Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentComplications and Risk Factors
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Complications and Risk Factors
This article discusses labile affect—what it is, what causes it, how it is diagnosed, and ways it is treated.
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Symptoms of a Labile Affect
It’s normal to experience various emotions throughout the day, but these shifts in mood are typically related to things that happen or thoughts that are occurring.
People with a labile affect often experience extreme emotional reactions that may not relate to their current situation.These emotions are very strong and can seem to come out of nowhere. Oftentimes, these severe mood changes can interfere with daily activities.
Strong emotional reactions that shift rapidly are the main symptom of a labile affect. These can include:
Emotional labilityLabile moodEmotional incontinencePathological laughing and cryingPseudobulbaraffect (PBA)Involuntary emotional expression disorder (IEED)
Causes of a Labile Affect
People with certain neurological conditions and those with brain injuries can develop a specific type of labile affect calledpseudobulbar affect(PBA).These medical conditions affect the way the brain controls emotion, which leads to unpredictable outbursts of laughing or crying. These conditions include:
A labile affect can also occur with certain mental health and medical conditions, though the mood changes are not as sudden or inappropriate to the situation (like laughing uncontrollably in a serious setting).Mental health causes of a labile affect include:
What Medications Can Cause a Labile Affect?
Medications that may have a labile affect as a side effect includeoral corticosteroids, such as prednisone, and someantidepressants.
Are There Tests to Diagnose the Cause of a Labile Affect?
There are no tests to directly diagnose a labile affect. However, routine testing may be done to determine an underlying cause, such as a brain injury.
Mental health conditions that cause a labile affect are diagnosed using theDiagnostic and Statistical Manual of Mental Disorders(DSM-5). This clinical handbook gives mental health professionals specific criteria for determining whether or not a mental health condition is present.
Pseudobulbular affect (PBA) is diagnosed using history, mental status examinations, and neurological testing. Sometimes standardized questionnaires and scales are used.Certain criteria that might support the diagnosis of PBA include:
How to Treat a Labile Affect
A labile affect that is not severe might not require treatment. However, for many people, symptoms significantly interfere with daily life. Treatment for a labile affect can include medications and therapy.
Medications
Medications are generally targeted to any underlying condition that might be contributing to a labile affect. They include:
Therapy
Psychotherapy is very beneficial for people who live with a labile affect related to a mental illness. Two types of therapy that are used include:
Signs of Repressed Childhood Trauma in Adulthood
Tips for Coping With a Labile Affect
Several coping techniques can improve quality of life for a person with a labile affect:
Complications and Risk Factors Associated With a Labile Affect
Depending on the severity and cause, a labile affect can significantly impact one’s personal life. Persons with a labile affect may experience frequent feelings of frustration, embarrassment, uneasiness, and/or confusion, which can result in withdrawal or social isolation. It may also affect their ability to work, perform daily tasks, or maintain personal relationships.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
Summary
