Uncontrolled emotional outbursts are common after a stroke and are sometimes attributed to the so-called pseudobulbar effect. This secondary effect of stroke results in extreme emotional reactions that could be inappropriate to the situation or context. For instance, you could start sobbing uncontrollably when you’re only barely sad for some reason. One other example is laughing at situations that should not necessarily funny.

Pseudobulbar affect could be distressing or frustrating for stroke survivors. Fortunately for survivors, there are some options available to assist address this secondary effect. To assist you to understand this condition, we are going to discuss the causes and symptoms of pseudobulbar affect. We are going to then review the varied treatments available to survivors who experience pseudobulbar symptoms. Different people will respond otherwise to treatment, so it is vital to grasp all treatment options before you start.

Causes of pseudobulbar affect

Pseudobulbar seizures (PBA), also referred to as emotional lability, occur after damage to the areas of the brain that regulate emotions. This will occur because of this of a stroke, traumatic brain injury, or other neurological conditions.

The mechanism behind PBA remains to be not fully understood, nevertheless it involves interference emotional pathways within the brain. One area of ​​the brain called the cerebellum is now thought to play a much larger role in pseudobulbar affect than previously suggested. Moreover, although scientists are still divided on which areas of the brain control emotions, they do limbic system is believed to be heavily involved. This includes areas of the brain comparable to the hypothalamus, hippocampus, and amygdala.

If a stroke affects any of those areas, it will probably cause emotional disturbances comparable to pseudobulbar affect. Survivors should do not forget that every stroke is different and each brain has unique wiring. Because of this pseudobulbar effects should not limited to strokes within the limbic system or cerebellum.

Survivors should ask their medical team in regards to the location of the stroke. By doing this, you possibly can higher understand your specific symptoms and why you could be experiencing unwanted side effects like PBA. Before we delve into treatment options for pseudobulbar affect, let’s discuss the common symptoms of this condition.

Symptoms of pseudobulbar affect

A characteristic symptom of pseudobulbar affect is random, uncontrolled emotional outbursts, comparable to laughing or crying. Often, these emotions are an exaggerated response to something the person is already feeling. Nonetheless, sometimes emotions may not reflect an individual’s true feelings.

For instance, a stroke survivor with pseudobulbar symptoms may normally laugh hysterically. Likewise, a survivor may begin to cry even in the event that they should not unhappy. A survivor with pseudobulbar affect may experience mood swings from one emotional extreme to a different. These emotional outbursts can last anywhere from seconds to minutes.

Uncontrolled emotional outbursts could be distressing for each the person affected by pseudobulbar affect and people around them. Along with the frustration and discouragement it will probably cause, these emotional outbursts could be embarrassing. Fortunately, there are treatment options for post-stroke pseudobulbar syndrome to assist survivors deal with these emotional changes.

Avoiding misdiagnosis of pseudobulbar affect

Probably the most common treatments for pseudobulbar affect include medications and psychotherapy. Nonetheless, due to its impact on emotional expression, it is commonly incorrectly labeled as post-stroke depression or one other mood disorder. Accurate diagnosis of pseudobulbar syndrome is amazingly necessary because treatment for these different conditions may vary.

To assist your doctor find the best treatment, try to explain your symptoms as precisely as possible. For instance, one among the important thing differences between pseudobulbar affect and depression is that PBA causes outbursts of crying or laughing for no apparent reason. Moreover, these outbursts often only last for a short while and should occur several times a day.

Subsequently, you must not simply tell your doctor that you simply cry or laugh more often after a stroke. Be specific and tell them that there is commonly no reason for emotional outbursts. This can help your doctor make an accurate diagnosis. Moreover, it might be helpful to maintain a diary of those outbreaks to permit your medical team to raised understand any patterns or specific symptoms. Once a correct diagnosis has been made, the medical team may help determine different treatments for pseudobulbar syndrome.

Treatment of pseudobulbar affect

One strategy for coping with pseudobulbar affect is taking medication. Medications can minimize the severity of emotional outbursts and make them occur less continuously.

One among the major treatments for pseudobulbar affect is antidepressants. Probably the most effective antidepressants for reducing pseudobulbar affect include:

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Citalopram (Celexa)

Several studies have shown that these antidepressants reduce the danger of laughing and crying greater than placebo. Although antidepressants may help, the FDA has not approved them for the treatment of pseudobulbar syndrome. Fortunately, the FDA has approved a drug specifically designed to treat PBA, so-called Nuedexta.

Studies found that patients taking Nuedexta had half as many emotional outbursts as those taking placebo. Symptoms often improve inside the first week of treatment. Consult with your doctor about your symptoms to assist develop a treatment plan that is perfect in your individual needs.

Additional coping techniques

Although medication is the one scientifically proven treatment for PBA, many stroke survivors have found it effective by utilizing quite a lot of coping mechanisms. Some psychologists recommend, for instance, the so-called emotional practice. Emotional practice is a cognitive-behavioral technique that goals to reprogram the brain to grow to be higher in a position to control emotions again. You’ll do that by practicing feeling the suitable emotions in a given contextual situation.

For instance, when watching a funny movie, try saying to yourself, “I feel completely satisfied watching this.” Even should you do not feel anything yet, the goal is to create a connection in your brain between emotion and activity. The thought is that with enough practice, your brain can begin to reply higher to emotional situations. This method has not been clinically tested like other treatments for pseudobulbar syndrome. Medicines are still considered probably the most effective treatment method.

Along with emotional practice, there are other ways to take care of symptoms of pseudobulbar affect. A few of these coping techniques include:

• Talking to friends, family or a support group about your experiences with pseudobulbar affect
• Practicing deep respiration or rest techniques
• Change of position or getting distracted while you feel like you would possibly experience an outburst
• PBA research to raised understand why these emotional changes and outbursts occur

Understanding and treating PBA after stroke

Post-stroke pseudobulbar affect causes survivors to experience extreme emotional outbursts. These outbursts could be frustrating and make it difficult to take part in activities you enjoy. Nonetheless, treatment options can be found to survivors of pseudobulbar syndrome.

Medicines like Nuedexta may help relieve the symptoms of PBA and help you regain control of your emotions. In some cases, antidepressants may be appropriate. Consult with your doctor about what treatment options could also be best for you.

Along with pharmacological treatment of pseudobulbar symptoms, some survivors use techniques to deal with emotional outbursts. Strategies comparable to emotional practice, rest techniques, and distraction can reduce the frequency of outbursts. Moreover, it is vital to consult with family members or other survivors about your experiences. To try locating a support group in your community should you think it will be a helpful resource. More detailed information on coping with the emotional effects of a stroke could be present in our book Healing and happiness after a stroke.