What is PBA?

Pseudobulbar Affect (PBA) is a medical condition causing sudden, frequent, uncontrollable
crying and/or laughing that doesn’t match how the person feels.

Because PBA is often misunderstood, help starts with educating yourself on what it is. PBA can happen in people with a brain injury or certain neurologic conditions. PBA often occurs alongside mood disorders, like depression, but it’s important to know that PBA and depression are two are separate conditions that should be diagnosed and managed separately.

Marilyn, a caregiver to her husband with Pseudobulbar Affect (PBA) walking through a door
Marilyn, a caregiver to her husband with Pseudobulbar Affect (PBA) walking through a door
Marilyn is there for Jim in sickness and in health, including when he has a crying episode in public.
Read Their Story

Understand the impact.

Observe the impact PBA episodes could have on your loved one’s life.

  • Are they avoiding social events?
  • Are they not going out in public as much as they used to?
  • Do they suddenly dread going to work?
  • Have their daily routines changed since the episodes started?
Share details with their doctor. It’s critical to making an accurate PBA diagnosis.

What small actions can you take to make a big difference?

Lori, an advocate for her husband with Pseudobulbar Affect (PBA)
Lori, an advocate for her husband with Pseudobulbar Affect (PBA)
Lori advocated for her husband at his doctor’s appointments. And she continues to advocate for all PBA patients, so they get the help they need and deserve.
Read Their Story


all you can about PBA.

  • If you or your loved one haven’t yet take the PBA quiz
  • Understand the differences between PBA and depression and how someone can have both.
  • Join Our PBA Support Group on Facebook, where you can meet other people living with or affected by PBA.
  • Encourage your loved one to make an appointment with a doctor.


for your loved one’s health care.

  • If you’re able to, go to the doctor’s appointment with your loved one.
  • Discuss with their doctor the impact their episodes have had on their daily routines.
  • If you can’t accompany them to their appointment, help write down notes for them to share with the doctor so they can advocate for themselves.


your loved one in social situations.

  • Make a plan ahead of time, together.
  • Find a private place to take a break if they feel an episode coming on.
  • Take the lead on the situation and leave with your loved one if it becomes too much for them.
  • Let them know you are not embarrassed by them.
Health care professional and patient
Health care professional and patient

Make an appointment with their health care provider.

Your general practitioner can make a referral to a specialist such as:

  • Neurologist
  • Neuropsychologist
  • Psychiatrist
  • Internist

Remember: PBA can be managed, but a doctor needs to make the diagnosis.

PBA Quiz

Wondering if someone you care for might have PBA? This 7-question quiz can be used to start productive conversations with a health care provider.

The PBA Quiz

Could you or someone you care for have Pseudobulbar Affect (PBA)?

PBA happens in people with a brain injury or certain neurologic conditions, but PBA can often be confused with depression. The two are separate conditions with their own symptoms. This 7-question quiz can help determine if you have the symptoms seen with PBA and help you start discussions with your healthcare provider.

The Center for Neurologic Study-Lability Scale (CNS-LS) was developed by healthcare professionals to identify and measure PBA symptoms. It does not diagnose PBA and is not intended to substitute for professional medical assessment and/or advice. Please consult with your doctor.

Meet Our Caregivers

Each of our real caregivers play an important role in the life of their loved one. Read their stories below.

Have your own caregiver story?

If you’re interested in sharing your story as a caregiver, learn how you can become a PBA Ambassador

Learn more

The Partner

Jim has PBA. Marilyn is his spouse.

Marilyn and her husband Jim had been married for three weeks when he had two strokes in 2013. That’s when she became a caregiver. “Jim’s symptoms began after that, uncontrollable crying or laughing—he had never done that before,” says Marilyn. She remembers him having symptoms just two or three days after his stroke, while he was still in his hospital bed. “Our friends came to visit, and he had some pretty bad episodes, so we knew something was wrong.”

Jim’s doctors were familiar with PBA, so they were able to explain to him what he had. “Having a name put on the issue gave me hope. When you cannot put a name on something, you feel like you’re in limbo”

Marilyn helps Jim by being accepting and supportive of his condition, which has helped him remain social. “He continues to go to social activities, such as shopping, going to church, being out with friends. He feels bad when it happens. I think at first, he thought it was embarrassing for me and I told him it’s not. It’s improved so much.”

I think at first he thought it was embarrassing for me, and I told him it’s not.

The Cheerleader

Amy has PBA. Laura is her friend.

The first thing Laura remembers about Amy when they met at 18 was that she could dance like Axl Rose. “I thought she was the coolest chick ever.” Though they now live in different states, they’ve been friends ever since.

Laura remembers getting the news of Amy’s big accident. “It was terrible, scary,” she says.

Soon after, when Amy started not being able to control her laughing and crying, they would talk about it on the phone. “We both thought it was part of her brain injury. We didn’t understand it was a separate disorder,” Laura says. It wasn’t until Amy saw a PBA awareness commercial that she had a name for it.

“She called me one day and said, ‘I found out what’s going on, it’s PBA,” Laura says. She started doing her own research, “and everything I read was her down to a T.” Amy was able to get the support of her doctor, and the help she needed.

Laura has been a consistent support for Amy though phone calls, texts, and frequent visits. “She’s my best friend, and I’m five hours older than her, so she’s got to take care of me,” says Amy.

We didn’t understand it was a separate disorder.

The Champion

Lori’s husband has PBA.

When Lori’s husband started laughing and crying 15 years after his Parkinson’s diagnosis, she thought maybe he was just an emotional person. It took a while to figure out he also has PBA.

“It was a little crying here or there, maybe from a commercial, or when the grandkids walked in,” Lori says. Then, it was constant. Explaining it to the little ones wasn’t easy. “Papa just cries sometimes,” she’d tell them. Then they’d say, “Oh Papa, oh Papa.” And then he would try to help them feel better by saying he was OK. “It was hard on everyone,” she says.

At first his doctor suspected depression. But Lori and her husband both knew that wasn’t it. “He was a little sad here or there, but as quick as it came, that’s as quick as it stopped.”

“I had to be his advocate.” She talked further to the doctor about her husband’s experiences. The conversation helped him to diagnose her husband with PBA.

Now her favorite moments are when they’re together eating dinner, or traveling or going out socially, “which was hard before his diagnosis,” she says. “But now it’s a lot easier.”

I didn’t know what was going on with him.

PBA Nurse Talk

This program gives those experiencing relevant symptoms the opportunity to speak with a registered nurse about PBA.

Learn more and find out if you're eligible