Emotional lability is a neurological condition that causes uncontrollable laughing or crying, often at inappropriate times. It tends to affect people with preexisting neurological conditions or injuries.
It has many other names, including:
- pathological laughing and crying
- pseudobulbar affect
- affective lability
- emotional incontinence
- involuntary emotional expression disorder
While the symptoms of emotional lability seem psychological, they’re actually a result of changes to the part of your brain that’s responsible for emotional control.
The main symptoms of emotional lability are uncontrollable outbursts of crying or laughing. These outbursts are usually an exaggerated or inappropriately intense emotional reaction. They can also be completely unrelated to your current emotional state. For example, you might start laughing uncontrollably when you’re upset.
Other symptoms of emotional lability include:
- short emotional outbursts that don’t last for more than a few minutes
- mixed emotional outbursts, such as laughing that turns into crying
- lack of emotional symptoms between episodes
- laughing or crying in situations that other people don’t find funny or sad
- emotional responses that are over-the-top for the situation
- emotional outbursts that are very different from your usual behavior
Strokes happen when a blood vessel in your brain bursts or something cuts of your brain’s blood supply. This causes brain cells to start dying within minutes, which can damage the parts of your brain responsible for memory, language, and emotion.
Researchers aren’t sure about the exact cause of emotional lability after a stroke. However, the most popular theory suggests it’s related to damage to the connections between the brainstem and frontal lobes.
In addition to strokes, neurological conditions and traumatic brain injuries (TBIs) can lead to emotional lability.
Common neurological conditions that can cause emotional lability include:
Types of TBIs that can cause emotional lability include:
Emotional lability is often misdiagnosed as depression or another mental health condition. To make getting a diagnosis easier, try to keep a journal of your symptoms, including when they occur and how long they last. If possible, note your general mood and emotional state between outbursts. If you don’t notice any emotional symptoms between episodes, it’s a good indicator that you likely have emotional lability, rather than a psychological condition.
Make sure to tell your doctor about any recent head injuries or underlying conditions. You might also find it helpful to bring along a loved one who’s observed your emotional outbursts.
While there’s no specific test for diagnosing emotional lability, your doctor will ask you a series of questions about your medical history and moods to confirm the diagnosis.
More mild cases of emotional lability may not need treatment. However, if it causes significant stress, certain medications can help to reduce the severity and frequency of your outbursts. This can make the condition much more manageable and less destructive in social situations.
Medications often used to treat emotional lability include:
Low doses of antidepressants may reduce the intensity of your emotional outbursts and make them occur less often.
Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta)
This is currently the only medication approved by the FDA to specifically treat emotional lability. Clinical studies in people with neurological conditions found that it reduced the frequency of emotional outbursts by about half.
Living with emotional lability can be frustrating, especially if it makes it hard for you to participate in social situations or those close to you don’t understand your condition.
Here are a few tips for coping with emotional lability:
- Take frequent breaks from social situations to calm yourself.
- Look for a local support group or online community to meet other people dealing with the condition that caused your emotional lability.
- Practice slow breathing techniques and focus on your breath during episodes.
- Figure out what triggers your episodes, such as stress or fatigue.
- Distract yourself from rising emotions with a change of activity or position.
- Distract yourself by counting objects in the room or counting your breath.
- If you have an episode, try to move on with your day and avoid dwelling on it.
- Prepare a short explanation to give to people who may be confused by your behavior, such as: “Since my stroke, I giggle sometimes. Just ignore it.”
The long-term outlook for people with emotional lability depends on the underlying cause. If you have permanent brain damage from a stroke, you may continue to have outbursts for the rest of your life. However, over time, you may be able to identify things that trigger your outbursts or come up with ways to distract yourself when you feel one coming on.
If your episodes start to cause you a lot of stress, medication may also help. Work with your doctor to find treatment options that work best for you.