Pseudobulbar affect (PBA) is a neurological condition that can cause sudden, involuntary episodes of laughing or crying that may not match how a person actually feels. PBA can occur after stroke or other conditions that affect the brain and nervous system. A healthcare professional can help distinguish PBA from depression and other causes of emotional changes.
Damage to the brain caused by a stroke can cause emotional symptoms and personality changes that can be difficult for both the stroke survivor and their loved ones. One specific type of stroke damage that can be particularly unsettling is pseudobulbar affect.
What Causes PBA
PBA occurs when there is a communication disruption between the brain’s frontal lobe, which governs emotional responses, and the cerebellum and brain stem, which controls reflexes. The result can be displays of emotion that are inappropriate or disproportional.
One survey suggested that more than one quarter of stroke survivors demonstrate signs of PBA. Fortunately, patients do have some treatment options and they can also make adjustments to their routines to manage any PBA episodes that may occur.
Signs of PBA
PBA is associated with hallmark outbursts of crying or laughing due to the neurological disconnect between emotional and reflex control. Those outbursts can be:
- Involuntary
- Temporary
- Uncontrollable
- Often inappropriate
- Unpredictable
- Possibly disproportionate to the situation or trigger
Any stroke survivor or loved one who suspects that PBA might be present should consult with a physician to learn about treatment options and next steps.
PBA Treatment and Coping Strategies
Stroke survivors who are demonstrating signs of PBA should speak with their doctors to confirm the diagnosis and explore possible treatment options. PBA-specific medications are available, and talk therapy can be helpful in PBA management, as well.
Certain coping strategies can help to reduce the effects of PBA on your day-to-day life, such as:
- Distracting yourself by counting (such as all of the items of one color in a room) or thinking about something else if a PBA episode is imminent.
- Taking slow, deep belly breaths until you feel settled again.
- Engaging in progressive muscle relaxation to reduce the muscle tension that occurs during a PBA episode.
- Changing your body position or posture to disrupt the emotional response.
It can also be helpful to be upfront and honest with others about your condition. Having this information will help them to prepare and better manage their own response to any outbursts.
Hear from people living with neurological conditions and how they’ve reclaimed independence and read their patient stories.
PBA can be upsetting, but with the right treatments and techniques, it doesn’t have to be totally disruptive to your life. Talk to your doctor to find out how you can address this condition.
You can find more on life after a stroke, including communication strategies and support for caregivers, in our stroke recovery resources.