Overview
Pseudobulbar affect (PBA) is a condition that's characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.
If you have pseudobulbar affect you'll experience emotions normally, but you'll sometimes express them in an exaggerated or inappropriate way. As a result, the condition can be embarrassing and disruptive to your daily life.
Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication.
Products & Services
Symptoms
The primary sign of pseudobulbar affect (PBA) is frequent, involuntary and uncontrollable outbursts of crying or laughing that are exaggerated or not connected to your emotional state. Laughter often turns to tears. Your mood will appear normal between episodes, which can occur at any time. Crying appears to be a more common sign of PBA than laughing.
The degree of the emotional response caused by PBA is often striking, with crying or laughing lasting up to several minutes. For example, you might laugh uncontrollably in response to a mildly amusing comment. Or you might laugh or cry in situations that others don't see as funny or sad. These emotional responses typically represent a change from how you would have previously responded.
Because pseudobulbar affect often involves crying, the condition is frequently mistaken for depression. However, PBA episodes tend to be short in duration, while depression causes a persistent feeling of sadness. Also, people with PBA often lack certain features of depression, such as sleep disturbances or a loss of appetite. But depression is common among those who have pseudobulbar affect.
When to see a doctor
If you think you have PBA, talk to your doctor. If you have a neurological condition, you might already be treated by a doctor who can diagnose PBA. Helpful specialists include neuropsychologists, neurologists and psychiatrists.
It's suspected that many cases of pseudobulbar affect go unreported and undiagnosed due to a lack of awareness about the condition.
Causes
Pseudobulbar affect (PBA) typically occurs in people with neurological conditions or injuries, including:
- Stroke
- Amyotrophic lateral sclerosis (ALS)
- Multiple sclerosis (MS)
- Traumatic brain injury
- Alzheimer's disease
- Parkinson's disease
While further research is needed, the cause of PBA is believed to involve injury to the neurological pathways that regulate the external expression of emotion (affect).
Complications
Severe symptoms of pseudobulbar affect (PBA) can cause embarrassment, social isolation, anxiety and depression. The condition might interfere with your ability to work and do daily tasks, especially when you're already coping with a neurological condition.
May 16, 2018
- Mack E, et al. Information/education page: Pseudobulbar affect. Archives of Physical Medicine and Rehabilitation. 2014;95:1599.
- Brooks BR, et al. PRISM: A novel research tool to assess the prevalence of pseudobulbar affect symptoms across neurological conditions. PLOS One. 2013;8:e72232.
- Ahmed A, et al. Pseudobulbar affect: Prevalence and management. Therapeutics and Clinical Risk Management. 2013;9:483.
- Engleman W, et al. Diagnosing pseudobulbar affect in traumatic brain injury. Neuropsychiatric Disease and Treatment. 2014;10:1903.
- Galvez-Jimenez N. Symptom-based management of amyotrophic lateral sclerosis. http://www.uptodate.com/home. Accessed Feb. 29, 2016.
- National Stroke Association. Pseudobulbar affect — PBA. http://www.stroke.org/we-can-help/survivors/stroke-recovery/post-stroke-conditions/emotional/pba. Accessed March 1, 2016.
Related
Pseudobulbar affect
Advertisem*nt
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
Advertising & Sponsorship
Mayo Clinic Press
Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press.
- Mayo Clinic on Incontinence - Mayo Clinic PressMayo Clinic on Incontinence
- The Essential Diabetes Book - Mayo Clinic PressThe Essential Diabetes Book
- Mayo Clinic on Hearing and Balance - Mayo Clinic PressMayo Clinic on Hearing and Balance
- FREE Mayo Clinic Diet Assessment - Mayo Clinic PressFREE Mayo Clinic Diet Assessment
- Mayo Clinic Health Letter - FREE book - Mayo Clinic PressMayo Clinic Health Letter - FREE book
CON-20192124
- Patient Care & Health Information
- Diseases & Conditions
- Pseudobulbar affect