16 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.Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.Am J Manag Care. 2017;23(18 Suppl):S339-S344.Engelman W, Hammond FM, Malec JF.Diagnosing pseudobulbar affect in traumatic brain injury.Neuropsychiatr Dis Treat. 2014;10:1903-1910. doi:10.2147%2FNDT.S63304PBA Info.What is pseudobulbular affect?Goldin DS.Pseudobulbar affect: An overview.J Psychosoc Nurs Ment Health Serv. 2020;58(9):19-24. doi:10.3928/02793695-20200624-08Genetic and Rare Diseases Information Center.Pseudobulbar affect.Young FG, Nguyen D.Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report.J Med Case Reports. 2020;14(1):235. doi:10.1186/s13256-020-02525-3Kapugi M, Cunningham K.Corticosteroids.Orthopaedic Nursing.2019;38(5):336-339. doi:10.1097/NOR.0000000000000595Johns Hopkins Medicine.Mood disorders.Yang LPH, Deeks ED.Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect.Drugs. 2015;75(1):83-90. doi:10.1007/s40265-014-0328-zKazantzis N, Luong HK, Usatoff AS, Impala T, Yew RY, Hofmann SG.The processes of cognitive behavioral therapy: a review of meta-analyses.Cogn Ther Res. 2018;42(4):349-357. doi:10.1007/s10608-018-9920-yMay JM, Richardi TM, Barth KS.Dialectical behavior therapy as treatment for borderline personality disorder.Ment Health Clin. 2016;6(2):62-67. doi:10.9740%2Fmhc.2016.03.62Queensland Health Acquired Brain Injury Outreach Service.Understanding emotional lability.Brain Injury Association of America.Pseudobulbar affect (PBA).Lahaie FS, Fraser R.Diagnosis and treatment of comorbid borderline personality disorder and substance use disorder.Canadian Journal of Addiction. 2018;9(3):30-35. doi:10.1097/CXA.0000000000000027Preuss UW, Schaefer M, Born C, Grunze H.Bipolar disorder and comorbid use of illicit substances.Medicina. 2021;57(11):1256. doi:10.3390/medicina57111256Brådvik L.Suicide risk and mental disorders.Int J Environ Res Public Health. 2018;15(9):2028. doi: 10.3390/ijerph15092028
16 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.Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.Am J Manag Care. 2017;23(18 Suppl):S339-S344.Engelman W, Hammond FM, Malec JF.Diagnosing pseudobulbar affect in traumatic brain injury.Neuropsychiatr Dis Treat. 2014;10:1903-1910. doi:10.2147%2FNDT.S63304PBA Info.What is pseudobulbular affect?Goldin DS.Pseudobulbar affect: An overview.J Psychosoc Nurs Ment Health Serv. 2020;58(9):19-24. doi:10.3928/02793695-20200624-08Genetic and Rare Diseases Information Center.Pseudobulbar affect.Young FG, Nguyen D.Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report.J Med Case Reports. 2020;14(1):235. doi:10.1186/s13256-020-02525-3Kapugi M, Cunningham K.Corticosteroids.Orthopaedic Nursing.2019;38(5):336-339. doi:10.1097/NOR.0000000000000595Johns Hopkins Medicine.Mood disorders.Yang LPH, Deeks ED.Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect.Drugs. 2015;75(1):83-90. doi:10.1007/s40265-014-0328-zKazantzis N, Luong HK, Usatoff AS, Impala T, Yew RY, Hofmann SG.The processes of cognitive behavioral therapy: a review of meta-analyses.Cogn Ther Res. 2018;42(4):349-357. doi:10.1007/s10608-018-9920-yMay JM, Richardi TM, Barth KS.Dialectical behavior therapy as treatment for borderline personality disorder.Ment Health Clin. 2016;6(2):62-67. doi:10.9740%2Fmhc.2016.03.62Queensland Health Acquired Brain Injury Outreach Service.Understanding emotional lability.Brain Injury Association of America.Pseudobulbar affect (PBA).Lahaie FS, Fraser R.Diagnosis and treatment of comorbid borderline personality disorder and substance use disorder.Canadian Journal of Addiction. 2018;9(3):30-35. doi:10.1097/CXA.0000000000000027Preuss UW, Schaefer M, Born C, Grunze H.Bipolar disorder and comorbid use of illicit substances.Medicina. 2021;57(11):1256. doi:10.3390/medicina57111256Brådvik L.Suicide risk and mental disorders.Int J Environ Res Public Health. 2018;15(9):2028. doi: 10.3390/ijerph15092028
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.
Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.Am J Manag Care. 2017;23(18 Suppl):S339-S344.Engelman W, Hammond FM, Malec JF.Diagnosing pseudobulbar affect in traumatic brain injury.Neuropsychiatr Dis Treat. 2014;10:1903-1910. doi:10.2147%2FNDT.S63304PBA Info.What is pseudobulbular affect?Goldin DS.Pseudobulbar affect: An overview.J Psychosoc Nurs Ment Health Serv. 2020;58(9):19-24. doi:10.3928/02793695-20200624-08Genetic and Rare Diseases Information Center.Pseudobulbar affect.Young FG, Nguyen D.Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report.J Med Case Reports. 2020;14(1):235. doi:10.1186/s13256-020-02525-3Kapugi M, Cunningham K.Corticosteroids.Orthopaedic Nursing.2019;38(5):336-339. doi:10.1097/NOR.0000000000000595Johns Hopkins Medicine.Mood disorders.Yang LPH, Deeks ED.Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect.Drugs. 2015;75(1):83-90. doi:10.1007/s40265-014-0328-zKazantzis N, Luong HK, Usatoff AS, Impala T, Yew RY, Hofmann SG.The processes of cognitive behavioral therapy: a review of meta-analyses.Cogn Ther Res. 2018;42(4):349-357. doi:10.1007/s10608-018-9920-yMay JM, Richardi TM, Barth KS.Dialectical behavior therapy as treatment for borderline personality disorder.Ment Health Clin. 2016;6(2):62-67. doi:10.9740%2Fmhc.2016.03.62Queensland Health Acquired Brain Injury Outreach Service.Understanding emotional lability.Brain Injury Association of America.Pseudobulbar affect (PBA).Lahaie FS, Fraser R.Diagnosis and treatment of comorbid borderline personality disorder and substance use disorder.Canadian Journal of Addiction. 2018;9(3):30-35. doi:10.1097/CXA.0000000000000027Preuss UW, Schaefer M, Born C, Grunze H.Bipolar disorder and comorbid use of illicit substances.Medicina. 2021;57(11):1256. doi:10.3390/medicina57111256Brådvik L.Suicide risk and mental disorders.Int J Environ Res Public Health. 2018;15(9):2028. doi: 10.3390/ijerph15092028
Demler TL.Introduction to pseudobulbar affect: setting the stage for recognition and familiarity with this challenging disorder.Am J Manag Care. 2017;23(18 Suppl):S339-S344.
Engelman W, Hammond FM, Malec JF.Diagnosing pseudobulbar affect in traumatic brain injury.Neuropsychiatr Dis Treat. 2014;10:1903-1910. doi:10.2147%2FNDT.S63304
PBA Info.What is pseudobulbular affect?
Goldin DS.Pseudobulbar affect: An overview.J Psychosoc Nurs Ment Health Serv. 2020;58(9):19-24. doi:10.3928/02793695-20200624-08
Genetic and Rare Diseases Information Center.Pseudobulbar affect.
Young FG, Nguyen D.Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report.J Med Case Reports. 2020;14(1):235. doi:10.1186/s13256-020-02525-3
Kapugi M, Cunningham K.Corticosteroids.Orthopaedic Nursing.2019;38(5):336-339. doi:10.1097/NOR.0000000000000595
Johns Hopkins Medicine.Mood disorders.
Yang LPH, Deeks ED.Dextromethorphan/quinidine: a review of its use in adults with pseudobulbar affect.Drugs. 2015;75(1):83-90. doi:10.1007/s40265-014-0328-z
Kazantzis N, Luong HK, Usatoff AS, Impala T, Yew RY, Hofmann SG.The processes of cognitive behavioral therapy: a review of meta-analyses.Cogn Ther Res. 2018;42(4):349-357. doi:10.1007/s10608-018-9920-y
May JM, Richardi TM, Barth KS.Dialectical behavior therapy as treatment for borderline personality disorder.Ment Health Clin. 2016;6(2):62-67. doi:10.9740%2Fmhc.2016.03.62
Queensland Health Acquired Brain Injury Outreach Service.Understanding emotional lability.
Brain Injury Association of America.Pseudobulbar affect (PBA).
Lahaie FS, Fraser R.Diagnosis and treatment of comorbid borderline personality disorder and substance use disorder.Canadian Journal of Addiction. 2018;9(3):30-35. doi:10.1097/CXA.0000000000000027
Preuss UW, Schaefer M, Born C, Grunze H.Bipolar disorder and comorbid use of illicit substances.Medicina. 2021;57(11):1256. doi:10.3390/medicina57111256
Brådvik L.Suicide risk and mental disorders.Int J Environ Res Public Health. 2018;15(9):2028. doi: 10.3390/ijerph15092028
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