Why uncontrollable laughter and crying is a serious health concern…

pseudobulbar - neurological disorder

On the stage of life, our emotions tend to mimic classic theatre masks. Representing the division between comedy and tragedy, the masks are symbols of drama. Simply put, when something is funny, we laugh. When something is sad, we cry. These are typical reactions to an event or story. But, for people with pseudobulbar affect, it is much more difficult to control emotional responses such as laughter or crying. Outbursts are common.


So, what exactly is Pseudobulbar affect (PBA)? It is a neurological disorder also commonly known as emotional incontinence. It was first reported in medical journals by Charles Darwin. Recently, the neurological disorder has been receiving more attention due to celebrity PSAs.

PBA is a condition where individuals cannot control their laughter or crying. This may be due to injury or a neurological condition. Essentially, a person with pseudobulbar affect has difficulty matching their emotions with a situation, meaning they may overreact or exaggerate their emotions. Other people might project an emotion that is contrary to the emotional cue, for example sad news might elicit laughter.

Conditions or injuries that can lead to PBA include:

  • Traumatic brain injury (TBI)
  • Alzheimer’s disease or other dementias
  • Stroke or TIA’s
  • Multiple sclerosis (MS)
  • Parkinson’s disease
  • Lou Gehrig’s disease (ALS)

PBA vs. depression

Often pseudobulbar affect can be confused with depression, but the two conditions are different. Although both conditions may co-exist, a person can suffer from one without the other.

There are many differences between PBA and depression which are important to understand. To understand the difference between PBA and depression, see the below chart.

Differences between PBA and Depression

pba vs depression chart
Source: pbainfo.org

The 3 steps to living with PBA

living with PBATake your medications: Pseudobulbar affect can make life challenging, but it is manageable. Medications are available to help alleviate symptoms. Although side effects may vary, medications for PBA work to minimize the amount of outbursts and can potentially eliminate them.

Be open about your condition: Another way to cope with PBA is to be open about your condition. The more those around you are made aware of it, the more understanding they can be, especially when an episode occurs. Reaching out to other patients with PBA can also be helpful to exchange stories and tips on how to better manage the disorder.

Practice breathing and relaxing methods: Lastly, practicing breathing and relaxing methods can also help you regain control, especially during an episode of intense laughter or crying. Try to use the four-four-six model. Breathe in for four counts, hold it for four counts and then breathe out for six counts.

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