UNDERSTANDING PBA

Pseudobulbar affect (PBA) is a neurological condition involving involuntary, sudden, and frequent episodes of laughing or crying.

What is Pseudobulbar Affect?      |       Recognizing Signs & Symptoms      |      Differentiating PBA from Depression      |      FAQs

WHAT IS PSEUDOBULBAR AFFECT?

Pseudobulbar affect, or PBA, is a neurological condition causing sudden, uncontrollable crying, and/or laughing that does not match how the person feels. Often misdiagnosed as a mood disorder, PBA is neurological condition that occurs because of an existing neurological disorder or disease, such as:

Doctor examining a patient

IF THIS SCENARIO LOOKS FAMILIAR, YOU MAY KNOW SOMEONE WITH PBA.

Research indicates PBA involves an injury to the neurological pathways that regulate the external expression of emotion. When neural pathways are disrupted, a person may involuntarily express emotions that are not appropriate to the situation.

HOW IT WORKS.

Normally, the cerebral cortex (at the front of the brain) communicates with the cerebellum (at the back of the brain) to control our emotional responses to situations. But, sometimes, the cerebellum becomes damaged by lesions or nerve problems, disrupting communication between these two areas. PBA is thought to result from this miscommunication. Individuals who have PBA may laugh uncontrollably in response to something that is not funny or cry for no apparent reason.

Proposed brain circuitry involved in emotional expression and its hypothesized dysfunction in pseudobulbar affect (PBA).

Source: Pseudobulbar affect: the spectrum of clinical presentations, etiologies and treatments. Miller, A., Pratt, H., & Schiffer, R.B., Expert Review of Neurotherapeutics. January 9, 2014, Taylor & Francis Ltd, http://www.tandfonline.com

A doctor with a clipboard and a patient

FIVE FACTS TO KEEP IN MIND:

  1. PBA is a condition that occurs secondary to a neurological disorder or brain injury.
  2. Because crying is a common symptom, people often confuse PBA with depression. But PBA is different. It’s neurological – caused by damage to the nervous system. Depression is psychological – related to a person’s emotional or mental state.
  3. PBA episodes – such as uncontrollable laughter or involuntary crying – are unpredictable. They can occur any time and last several seconds or minutes.
  4. People who experience PBA (and their caregivers and those around them) may feel frustrated, embarrassed, worried and/or confused. Untreated, PBA may negatively impact everything from relationships and social situations to work and quality of life. Treatment can help.
  5. Symptoms can range from mildly disturbing to seizure-like episodes.