Pseudobulbar Affect (PBA) is an unwanted behavior condition that may appear following a stroke. It often takes the form of uncontrolled crying or laughing, sometimes in inappropriate settings.
Stroke or another brain injury can impact the part of the brain that regulates how emotion is expressed. Instead of signaling for the correct emotion to be displayed, the brain sends incorrect signals to the face and other parts of the body, triggering the inappropriate or prolonged emotional outburst.
If you have pseudobulbar affect, you display unusual emotional outbursts that are not related to how you really feel. Often, this may take the form of crying, and may be mistaken for depression.
People who have PBA may show other signs of depression that are related to their brain disease or injury. You may begin to isolate yourself from other people because of the fear of displaying an inappropriate emotional response.
The cause of pseudobulbar affect is biological involving a traumatic brain injury or a neurological disorder. It’s a secondary reaction to primary conditions like multiple sclerosis, stroke or Parkinson’s disease. Multiple sclerosis causes pseudobulbar affect by damaging the nervous system. When our central nervous system sends a message, the brain misinterprets it, signaling an incorrect body function.
Science believes the cause of pseudobulbar affect results from damage to the prefrontal cortex, the section of the brain that controls the emotions of laughter and tears. It happens when something goes wrong in our body’s nervous system and the controls between the brain and our emotions malfunction causing pseudobulbar affect.
Medically, our neurological pathways involve multiple parts of the brain; one region’s message affects how another responds. When damage occurs, there are molecular changes triggering pseudobulbar affect, which alters our behavior controls.
The treatment for PBA can vary depending on how severe the symptoms are. For most people, PBA impacts the quality of life, so treating it is important. Many doctors prescribe an antidepressant at a low dose, which helps to regulate the brain and prevent the “short circuit” that may cause inappropriate displays of emotion. In other cases, a medication called Nuedexta may be prescribed to help prevent PBA episodes.
If your emotional outbursts interfere with your day-to-day life, an occupational therapist may be able to help you develop strategies for working around episodes of PBA.
There is no cure to prevent pseudobulbar affect, but treatments and therapy are available to help control its effect. Some doctors will prescribe medications to suppress the outburst of crying or laughing. Your doctor will decide the best medication for the condition since some medications may have side effects to your health.
The best self-therapy is to learn as much as you can about the disorder. It will help you to recognize an approaching episode and use relaxation techniques to ease the symptoms and decrease the severity or frequency. Sharing information about the condition with friends and family won’t make it any easier but helps so that in the event that an incident becomes serious, they will learn how to respond or seek help.
Talk with your medical doctor and ask about meeting with a cognitive therapist. The combination of treatments will boost your own self-help skills for gaining control over pseudobulbar affect behaviors.