Laughter for no reason, uncontrollable crying - Let's talk about Pseudobulbar Affect (PBA)

Imagine that you are feeling a little sad, or normal. But suddenly you start laughing uncontrollably. Or when you are not feeling happy at all, you cry continuously. Are you familiar with this kind of experience? This is not a mental weakness or something you do intentionally as you sometimes think. This could be a condition related to the nervous system . This is what we are talking about today.

What is Pseudobulbar Affect (PBA)?

Simply put, Pseudobulbar Affect, or PBA for short, is a condition that affects the nervous system. It is a condition in which there is a disconnect between your inner mood and your outward emotional expression. This means that you may cry without feeling sad, laugh without feeling happy, or get angry over small things. The most important thing is that you cannot control these emotional expressions.

This condition is known by several other names:

• Emotional lability
• Emotional incontinence (inability to control emotions)
• Involuntary crying
• Pathological laughing and crying

What are the main symptoms of PBA?

If you or someone you know has PBA, you may experience these symptoms. They may occur several times a day or several times a month.

Because of these symptoms, many people confuse it with a mental illness like depression or bipolar disorder . However, there are clear differences between the two.

A person with depression can cry, but to some extent, they can control it. And the crying is appropriate for the sadness they feel. But that's not the case with PBA. You can cry continuously even when you're happy. Also, smiling is not seen as a symptom in depression.

This condition can make you feel embarrassed and uncomfortable in social situations. You may avoid going out with friends or going to parties because you're afraid of "Will this happen to me again?" This can also lead to anxiety and depression for some people.

Why does this situation occur?

Scientists believe that the main cause of PBA is damage to the part of our brain that controls emotions, the prefrontal cortex . This damage changes the functioning of brain chemicals, leading to a loss of the ability to control emotions.

PBA can be caused by any medical condition or injury that affects the brain. Some of the main conditions include:

• Stroke
• Traumatic Brain Injury
• Multiple sclerosis (MS)
• Amyotrophic lateral sclerosis (ALS)
• Parkinson's disease
• Alzheimer's disease
• Dementia
• Brain tumor

Research has shown that more than a third of people who have been paralyzed may develop symptoms of PBA.

How does a doctor accurately diagnose PBA?

If you or a loved one is constantly crying or laughing for no reason, be sure to see a doctor and talk about it. It's important to get an accurate diagnosis, as PBA can be easily confused with other mental illnesses.

When you go to see your doctor, be prepared to talk about these things:

• What are the symptoms? (Crying, laughing, getting angry?)
• Since when has this been around?
• How long has this been going on? (A few minutes or more?)
• How many times a day?

When these kinds of events occur, keeping a diary of what you think may have caused them will greatly help the doctor understand your condition.

There are no specific tests to diagnose PBA. However, to check for epilepsy conditions that can cause these symptoms, your doctor may order an EEG (Electroencephalogram) . This is a simple, painless test that measures brain waves.

In addition, doctors use two questionnaires to confirm whether it is PBA or not.

1. Pathological Laughing and Crying Scale (PLACS): Here, the doctor asks you questions about these events, how they related to your feelings, and how they affected social situations.

2. Center for Neurologic Study-Lability Scale (CNS-LS): Here you have to answer a few questions yourself. For example, questions like "I cry very easily" or "I can't control my laughter easily" have to be scored according to your experience.

What are the treatments for PBA?

There are treatments available to help manage PBA. Your doctor may prescribe low doses of antidepressants to help manage your symptoms.

Also in 2010, the US FDA approved the first drug specifically for PBA, dextromethorphan/quinidine (Nuedexta) . Research has shown that this drug is very effective in controlling uncontrollable crying and laughing in people with diseases like MS and ALS.

To receive treatment for this condition, you can seek the help of a specialist such as a neurologist, psychiatrist, or neuropsychologist.

What can we do when living with PBA?

Living with PBA can be challenging, but by following these tips, you and your family can successfully cope with the condition.

• Tell the people around you: Talk to your family and close friends about PBA and how it affects you. That way, if something like this happens suddenly, they won't be upset or misunderstand.
• Keep a diary: As we mentioned earlier, write down when these events occur and what you think may have caused them. This will be very important when discussing treatment with your doctor.
• Change your posture: When you feel like crying or laughing, change the way you are sitting or standing.
• Breathe slowly, deeply: During an event, breathe slowly and deeply until you feel in control.
• Relax: After an event like this, your shoulders and forehead may feel tight. So try to relax your body after the event.
• Join a support group: Talking to other people with PBA can be a great source of strength. They will understand your experience and can give you other tips that have helped them.

Pseudobulbar Affect, PBA, Uncontrolled Laughter, Uncontrolled Crying, Neurosis, Depression, Brain Disease, Paralysis