Serving Central California Since 1995

ASK THE ADVOCATE: A few months ago, my 60-year-old husband began acting very strange. He began either laughing or crying uncontrollably for no apparent reason. This has caused embarrassment with friends and family but most importantly, he lost his job because of the outbursts. His primary doctor sent him to a neurologist. That doctor thought he had pseudobulbar affect. We both asked what it was and how he got it. A brain MRI revealed problems in the frontal lobe of his brain. We are waiting on further tests. Do you think he might qualify for disability?

THE ADVOCATE: Once you get a proper diagnosis and treatment his doctor can help with prognosis and functional issues. Pseudobulbar affect, or PBA, occurs most commonly among people who have Parkinson disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS) or Alzheimer disease or have experienced a traumatic brain injury, stroke and other neurological diseases that damage the central nervous system.

I did some digging and found out PBA has been labeled emotional lability, emotional incontinence, involuntary emotional expression disorder, emotional dysregulation, emotionalism, or pathological laughing and crying. In most cases, the laughter or crying does not always coincide with the mood or intensity of the experience the person describes. Apparently, PBA is often misdiagnosed as a psychiatric disorder, such as depression.  Unlike patients diagnosed with mood disorders, those with PBA have unsustained, explosive, and irregular emotional responses.

It is very important that you tell his doctors about all the symptoms and disabilities he is experiencing and make sure the medical records include a diagnosis, prognosis, and complete description of your limitations, including physical, neurological, cognitive, and psychological impairments. The medical records will be the primary source of information used in his case, and if he (you) fail to mention any symptoms, limitations, or disabilities to his doctor, or if the doctor neglects to record them, they won’t be included. You should make sure his doctor records everything you tell him/her.

Many people suffer from multiple symptoms that make it impossible to work. SSA will determine if the combination of impairments is sufficiently disabling to keep you from returning to work.