An Overview of Uncontrollable Crying

Woman with uncontrollable crying.

 Getty / Arman Zhenikeyev

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Have you ever experienced episodes of uncontrollable crying? If so, you might feel worried about why you are crying or feel unable to control it. While crying can be a symptom of some mental health disorders, uncontrollable crying can also be a sign of an underlying neurological issue. As a result, the treatment options and coping strategies that you employ will differ depending on the cause.

Signs of Uncontrollable Crying

Not sure if your uncontrollable crying is normal or a problem? Have a look at this list of signs that something might be wrong or more than just normal tears:

  • You have uncontrollable episodes of crying, laughter, or both
  • Your crying seems to happen without an obvious trigger or in relation to something that doesn't seem like a natural trigger
  • Your crying does not seem to relate to feelings of sadness
  • Your laughter easily turns into crying
  • You avoid being around people for fear of crying or having an outburst
  • Your crying episodes are unpredictable

Causes of Uncontrollable Crying

What are the causes of uncontrollable crying? Crying that is truly uncontrollable is usually a symptom of a brain dysfunction. However, crying can also be a symptom of a mental health disorder. Let's consider each of these in turn.

Neurological Causes

Uncontrollable crying can be caused by neurological disturbances related to stroke, ALS, traumatic brain injury, multiple sclerosis, Parkinson's disease, and Alzheimer's disease.

In fact, 43% to 49% of people with ALS have pseudobulbar affect (PBA), which involves uncontrollable inappropriate crying and/or laughing that can be triggered by anything and interfere with functioning.

Many people with PBA are unaware that they have a real condition and rarely complain about their symptoms (so don't receive treatment). Doctors also don't usually screen for PBA because many don't know about it. However, the condition has been documented for over 100 years.

There are different theories as to the brain structures that are involved in PBA.

One theory is that there is damage to the cerebro-ponto-cerebellar pathways, which adjust laughter or crying to match the situation. Another theory is that there is damage to pathways in motor areas of the cerebral cortex that inhibit laughter and crying.

Mental Health Causes

Extended crying can also be a sign of mental health issues. Crying can be a symptom of various forms of grief. Acute grief resulting from a situation such as the loss of a loved one is one type. In addition, there is chronic grief, usually related to an ongoing situation in your life (e.g., infertility).

In general, crying that is part of grief is only treated if it is considered part of a depressive disorder or is significantly disruptive of one's functioning.

Major depression also involves crying; however, it has other features such as sleep issues, lack of enjoyment of usual activities, and appetite changes. PBA is sometimes also mistaken for depression. One way to distinguish them is based on the trigger; PBA seems to lack a trigger or be triggered in inappropriate ways.

Effects of Uncontrollable Crying

Uncontrollable crying can have negative effects on your life. Below are some of the things you might experience:

  • Social embarrassment over your inability to control your crying
  • Distress in social situations, the workplace, and with family
  • Feeling emotionally exhausted
  • Choosing to isolate yourself due to your crying
  • Changing your life to avoid things that might trigger your crying
  • Secondary depression resulting from chronic untreated uncontrollable crying

Treatment for Uncontrollable Crying

The treatments for uncontrollable crying depend on the underlying cause. Complicated grief and depression are usually treated with therapy and/or medication.

PBA may be treated with low doses of tricyclic antidepressants such as amitriptyline and selective serotonin reuptake inhibitors (SSRIs) such as citalopram or fluoxetine.

There is also one drug, dextromethorphan hydrobromide and quinidine sulfate (Nuedexta), that is approved by the U.S. Food and Drug Administration (FDA) for treating PBA. It was actually discovered quite accidentally while testing it to treat ALS patients. While it was never approved for ALS, it was later approved for PBA.

This drug contains the active ingredient dextromethorphan which is found in many cough syrups; however, you can't self medicate with cough syrup as it has a different formulation.

An occupational therapist can also help people with PBA learn how to cope in everyday life.

Coping on Your Own with Uncontrollable Crying

There are also a number of things you can do on your own to cope with uncontrollable crying that is interfering with your life. Below are some ideas:

  • Explain the problem to others so they are not surprised or confused
  • Speak to other people with the same problem and ask for advice
  • Distract yourself with something opposite of crying like having someone tell you a funny joke
  • Practice deep breathing and relaxation techniques
  • Getting up and walking around to change your position
  • Keeping a diary of your episodes to track the triggers, length, related emotions, and ill effects
  • Examine life stresses and how you can address them

A Word From Verywell

If you are living with uncontrollable crying that is interfering with your daily life, it's important to seek answers from your doctor. If you live with certain neurologic conditions, PBA may be a concern.

On the other hand, if you have grief that is adversely impacting your life or a depressive disorder, medication or therapy may help. Regardless of the cause, your doctor will be able to prescribe the best course of action.

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