depression, as well as the less common psychotic features as early warning signs of impending progression of a neurodegenerative disorder such as Huntington’s disease.