PBA or Pseudobulbar Affect is not Depression

PBA is neurologic resulting from stroke, alzheimer's, dementia, parkinson's, a traumatic brain injury, lou gehrig's disease, multiple sclerosis.  Photo from https://www.pbafacts.comRecently, you’ve probably noticed the commercials on tv talking about PBA. I had never heard of it, until a year ago when we took on a new client with PBA or Pseudobulbar Affect. PBA is not depression it is a neurological condition that causes uncontrollable laughing or crying – emotions that someone may not even be feeling at the time of the outbursts.

According to the pbafacts.com website: “One of the jobs of the brain is to figure out how we feel in the moment. That information is then sent down the brain stem, also known as the “bulb.” The brainstem then sends signals to the face and other parts of the body that show emotion.

PBA is believed to be the result of a disruption of these signals. When people have certain neurologic conditions or brain injuries, it can cause damage in the brain tissue that creates a disconnection between the parts of the brain that express emotion and those that control emotion. The result is the frequent outbursts of involuntary crying or laughing known as pseudobulbar affect. If you break the term down literally, “pseudo” means false, “bulbar” refers to the brain stem and “affect,” describes how the body shows mood or emotion.”

Nearly 2 million people who have suffered from a brain injury or neurologic condition have PBA. Some of the brain injuries or conditions that can cause PBA include:
*Lou Gehrig’s disease
*Parkinson’s disease
*Traumatic Brain Injury (TBI)
*Multiple Sclerosis

People who suffer from PBA can have uncontrollable crying when they are happy and/or uncontrollable laughing when they are sad. Their outbursts do not necessarily reflect how they are feeling. Also, these outbursts are just that, outbursts. They are exaggerated and last longer than the situation calls for.

PBA can be treated with medication. But here are some tips with learning how to deal with this condition:

1. Keep an episode diary to help you and your doctor to understand what may trigger your episodes. You can download and print out a convenient diary form from here https://www.pbafacts.com/pba-tips .

2. Be open about it. Let people know that you cannot always control your emotions because of a neurologic condition. This can help ensure that people are not surprised, confused or insulted.

3. Distract yourself. If you feel an episode coming on, try to focus on something unrelated.

4. Breathe. Take slow deep breaths until you are in control.

5. Relax. Release the tension in your forehead, shoulders, and other muscle groups that tense up during a PBA episode.

6. Change your body positions. Note the posture you take when having an episode. When you think you are about to cry or laugh, change your position.

These tips are general coping techniques and are not substitutes for medical advice. Talk with your doctor about additional ways to cope with your PBA episodes and whether a treatment plan may be appropriate. For more information you can visit the PBAFacts website: https://www.pbafacts.com

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