Disordered Displays of Emotions: An Exploration of Pseudobulbar Affect

Abstract

For many of us, our emotional responses to situations seem to almost follow a universal script. Different scenarios generally tend to elicit different emotional outputs based on the affective tone of the scenario itself to the severity of its emotional quality. When we recount a mildly funny situation to a coworker by the water-cooler, we expect them to politely chuckle for a brief moment. Meanwhile, while watching comedy specials of our favorite comedians, we would predictably allow ourselves to let out gut-busting laughs complete with a touch of knee-slapping and a single happy tear. Spilling coffee on a favorite shirt would not draw out anything more than a frown, but news of the sudden death of a loved one may send us into a sustained, hysterical, body-racking cry. These are the emotional norms we follow both implicitly and deliberately. ‘X’ emotional stimulus outputs ‘y’ emotional response, in which ‘y’ is both mood-congruent and lasts for an appropriate duration of time. However, in some people with a rare neurological condition called Pseudobulbar Affect (PBA), something in this system gets disrupted. The bout of laughter that you and I would let out in response to a well-crafted stand-up joke may be elicited by a PBA patient even if they were not provoked. While I might feel a twinge of displeasure if I receive harsh feedback from an editor on this article, someone with PBA would probably exhibit a prolonged cry to something of a similar negative valence. This article explores the symptoms, underlying pathophysiology, and proposed treatment of Pseudobulbar Affect, a neurological condition marked by episodes of sudden, uncontrollable, mood-incongruent and inappropriate crying and / or laughing.