Prepare to Talk to a Doctor Who Treats Pseudobulbar Affect (PBA)
Since crying and laughing are normal displays of emotion, it can be challenging to try to explain how your crying and/or laughing isn’t normal, especially when you’re not sure why it’s happening. Consider taking steps to prepare for your doctor's appointment so you're equipped to explain your episodes and how they affect you. If you’d like more information on how to prepare for a conversation with your doctor, download the Doctor Discussion Guide.
Before Your Appointment
Preparation is key. Set yourself up for a productive doctor’s appointment by preparing ahead of time. Be sure to arrive with the following information:
- A list of prescriptions, over-the-counter medications, and any supplements you’re taking
- Your pharmacy’s name, address, and phone number
- Specific details about your symptoms and the impact
- Updated medical history, especially for a new doctor
- Your completed Doctor Discussion Guide
Take it a step further: Consider asking a caregiver or loved one to come to your appointment for support.
Download the Doctor Discussion Guide
This guide will help you gather the right documentation and fully prepare yourself for a productive conversation with your doctor.
This guide will help you gather the right documentation and fully prepare yourself for
a productive conversation with your doctor.
During Your Appointment
It is important to share all the details about your medical history, the specifics of your crying and/or laughing episodes, and how they are affecting your day when being evaluated by the doctor so they can make an accurate diagnosis. Prepare these details ahead of your visit using the Doctor Discussion Guide.
Here is what you may expect at your doctor’s appointment:
Step 1: Review of Your Medical History
Your doctor may want to confirm that you have a neurologic condition or brain injury that is associated with PBA, including but not limited to:
- Traumatic brain injury (TBI)
- Stroke
- Multiple sclerosis (MS)
- Alzheimer disease or dementia
- Amyotrophic lateral sclerosis (ALS)
- Parkinson’s disease
- Traumatic brain injury (TBI)
- Alzheimer disease or dementia
- Stroke
- Amyotrophic lateral sclerosis (ALS)
- Multiple sclerosis (MS)
- Parkinson’s disease
While these are the six most common primary conditions, PBA can occur as a result of any neurologic condition or brain injury.
“My psychiatric nurse practitioner reviewed my symptoms and asked me if I had ever suffered any serious head injuries. It turned out to be an important medical detail that I had not thought serious enough to disclose.”
Jill, a patient living with TBI and PBA
Individual results vary. Jill is a real patient living with PBA. Image reflects patient’s health status at the time the image was captured.
Step 2: Assessment of Your Crying and/or Laughing Episodes
To help understand your crying and/or laughing episodes, your doctor may ask you to tell them about any changes in your crying and/or laughing since your neurologic condition or brain injury diagnosis. Their questions may cover:
- Changes in your crying and/or laughing: how severe it is, how long it lasts, how often it occurs, and if your crying is accompanied by tears
- Whether your crying and/or laughing is involuntary, sudden, frequent, or uncontrollable
- If your crying and/or laughing does or doesn’t match your mood
- How disruptive your crying and/or laughing is when it comes to work and interacting with others
Step 3: A PBA Screening
Your doctor may also use a screening tool called the Center for Neurologic Study-Lability Scale (CNS-LS). This tool includes 7 questions and generates a score that indicates how likely it may be that you have PBA. It’s the same set of questions featured in the PBA Quiz.
How To Approach the Conversation With Your Doctor
Explain What’s Unique About Your Crying and/or Laughing
When you describe your crying and/or laughing to your doctor, be as detailed as possible about the nature of your episodes. Consider recording your experiences as they happen to help you keep track of your episodes so you can share that information with your doctor.
Though PBA is often misdiagnosed as depression, it’s important to share if you think you’re also experiencing psychological symptoms. It’s possible to have both PBA and depression, and your doctor can create treatment plans for both.
“I would suggest bringing specific incidences [to] give the doctor what they need to [make an accurate diagnosis].”
Mary-Beth, a patient living with epilepsy and PBA
Share the Impact of Your Episodes
Help your doctor understand how your uncontrollable crying and/or laughing episodes make you feel and how you are coping. Be open and honest about the impact of the episodes and any concerns you may have.
“Ask about PBA. Don’t try to tough it out or be too proud to seek help. Finding this saved me, figuratively and literally.”
Dan, a real patient living with multiple sclerosis and PBA
Advocate for Yourself
Not all doctors consider PBA right away. Some may prioritize your neurologic condition or brain injury. Others may want to consider more common disorders, like depression, before exploring PBA, especially if they aren’t familiar with it. That’s why what you share with them is so important.
No one knows you better than yourself. It's OK to let your doctor know if something doesn’t seem right to you. If you receive a treatment for your uncontrollable crying and/or laughing and you don't notice an improvement, make sure you let your doctor know.
“When I was being treated for all these other conditions, I knew that I wasn’t depressed. My internal emotions did not match the external crying. I knew it was more than just a concussion.”
Carol, a patient living with TBI and PBA
Individual results vary. All ambassadors are real patients living with PBA or caregivers for real patients living with PBA. Images reflect patients’ health status at the time the images were captured.
Is NUEDEXTA Right for You?
As you prepare to talk to your doctor about PBA, learn about treatment with NUEDEXTA and hear from others who also successfully advocated for a PBA diagnosis and treatment with NUEDEXTA.
Jill (right) is a real patient living with PBA. The other person depicted is not a real doctor. Image reflects patient’s health status at the time the image was captured.