Table of ContentsView AllTable of ContentsCausesDiagnosisTreatmentComplicationsCoping
Table of ContentsView All
View All
Table of Contents
Causes
Diagnosis
Treatment
Complications
Coping
Studies have estimated that up to 2 million people in the United States have PBA and that up to 7 million people in the United States exhibit PBA symptoms.
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What Causes PBA?
The disruption in central nervous system functioning that causes PBA can be a result of various preexisting neurological conditions, including:
Each of these conditions is a risk factor for PBA as it disrupts how the brain functions. For example, in people with MS, brain lesions that disrupt neurotransmitters (chemical messengers that help nerve cells, or neurons, to communicate with each and other body cells), brain atrophy (loss of neurons in the brain), brain atrophy, and the use of steroids can increase the risk of developing PBA.
Why PBA Is Not a Mental IllnessIntense emotional episodes due to PBA are often mistaken for mental illness. For example, excessive crying is often confused with depression.PBA is not a mental illness but rather a neurological problem associated with preexisting neurological conditionsthat cause damage to the nervous system.PBA is often misdiagnosed as a psychiatric disorder, including depression, but differs from some mood disorders in that it causes explosive, noncontinuous, and irregular emotional responses.Sudden emotional reactions are a distinguishing feature of PBA compared to depression.
Why PBA Is Not a Mental Illness
Intense emotional episodes due to PBA are often mistaken for mental illness. For example, excessive crying is often confused with depression.PBA is not a mental illness but rather a neurological problem associated with preexisting neurological conditionsthat cause damage to the nervous system.PBA is often misdiagnosed as a psychiatric disorder, including depression, but differs from some mood disorders in that it causes explosive, noncontinuous, and irregular emotional responses.Sudden emotional reactions are a distinguishing feature of PBA compared to depression.
Intense emotional episodes due to PBA are often mistaken for mental illness. For example, excessive crying is often confused with depression.
PBA is not a mental illness but rather a neurological problem associated with preexisting neurological conditionsthat cause damage to the nervous system.
PBA is often misdiagnosed as a psychiatric disorder, including depression, but differs from some mood disorders in that it causes explosive, noncontinuous, and irregular emotional responses.Sudden emotional reactions are a distinguishing feature of PBA compared to depression.
How PBA Is Diagnosed
PBA is often mistaken for something else, like depression, or missed altogether as symptoms of associated neurological disorders can cover up PBA symptoms.
The questionnaire has seven questions to assess control of crying and laughing, with each question getting a score of 1 (applies never) to 5 (applies most of the time). The score can range from 7 to 35, with some studies stating a score of 13 or higher indicates PBA symptoms.Higher CNS-LS scores have been linked to worse quality of life.
Accurate diagnosis of PBA is important as, unlike some mental illnesses, it can’t be treated with therapy or counseling.However, antidepressants may be used as a treatment for PBA, discussed in more detail below.
Talk to a healthcare provider or neurologist if you experience symptoms of PBA. They may give you the CNS-LS questionnaire and ask you questions to help determine if PBA is at play and design a treatment plan accordingly.
How PBA Is Treated
Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (sertraline) and Celexa (citalopram), have also been prescribed to help with PBA.While they may help manage PBA symptoms, they are not a cure for PBA.
In addition to drug treatments, like medications, it’s important for people with PBA to have support from caregivers, family, and friends. Counseling to help with the social aspects of living with PBA, such as embarrassment and distress from inappropriate emotional reactions, may also make living with PBA more manageable.
Outlook and Possible Complications of PBA
Emotional outbursts due to PBA can cause embarrassment and distress.The potential of laughing uncontrollably at something not funny or crying hysterically for no apparent reason can make social situations fraught with anxiety. This can then lead to social isolation.
In addition, PBA symptoms can disrupt daily functioning, including at work, and strain relationships, adding to the caregiver burden.Taken together, these disruptions can significantly impact quality of life.
Ways to Cope with PBA
PBA impacts everyday life. Part of coping with PBA involves understanding and patience on the part of loved ones and yourself. It’s important to keep in mind that emotional episodes due to PBA are involuntary—they are certainly not intentional. If you have PBA, it may help to talk honestly with your loved ones about what it’s like to live with PBA to garner an understanding
The following coping strategies and practical tips may also help manage daily life with PBA:
Ask a healthcare provider such as a neurologist for other practical, everyday strategies to help make PBA episodes less intense and reduce their impact on your daily life.
Summary
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ahmed A, Simmons Z.Pseudobulbar affect: prevalence and management.Therapeutics and Clinical Risk Management. 2013;9:483-489. doi:10.2147/TCRM.S53906Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.American Journal of Managed Care. 2017;23(18).Multiple Sclerosis Association of America.Pseudobulbar affect (PBA).American Stroke Association.Pseudobulbar affect (PBA).Johns Hopkins Medicine.Multiple sclerosis and mental health: 3 common challenges.Brooks BR, Crumpacker D, Fellus J, Kantor D, Kaye RE.PRISM: a novel research tool to assess the prevalence of pseudobulbar affect symptoms across neurological conditions.PLoS One. 2013;8(8):e72232. doi:10.1371/journal.pone.0072232
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ahmed A, Simmons Z.Pseudobulbar affect: prevalence and management.Therapeutics and Clinical Risk Management. 2013;9:483-489. doi:10.2147/TCRM.S53906Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.American Journal of Managed Care. 2017;23(18).Multiple Sclerosis Association of America.Pseudobulbar affect (PBA).American Stroke Association.Pseudobulbar affect (PBA).Johns Hopkins Medicine.Multiple sclerosis and mental health: 3 common challenges.Brooks BR, Crumpacker D, Fellus J, Kantor D, Kaye RE.PRISM: a novel research tool to assess the prevalence of pseudobulbar affect symptoms across neurological conditions.PLoS One. 2013;8(8):e72232. doi:10.1371/journal.pone.0072232
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ahmed A, Simmons Z.Pseudobulbar affect: prevalence and management.Therapeutics and Clinical Risk Management. 2013;9:483-489. doi:10.2147/TCRM.S53906Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.American Journal of Managed Care. 2017;23(18).Multiple Sclerosis Association of America.Pseudobulbar affect (PBA).American Stroke Association.Pseudobulbar affect (PBA).Johns Hopkins Medicine.Multiple sclerosis and mental health: 3 common challenges.Brooks BR, Crumpacker D, Fellus J, Kantor D, Kaye RE.PRISM: a novel research tool to assess the prevalence of pseudobulbar affect symptoms across neurological conditions.PLoS One. 2013;8(8):e72232. doi:10.1371/journal.pone.0072232
Ahmed A, Simmons Z.Pseudobulbar affect: prevalence and management.Therapeutics and Clinical Risk Management. 2013;9:483-489. doi:10.2147/TCRM.S53906
Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.American Journal of Managed Care. 2017;23(18).
Multiple Sclerosis Association of America.Pseudobulbar affect (PBA).
American Stroke Association.Pseudobulbar affect (PBA).
Johns Hopkins Medicine.Multiple sclerosis and mental health: 3 common challenges.
Brooks BR, Crumpacker D, Fellus J, Kantor D, Kaye RE.PRISM: a novel research tool to assess the prevalence of pseudobulbar affect symptoms across neurological conditions.PLoS One. 2013;8(8):e72232. doi:10.1371/journal.pone.0072232
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