What to Do When You're Crying Uncontrollably

Why It Matters

Accurate identification of PBA prevents unnecessary psychiatric treatment and enables targeted medication, reducing personal distress and hidden economic costs. Awareness also guides employers and insurers toward appropriate accommodations for affected workers.

Key Takeaways

• PBA affects up to 7 million Americans, many undiagnosed
• Nuedexta is FDA‑approved drug specifically for PBA
• SSRIs and tricyclics treat crying linked to neurological causes
• Hormonal shifts like PMDD can trigger uncontrollable tears
• Coping includes breathing exercises, diary tracking, and support groups

Pulse Analysis

Uncontrollable crying is often dismissed as emotional excess, yet it can signal a serious neurological disorder known as pseudobulbar affect (PBA). Research estimates that as many as seven million Americans experience PBA, but only two million have received a formal diagnosis, leaving a large hidden population vulnerable to social stigma and unnecessary psychiatric treatment. The condition stems from damage to brain pathways that regulate emotional expression, causing tears or laughter to erupt without appropriate triggers. Recognizing the clinical signature of PBA—episodes that are sudden, involuntary, and context‑inappropriate—is essential for accurate referral and care.

Therapeutic options for PBA differ sharply from those for mood disorders. The FDA‑approved combination of dextromethorphan and quinidine, marketed as Nuedexta, directly targets the disrupted glutamatergic signaling believed to underlie the condition and has demonstrated rapid symptom reduction in clinical trials. In parallel, low‑dose tricyclic antidepressants and selective serotonin reuptake inhibitors are frequently prescribed off‑label to blunt episodic crying. These pharmacologic strategies contrast with the psychotherapy‑centric approaches used for depression or grief, underscoring the need for clinicians to distinguish neurological from psychiatric origins before initiating treatment.

Beyond the clinical sphere, uncontrolled crying can erode professional credibility and strain interpersonal relationships, prompting many sufferers to withdraw from work or social settings. Employers and insurers are beginning to recognize emotional dysregulation as a legitimate disability, which could expand coverage for diagnostic screening and medication like Nuedexta. Meanwhile, self‑management techniques—deep breathing, activity pacing, and episode logging—provide low‑cost adjuncts that empower patients to regain control. Raising public awareness about PBA and its distinction from depression will reduce misdiagnosis, improve treatment uptake, and ultimately lessen the hidden economic burden of untreated emotional disorders.