Updated 18 October 2017

Meet the man who can't stop laughing once he starts

What would you do if you had a fit of laughter at a funeral and couldn't contain your hysterical laughter?

They say laughter is the best medicine. They also say there’s nothing better than a good cry. But what do you do when you have no control over these displays?

Pseudobulbar affect (PBA), also known as emotional incontinence, causes people to laugh and/or cry uncontrollably at any given moment. People who suffer from the condition find themselves reacting this way, even though there might be little or no trigger.

A degenerative condition

Scott Lotan is your average family man – husband, father of two beautiful children and lover of pugs. What makes him different from the average family man, though, is that he suffers from PBA.

PBA is the result of brain injury or a traumatic neurological condition. In Lotan's case, PBA is the result of multiple sclerosis (MS), a degenerative condition where the central nervous system and the brain are affected.

Because MS damages or destroys the protective fatty layer that covers the nerves, suffering from this condition may result in several secondary conditions, and PBA is one of them.

PBA or depression?

Depression is a secondary condition that people with MS may suffer from.

People may confuse suffering from PBA as depression, because both conditions involve emotion. PBA Info, however, lists a number of distinct differences to tell the two conditions apart:

  • In PBA, there is a neurological condition or brain trauma, while in depression there may not have been any brain trauma or neurological condition.
  • PBA sufferers have frequent, random outbursts of laughing fits and/or bouts of crying or sobbing, whereas those suffering from depression may or may not experience crying.
  • Those suffering from depression may have control over their crying, whereas PBA sufferers have no control.
  • Those suffering from depression display the emotions they're actually feeling, so if they are crying, they will be feeling sad. PBA sufferers may be sobbing when they're not sad at all.
  • Depression may be experienced without any brain or nerve trauma, but in the case of PBA, there will be definite brain or neurological trauma.

Another condition PBA should not be confused with is pseudobulbar palsy, which is much worse than PBA, in that sufferers aren't able to control facial movements and have difficulty with speech and chewing.

Inappropriate display of emotions

Living with PBA can be extremely challenging and embarrassing, because there are many occasions where the emotion displayed is inappropriate.

A documentary has been produced to raise awareness about the condition, and many sufferers, including Lotan, have been able to share their stories and experiences living with the condition.

There are a few questions to find out if you or someone you care about may be suffering from the condition. The first would be if your laughter or crying matches the way you're feeling?

A neurologist would be able to give a proper diagnosis and recommend treatment, which may include taking medication, although there is no known cure for the condition.

There are several conditions that may cause people to develop PBA, including Parkinson's disease, Alzheimer's disease and stroke.