Manic laughter often bubbles up unprompted and out of context. If it doesn’t create challenges for you, it’s harmless. But if it creates awkward social interactions, there are ways to cope.

Bipolar disorder is a mood disorder in which people experience alternating periods of mania, in some cases with depression. Folks most likely will experience extreme mood changes, activity levels, and behavior in a manic state.

Sometimes mania can cause confusing behaviors or seem inappropriate to other people. For example, you might spend excessive amounts of money that you don’t have.

Bursting into laughter during solemn, quiet, or inopportune moments is another scenario where mania may present. This is called manic or inappropriate laughter — and isn’t your fault.

Typical laughterManic laughter
prompted by something externalunprompted
has clear start and subsiding pointsfeels unmanageable, for unpredictable spans of time
feels appropriatefeels jarring or disproportionate to the immediate situation
creates cheer around youcreates awkward social situations

Spontaneous laughter that’s known as manic laughter is an experience that:

  • may occur in tandem with an elevated mood if you live with bipolar disorder mania
  • doesn’t match your current mood
  • is out of context
  • feels unmanageable

Manic laughter is commonly part of bipolar disorder, a mood disorder and mental health condition characterized by highs and lows — or alternating periods of mania or hypomania, and possibly depression.

If you’re experiencing mania, you may have symptoms such as:

  • pressured or rapid speech
  • flight of ideas
  • racing thoughts
  • aggression
  • hostility
  • mood shifts
  • increased energy levels
  • enthusiasm
  • reduced need for sleep
  • increased sexual interest or sexual behaviors
  • increased goal-directed activity
  • overspending
  • inappropriate laughter

While not every person who experiences mania has all of these symptoms, any combination of these can cause disruptions in work, school, relationships, and daily living.

Is this the same as paradoxical laughter?

Short answer: They’re similar, as both are indications of humor that tend to be unwarranted by circumstantial events, but they aren’t the same.

Manic laughter has its own cause and self-perception apart from paradoxical laughter — a type of pseudobulbar affect (PBA) — also referred to as:

  • inappropriate laughter
  • pathological laughter

This is where it can get confusing. Manic laughter is usually inopportune and referred to as “inappropriate laughter,” but it’s not a type of PBA.

PBA is also called inappropriate laughter, but it’s different from mania. It’s a feature of neurological impairment, not a mental disorder.

The symptom of inappropriate laughter is common to both, but they’re different.

Paradoxical laughter (PBA)Manic laughter
unpromptedunprompted
aka inappropriate laughter aka inappropriate laughter
part of the pseudobulbar affect (PBA)potential symptom of bipolar disorder manic episodes
can also cause uncontrollable cryingcan be caused by elevated mood due to mania
causes frustration, embarrassment, or shamecan create awkward situations for those around but usually not the person themselves
treated with dextromethorphan/quinidine/hydrobromide (Nuedexta) or antidepressants mania itself is treated, not manic laughter exclusively; treated with mood stabilizers or antipsychotics

To be clear, you don’t have to apologize for living with bipolar disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), depending on the severity of the type of bipolar disorder you manage, symptoms may cause challenges or consequences in your:

  • social life
  • relationships
  • school
  • work
  • home life

If symptoms like manic laughter cause interpersonal issues in the above areas, you might want to take accountability for actions that may embarrass, offend, or hurt those you care about.

How to make amends

Once you’re in a calm state after the manic episode, you can choose how you make amends (depending on how close you are to the person).

You have the option of saying “I’m sorry” versus “I apologize.” They mean two different things.

“I’m sorry” expresses personal regret without accepting responsibility. “I apologize” takes responsibility for an action but not necessarily with any sentiment behind it.

When you manage a condition that may complicate your relationships, consider this way of acknowledging an action and moving past it:

  1. Name the behavior.
  2. Apologize.
  3. End on a high note, without rationalizing.

For example: “I laughed out of turn during the timeout in the game when you were reprimanding the team. I apologize. I respect how you coach them, and I appreciate your follow-through.”

You don’t have to disclose your diagnosis if the person you’re apologizing to isn’t in your trusted circle or you’re not comfortable.

It may be time to talk with a therapist if you have repeated laughing episodes that you can’t manage.

There might be an opportunity to revisit your medication and ensure that it’s still managing episodes of mania adequately. You could also discuss any new triggers to manic episodes and adjustments to your routine that might help.

Manic laughter is laughter that occurs during periods of mania that may be contextually inappropriate. This type of laughter also goes by the term inappropriate laughter, but it’s different from inappropriate laughter caused by the pseudobulbar affect.

Treatment strategies such as education for yourself and loved ones, medication, and self-care are all ways to reduce the impact of the symptoms.

Talking with a doctor is essential for managing your treatment effectively. If you have any concerns about emotional regulation and extreme moods, you don’t have to manage it alone. Medical treatment and seeking out supportive loved ones can help you.