Stroke Side Effects: Crying and Laughing Uncontrollably

Stroke can also cause cognitive problems

When someone is recovering from a stroke, most people think of physical problems like muscle weakness, but cognitive issues can be just as challenging to manage and overcome.

One common post-stroke symptom is a neurological condition called pseudobulbar affect, or PBA for short.

It causes uncontrollable laughing and crying, even in situations when it’s completely inappropriate.

And even though 53% of stroke survivors have reported PBA symptoms, less than 20% have heard of this disorder.

We explain what PBA is and why it causes these unintended emotional outbursts.

We also share 3 ways to support stroke survivors with PBA and 5 tips to help them cope with the symptoms.

Pseudobulbar affect causes uncontrollable laughing and crying

Pseudobulbar affect (PBA) is a neurological condition that causes uncontrollable crying or laughing.

These responses are exaggerated or inappropriate and usually don’t represent the person’s actual feelings.

Someone with PBA might laugh when hearing sad news, switch quickly from laughing to crying, or cry hysterically over something mildly sad.

They could also have spontaneous emotional outbursts, without any type of trigger.

These uncontrollable outbursts can be embarrassing, cause problems with social life and relationships, and cause your older adult to be unwilling to leave the house.

Even though 53% of stroke survivors have reported PBA symptoms, less than 20% have heard of this disorder.

This makes life even more difficult because it’s extra frustrating when you don’t know what’s wrong or why this strange behavior is happening.

 

Why does PBA cause uncontrollable emotional outbursts?

PBA happens when stroke damages areas in the brain that control how emotion is expressed.

The damage causes short circuits in brain signals, which trigger these involuntary episodes of laughing or crying.

Stroke is one cause of PBA, but it can also be caused by other neurological disorders like amyotrophic lateral sclerosis (ALS), Parkinson’s disease, traumatic brain injury, multiple sclerosis, dementia, Wilson’s disease, or brain tumors.

 

PBA is different from depression

Because PBA can cause uncontrollable crying after stroke, it’s often mistaken for depression.

That causes it to be underdiagnosed, undertreated, and sometimes inappropriately treated.

In general, depression is an ongoing feeling of sadness or hopelessness that can last for weeks or months.

PBA episodes are brief, spontaneous outbursts that might not reflect how your older adult really feels.

 

PBA treatment and 8 coping tips

It’s important to get a diagnosis to find out if your older adult truly does have PBA.

If that is the cause of the emotional episodes, the doctor may recommend a PBA drug or an anti-depressant.

These drugs are supposed to help control the symptoms, but may not completely get rid of the outbursts.

3 tips for supporting your older adult with PBA

1. Keep a log of emotional outbursts. By recording each episode, you can help their doctor make an accurate diagnosis.
2. Remind your older adult that their outbursts are a side effect of stroke, not a mental condition.
3. Let them know you support them, they’re not alone in this, and that many people suffer from PBA symptoms.

5 tips to help stroke survivors cope with PBA symptoms

1. Be open about the problem so family and friends aren’t surprised or confused when you have an episode.
2. When you feel an outburst starting, distract yourself by counting objects on a shelf or thinking about something unrelated.
3. Take slow deep breaths until you feel more in control.
4. Relax your forehead, shoulders and other muscles that tense up during an episode.
5. When you think you are about to cry or laugh, change your body position.

 

If you notice symptoms, talk with their doctor

If you’ve been struggling to understand why your older adult has been experiencing uncontrollable crying and laughing after their stroke, PBA could be the reason.

Check with their doctor or neurologist to get a diagnosis, treatment recommendations, and more information about how to manage the symptoms.

 

Next Step  Worried that your older adult has PBA? Take this quick assessment and discuss the results with their doctor

 

Recommended for you:

• 12 Home Modifications for Stroke Survivors Give Greater Independence
• 11 Adaptive Utensils and Eating Aids for Hand Tremors, Dementia, Parkinson’s, Stroke
• Dressing After Stroke: Tips to Regain Independence

 

By DailyCaring Editorial Team

 

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