Caregiver comforting PBA patient

Life with PBA symptoms

Tips for PBA

Sudden, frequent, uncontrollable laughter or crying can make things challenging at times. It’s important to talk to your doctor and get an accurate diagnosis, as PseudoBulbar Affect (PBA) symptoms can often be confused with other conditions such as depression.

PBA and depression are separate conditions that should be diagnosed and managed separately.

To make it a little easier to cope with PBA episodes, here are a few ideas from doctors and patients:

Educate those around you. Your PBA episodes may take people around you by surprise. The more you help them understand PBA, the more they’ll know how to react.

Try distracting yourself. If you feel a crying or laughing episode coming on, try focusing on something else.

Change the position of your body. When you think you are about to laugh or cry, try switching things up. If you’re standing, try sitting down. If you’re sitting, try getting up and walking.

Take deep breaths. Breathe in and out slowly until the episode passes.

Relax. Try to massage or release tension from your forehead, neck, shoulders, jaw, and other muscle groups that may tense up while you’re having a PBA episode.

These tips are general coping techniques and are not substitutes for medical advice from your doctor. Please talk to your doctor about more ways to cope with PBA episodes.

Learn what to tell your doctor with a free PBA Info Kit

This free guide helps you understand PBA and record the impact of your or your loved one's uncontrollable crying and/or laughing spells. You'll also find tips and questions to help at your doctor's appointment.

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Caregiver comforting loved one with PBA

What you can do to support someone with PBA

If you know or care for someone with PBA, you may be wondering how you can help. Here are some tips.

Show them you understand

People with PBA often say they feel embarrassed. They may not want to talk about their condition. Let them know you understand that:

  • PBA episodes are not something they can control
  • They’re not alone: about 7 million people in the US with neurologic conditions or traumatic brain injury have symptoms that may suggest PBA. It is thought that almost 2 million people in the US have PBA*
  • PBA is not their fault

It’s okay if you don’t always feel okay

Caregivers of people with PBA experience a wide variety of feelings:

  • They often feel confused or helpless, wondering where the crying or laughing is coming from
  • Some feel guilty about not knowing how to help
  • They may feel frustrated about the symptoms of PBA
  • Many also feel sad at seeing their loved one struggle with PBA

Feelings like these are normal and understandable. Whether you’re someone’s main caregiver or you provide occasional support, remember that PBA affects everyone—not just the person who has it.

Remember to take care of yourself

Sometimes it’s easy to put all the focus on the person you’re caring for—and forget to care for yourself. Make sure to establish healthy habits of your own, such as:

  • Accept help from others. People want to help. When they offer, be ready with a short list of simple tasks they can do.
  • Get some exercise. It can help lower stress, improve sleep, and increase energy.
  • Try yoga or meditation. Using a smartphone app can be an easy way to get started.


*When considering patients with any of 6 common neurologic conditions associated with PBA, it is estimated that 37%, or an estimated 7.1 million Americans, have symptoms suggestive of PBA as defined by a CNS-LS (Center for Neurologic Study-Lability Scale) score ≥13 and 9.4% of patients, or an estimated 1.8 million Americans, with CNS-LS scores ≥21. The presence of PBA symptoms was defined as a CNS-LS score ≥13 and a more restrictive definition was also evaluated using CNS-LS ≥21. The CNS-LS was validated as a PBA screening tool in ALS and MS populations. A CNS-LS score ≥13 merits further diagnostic assessment.

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Talking to your doctor about PBA

Learn what to ask, plus find out ways to manage PBA.