Emotions and Stroke: Living with PBA


Stroke survivors can experience emotional and behavioral changes during recovery. It is because stroke impacts the brain, which controls emotions and behavior. So you or your loved one may begin experiencing confusion, irritability, sadness, carelessness, and forgetfulness. Some people also feel anger, anxiety, and depression.

Others have a range of extreme and unprovoked mixed feelings resulting in bouts of excessive crying or laughing. These cases denote a post-stroke neurological condition called PBA.

What is Pseudobulbar Affect (PBA)?

Pseudobulbar affect (PBA) refers to a condition characterized by sudden, involuntary, and inappropriate laughing or crying episodes. Typically, it occurs in individuals with specific neurological injuries or illnesses that might affect how their brain controls emotions.

PBA is the latest name for this peculiar neurological condition. It is also called reflex crying, involuntary emotional expression disorder, and emotional lability, among others. Apart from stroke, other neurological diseases that cause PBA include Parkinson’s, dementia, Wilson’s disease, TBA (Traumatic brain injury), Amyotrophic lateral sclerosis (ALS), and brain tumors.

Living with PBA

Living with PBA can be a frustrating and isolating experience, especially after a stroke. Many people are not aware of the condition and might not understand the exaggerated emotional outbursts beyond the survivor’s control.

It is common for survivors to want to hide from everyone, but there are many ways to manage and treat PBA. First, get an accurate diagnosis. Then ask your healthcare provider about treatment options.

The coping techniques below may help:

  • Be open and honest about the problem to make people understand it and prevent surprise or confusion when you have an episode.
  • Learn to distract yourself by thinking about unrelated thoughts or counting in your head whenever you feel you are about to have another episode.
  • Relax your forehead and muscle groups, such as shoulders, that tense up during a PBA episode.
  • Take slow deep breaths until you regain control.
  • Know your triggers (such as frustration) and try to avoid them.
  • Note your posture during episodes and change it when you feel one about to start.
  • Try meditation to calm your mind.

Since people with PBA tend to cry a lot and isolate themselves, it is common to confuse their symptoms with depression.

Social Support for Stroke Survivors

A social support system for stroke survivors plays a considerable part in quick recovery and helping survivors accept their new normal. Family caregivers also need support to cope with the added stress and responsibilities. Communication is critical for the recovery and rehabilitation process to succeed.

Stroke support groups offer social support and provide an opportunity for survivors and caregivers to interact and know they are not facing PBA and other stroke-related conditions alone. The Stroke Support Association (SSA) offers resources, information, coping strategies, and an active support group system for survivors and caregivers.

SSA has separate weekly support group sessions for survivors and caregivers held every Tuesday in Long Beach, CA. For everyone’s safety during the COVID-19 pandemic, SSA is holding support group meetings virtually via the Zoom video platform. SSA sends all Zoom invitations every Monday for Tuesday morning meetings from 10:00 am to 10:50 am, and then 11:00 am to 11:50 am for stroke survivors and caregivers, respectively. Contact the SSA Group Administrator for more information.

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