Pseudobulbar Affect: All about this rare mental health condition

Pseudobulbar Affect (PBA) is a rare disorder that affects the nerves of the brain and causes outbursts of uncontrolled or inappropriate laughing or crying. These episodes do not generally match the occasion or event that the person might face, and may be triggered by a few incidents like watching a sad movie. However, these emotions cannot be controlled and are intense in most cases. PBA is also referred to by several other names, like ‘emotional lability’, ‘pathological laughing and crying’, ‘compulsive laughing or weeping’, and ‘emotional incontinence’.

For a person suffering from PBA, it can considerably impact their life along with that of their family members and caregivers. This condition can cause severe embarrassment and anxiety to the patient, leading to the patient tending to withdraw from their social circles.

crying involuntarily
What is Pseudobulbar Affect? Image Courtesy: Shutterstock

Who does PBA affect?

PBA affects both children and adults who already have an underlying neurological condition. According to studies, it is estimated that PBA affects the following categories of people and puts them at a higher risk:

  • Almost 50 per cent of people affected with PBA have Amyotrophic Lateral Sclerosis (ALS), a disease that weakens the muscles of the body and impacts physical function.
  • Nearly 48 per cent of people with traumatic brain injury can suffer from PBA.
  • Approximately 46 per cent of people with Multiple Sclerosis (MS) can be affected by PBA.
  • Alzheimer’s Disease and other forms of Dementia can put people at risk for PBA.
  • PBA also affects patients with stroke, Parkinson’s disease, brain tumours, epilepsy, and Wilson’s disease.

Does PBA cause mental illness?

Since PBA is caused as a result of damaged neurological circuitry in the brain, it is best to consider this as a neuropsychiatric syndrome. Alternatively, PBA is a brain condition caused by dysfunctional emotional expression. Since mood is a subjective experience of emotions like sadness, anger, or happiness, people with PBA cannot express their feelings like ordinary people.

What are the main symptoms of PBA?

The main signs and symptoms of PBA are generally a lot of crying or laughing that does not match the mood or the situation’s intensity. These laughing and crying episodes are often unpredictable, sudden, and involuntary, and they generally happen for no apparent reason, although they can sometimes have a trigger.

Pseudobulbar Affect
What are the symptoms of Pseudobulbar Affect? Image courtesy: Shutterstock

Which part of the brain does PBA affect?

Depending on the individual, PBA is likely to affect various regions along with the cerebro-ponto-cerebellar pathway in the brain. This disease can disrupt the neural pathways from specific areas of the brain to its cerebellum, leading to a loss or lack of control over various human emotions.

How is pseudobulbar affect treated?

There’s no cure for pseudobulbar affect, but certain medications available in the market can help to manage the condition. The main goal of any treatment related to PBA is to reduce the frequency and severity of episodes that affect the patient. Some FDA-approved medicines include – Dextromethorphan/ Quinidine Sulfate and a combination of antidepressants, although these doses are generally lower than the doses required to treat Depression.

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