Why am I yelling and crying?

Here is My Question:
What if I'm having severe issues with outbursts of yelling and then crying when I am not feeling heard about my symptoms of memory loss, speech, reading and handwriting issues.

Answer:
Psuedobulbar affect or PBA results from a damage to certain parts of the nervous system that lowers the threshold for expressing emotions such as laughing or crying . There are certain key features that distinguish PBA for other forms of labile mood.

1. The outburst or behavior can be dramatic or subtle. Subtle examples include an inability to suppress a smile when the desired response would be neutral or a frown. More dramatic examples include outbursts of sudden crying or laughing for no apparent reason.
2. The expressed emotion is often mood incongruent. An example would be a person who suddenly starts laughing uncontrollably at a sad event or during a solemn discussion.
3. The outburst comes on often without warning and can cease as quickly
4. If cognitive impairment is not severe, the person is at least partly aware of this aberrant emotional expression
5. PBA is a sign of neurological injury or impaired brain development. It is commonly seen in various degenerative neurological conditions including MS. Estimates of the frequency of PBA in people with MS varies widely depending on method of ascertainment, definition and study population. Severe cases are seen in less than 10 % of people with MS but many more experience milder symptoms
6. Treatment often only requires education of the involved person as well as friends and family. When necessary various medications are useful including dextromethorphan/quinidine combination (brand name nuedexta but now generic), low dose tricyclic antidepressants and even standard low dose SSRI class antidepressants.

It is important to different PBA from mood congruent emotional outbursts that are usually not as pervasive as PBA. These labile mood disorders are often associated with psychiatric conditions and personality disorders and are often associated with dramatic changes in opinions and feelings.

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego