An Overview of Uncontrollable Crying

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.

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
• you cry very easily and at inappropriate times
• your laughter easily turns into crying
• you feel unable to control your episodes of crying
• your crying is exaggerated or inappropriate for the situation
• you avoid being around people for fear of crying or having an outburst
• your crying episodes are unpredictable and short (seconds to minutes)
• it requires energy for you to hold back your 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.

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

Most 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; it was once called reflex crying.

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

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

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. If this crying extends beyond 6 months, it is considered to be complicated grief that requires treatment. In addition, there is chronic grief, usually related to an ongoing situation in your life (e.g., infertility).

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.

Uncontrollable crying can have negative side effects. 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

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, 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.

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

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 another condition such as Parkinson's disease or ALS, PBA may be a concern.

On the other hand, if you think you may have complicated grief or depression, medication or therapy may help. Regardless of the cause, your doctor will be able to prescribe the best course of action.