Pseudobulbar Affect Disorder: Causes, Symptoms, Diagnosis, Treatment and Complications

Pseudobulbar affect disorder (PBA) is characterised by bursts of unplanned, inappropriate crying or laughing. Pseudobulbar affect can be caused by specific neurological illnesses or injuries that impair an individual's capacity to control their emotions.

If you have pseudobulbar affect, you will feel emotions normally, but sometimes you will display them in inappropriate or too dramatic ways. As a result, the sickness could make you feel ashamed and make it difficult for you to go about your daily activities.

Pseudobulbar affect is frequently mislabeled or mistaken for mood disorders. Nonetheless, once pseudobulbar effects are identified, they can be treated with medication.

Causes Of Pseudobulbar Affect Disorder

Pseudobulbar affect (PBA) is frequently seen in people who have experienced trauma or neurological conditions like:

• a cerebrovascular accident
• Amyotrophic lateral sclerosis, or ALS
• Multiple sclerosis, sometimes known as traumatic brain injury
• Alzheimer's disease
• Parkinson's disease

Though more research is needed in this area, PBA is assumed to be caused by damage to the brain networks that control affect, or the outward presentation of emotion.

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Symptoms Of Pseudobulbar Affect Disorder

The primary symptom of pseudobulbar affect (PBA) is frequent, uncontrollable, involuntary crying or bouts of laughter that are exaggerated or unrelated to your emotional state. Usually, laughter is followed by tears. Your mood will seem normal during the times between episodes, which can occur at any time. It appears that sobbing is a more common sign of PBA than laughing.

PBA usually causes a prolonged emotional reaction, involving sobbing or laughing that lasts for many minutes. For example, you may find yourself laughing uncontrollably whenever someone says anything amusing. Or you may discover humour or melancholy in circumstances that others find intolerable or absurd. These emotional responses are typically a deviation from your normal behaviour.

Because pseudobulbar affect is often associated with sobbing, it is sometimes mistaken for depression. In contrast, PBA episodes usually last less time than depression, which leaves a person feeling hopeless all the time. Furthermore, PBA patients often do not experience symptoms of depression, such as appetite loss or insomnia. However, depression is a common occurrence in individuals with pseudobulbar affect.

Also Read: Schizoaffective Disorder: Causes, Symptoms, Diagnosis, Treatment and Complications

Diagnosis Of Pseudobulbar Affect Disorder

Pseudobulbar affect is often diagnosed by a neurological examination (PBA). Specialists including neuropsychologists, neurologists, psychiatrists, and internists can diagnose PBA.

PBA is often misdiagnosed as personality disorders, generalised anxiety disorder, bipolar illness, depression, and epilepsy. Provide your physician with specifics regarding your emotional outbursts so they can determine whether PBA is present.

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Treatment Of Pseudobulbar Affect Disorder

The goal of treating pseudobulbar affect (PBA) is to lessen the severity and frequency of emotional outbursts. Medication options consist of:

• Antidepressants drugs. Two antidepressants that can help decrease the frequency and severity of your PBA episodes are tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Antidepressant dosages are typically lower for PBA treatment than for depression treatment.
• Quinidine sulphate combined with hydrobromide dextromethorphan (Nuedexta). This is the only medication that the FDA has approved specifically for the treatment of PBA. In a trial involving MS and ALS, the frequency of episodes of laughing and crying was around half for those taking the medication and nearly half for those receiving a placebo.

Your doctor will work with you to choose the best course of action, taking into account any medications you take, any other conditions you may have, and any possible side effects. Additionally, you can work with an occupational therapist to develop coping mechanisms for performing daily chores despite your PBA.

Also Read: Illness Anxiety Disorder: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Complications Of Pseudobulbar Affect Disorder

Severe symptoms of pseudobulbar affect (PBA) can cause depressive, anxious, and humiliating feelings. The illness may make it more difficult for you to work and carry out daily tasks, especially if you already have to take care of a neurological problem.

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