Talk to your doctor about managing PBA
Unpredictable episodes of sudden, frequent, uncontrollable crying and/or laughter can be a challenge. But you can begin to manage PseudoBulbar Affect (PBA) by taking these steps.
Talking to your doctor about PBA
- Take a short PBA quiz and show the results to your doctor
- Use this list to guide your conversation
Tell your doctor if this sounds like you or someone you care for:
- Sometimes feels fine one minute, then suddenly cries over the smallest things or for no reason
- Laughs at very inappropriate times
- Experiences added stress or frustration because of crying and/or laughing episodes
- Avoids spending time in public or with family and friends because of uncontrollable crying and/or laughing episodes
- Concerned that these episodes could be mistaken for depression or another disorder
Ask your doctor these questions:
Do these things at your next appointment:
Getting an accurate PBA diagnosis is key
Because PBA always happens with certain neurologic conditions or brain injury, its symptoms are often misunderstood. Sudden, frequent, uncontrollable crying or laughing from PBA can be mistaken for other states or conditions, such as:
- A mood disorder that causes persistent feelings of sadness. Learn more about PBA and depression here.
- Bipolar Disorder
- A disorder associated with mood swings
- Excessive laughter sometimes associated with conditions like multiple sclerosis (MS)
- (post-traumatic stress disorder) – A disorder that follows a traumatic event, sometimes associated with conditions like traumatic brain injury (TBI)
- A feeling sometimes communicated through crying, especially in people with Alzheimer’s disease
It is possible to have any of these symptoms while having PBA. Each condition should be diagnosed and managed by a doctor.
Only your doctor can diagnose PBA. That's why it's important to give a full picture of your laughing and/or crying episodes —including how often they occur and their impact.
Supporting someone with PBA
If you know or care for someone with PBA, you may be wondering how you can help.
Show them you understand
People with PBA often say they feel embarrassed. They may not want to talk about their condition. Let them know you understand that:
- PBA episodes are not something they can control
- They’re not alone: about 7 million people in the US with neurologic conditions or traumatic brain injury have symptoms that may suggest PBA. It is thought that almost 2 million people in the US have PBA*
- PBA is not their fault
*When considering patients with any of 6 common neurologic conditions associated with PBA, it is estimated that 37%, or an estimated 7.1 million Americans, have symptoms suggestive of PBA as defined by a CNS-LS (Center for Neurologic Study-Lability Scale) score ≥13 and 9.4% of patients, or an estimated 1.8 million Americans, with CNS-LS scores ≥21. The presence of PBA symptoms was defined as a CNS-LS score ≥13 and a more restrictive definition was also evaluated using CNS-LS ≥21. The CNS-LS was validated as a PBA screening tool in ALS and MS populations. A CNS-LS score ≥13 merits further diagnostic assessment.
It’s OK if you don’t always feel OK