Do You Cry Too Much? Living With Pseudobulbar Affect

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Do you think you cry too much? Becoming easily tearful is a more common problem than you probably realize. Most of the time, we associate crying with the feeling of sadness. Some people are just very emotional and burst into tears frequently. And there is nothing wrong with that. Feeling sad or depressed can also cause weepiness.

But, if you find yourself embarrassed about your excessive crying, or if you suddenly start to weep when you don't even feel sad, you could have a problem called pseudobulbar affect.

Pseudobulbar affect can be caused by a number of neurological problems, such as Parkinson's disease, stroke, and head trauma.

Why Are You Crying?

If you have a tendency to get teary eyed, concerned friends may ask, "why are you crying?" And, chances are, you often ask yourself the same question. There are a variety of reasons for excessive crying, and you should not be upset with yourself about it. However, it may be useful for you to figure out the cause of your frequent sobs so that you can get help if you have a medical problem.

Mourning a Sad Event

Crying is perfectly understandable when you are sad about something. Loss of a loved one, losing a job, a breakup, a disappointment, stress, and conflicts are among the many reasons that people cry.

The event that has been causing you to cry more than usual may be unique, or it may be a situation that many people go through. Whatever has made you sad or stressed, crying is a normal response.

In fact, crying can help some people deal with emotions more effectively than ‘holding it in.’

People might cry several times per day for years after losing a loved one. But the frequency of crying is expected to diminish with time. You may need to take time off from a few of your responsibilities as you mourn.

Mourning a sad event is usually associated with crying episodes that may continue to occur for days, weeks, or months.  Eventually, if you are mourning, you should expect to experience some improvement or recovery, even if you continue to feel deeply sad about the loss and become occasionally tearful for years.

Depression

Depression goes beyond regular sadness or mourning and may affect daily life. If you are depressed, you might frequently feel sad and you might or might not repeatedly cry. If you have any of the signs of depression, you need to seek help to better manage your problem.

Pseudobulbar Affect

Pseudobulbar affect is a condition caused by damage to the nervous system. People who have pseudobulbar affect may feel very emotional and may go through frequent or extreme mood swings.

In addition to feeling moody, people who suffer from pseudobulbar affect also act moody and have trouble regulating emotional expressions, such as crying and laughing.

Crying even when you are not sad is one of the most upsetting symptoms of pseudobulbar affect.

Sometimes people who suffer from pseudobulbar affect start to weep and cannot understand why. The crying can be sudden and it may be mild or extreme. Tears may last for seconds or can continue for a while.

If you have pseudobulbar affect, you might also laugh excessively or inappropriately, even when there is nothing funny.

Why Do I Have Pseudobulbar Affect?

Many illnesses that affect the brain are known to produce pseudobulbar affect. As many as 20-50% of stroke survivors experience pseudobulbar affect, often experiencing erratic emotions, and sometimes crying or laughing even without the feelings of sadness or happiness. Parkinson's disease is commonly associated with pseudobulbar affect. Survivors of head trauma are also prone to pseudobulbar affect.

The reason that neurological diseases cause pseudobulbar affect is that these conditions disrupt the normal function of the neurons in the brain, making it difficult to regulate emotional expressions.

What Can You Do About Your Symptoms of Pseudobulbar Affect?

There are a few approaches to the management of pseudobulbar affect, but there is not a cure. That means that if you have this problem, you might need to take medication to control it, but you will probably need to follow up with your doctor for several years.

Behavioral Training

You can try to train yourself to avoid crying. Sometimes, you can decrease the tearfulness with self-control techniques and even by blinking your eyes or smiling. Most of the time, it is not possible to completely prevent the tears with self-control methods alone. Some people with pseudobulbar affect regularly meditate as a way to gain a degree of control over the crying and laughing episodes.

Medication

There are some medications used to help control pseudobulbar affect. Your doctor can give you a prescription and you can keep a diary to record the frequency of your tearfulness to evaluate how well the medicine is working.

Get It Out in the Open

If your primary concern about your symptoms is in how other people think of you, this is completely understandable. You can give a simple explanation to friends and close coworkers so that they will not worry about you and also so that you can explain that you are aware of your problem, that it has a name and a medical cause. As with many other medical conditions, people may simply be expressing concern and it can be easier to get out in the open. A few sample phases include,

"My brain makes me do this,"

"Crying is an effect of my concussion,stroke etc.”

“There are worse problems I am fortunate not to have."

Will My Pseudobulbar Affect Get Better or Worse?

The condition can get better or worse over time. It may get worse with repeated strokes or head trauma. After a stroke or head trauma, the symptoms of pseudobulbar affect tend to be the most severe within a few months after the event, and then typically improve over time.

If your pseudobulbar affect is caused by a neurological illness such as Parkinson’s disease, Multiple Sclerosis or Alzheimer’s disease, it may worsen as the disease progresses.

A Word From Verywell

A stroke can cause a range of behavioral and emotional changes, such as depression, losing your sense of humor and even excessive jealousy. Losing control of your emotions and your expressions can make you feel powerless. It is not easy living with pseudobulbar affect. When you understand that your excessive crying or inappropriate laughter is not your fault and that it is caused by a medical condition, you can take steps to control your symptoms. 

Sources:

Neuronal Dysregulation in Stroke-Associated Pseudobulbar Affect (PBA): Diagnostic Scales and Current Treatment Options, Lapchak PA, J Neurol Neurophysiol. 2015 Oct;6(5). pii: 323. Epub 2015 Oct 31

Prevalence of Pseudobulbar Affect following Stroke: A Systematic Review and Meta-Analysis, Gillespie DC, Cadden AP, Lees R, West RM, Broomfield NM, J Stroke Cerebrovasc Dis. 2016 Mar;25(3):688-94

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