Emotional lability involves laughing or crying at inappropriate times or levels that aren’t warranted at the time.

The condition can occur following a stroke, injury to the brain, or a neurological condition that affects the brain.

As a result, you or a loved one may experience symptoms of emotional lability. Fortunately, there are steps you or a loved one can take to help lessen the impact of the condition on your life.

Emotional lability is a condition that causes rapid, frequent, and intense shifts in your emotional state. It can manifest as intense laughing or crying that may occur either at inappropriate times or too strong for the present circumstances.

It’s also known as:

  • labile affect
  • pseudobulbar affect
  • pathological laughing and crying

The medical term for emotional lability is involuntary emotional expression disorder.

The changes in emotional regulation and expression come directly from injury to the brain or a neurological condition, such as Parkinson’s disease, with symptoms that are often persistent and potentially debilitating.

The damage to the brain causes you to lose control of the part of the brain that regulates:

  • your ability to regulate how and when emotions come out
  • strength of your emotional response
  • awareness of your other emotions

Emotional lability can cause uncontrollable, often inappropriate outbursts of crying or laughing. They’re often inappropriately strong or exaggerated responses that may not reflect what you or a loved one is feeling.

For example, you may burst out in laughter at the news of a family member’s death, or you may spontaneously laugh or cry for no known reason.

At other times, it can cause you to respond with the correct emotional response to the situation but at an exaggerated level. For example, you may laugh at a simple pun your friend made for too long or too loud for what the situation warranted.

Following a brain injury, you may find that your emotional responses are exaggerated, even if they occur at the right times. This could mean you may feel emotions at a higher level than usual, including:

Emotional lability can occur due to either an injury to the brain or a neurological condition that affects how the brain operates.

It typically causes you to laugh or cry in one of two ways:

  • at inappropriate times, such as laughing at something sad
  • at inappropriate levels, such as laughing too hard or for too long based on the situation

Several potential conditions can cause damage to the brain that can cause emotional lability.

For example, a stroke can cause damage to the brain and changes the chemicals in the brain, which can cause emotional lability, according to the American Heart Association.

Neurological conditions can also cause emotional lability. Some examples include:

Injuries to the brain can also cause emotional lability. Some potential causes include:

  • contusion
  • blunt force trauma to the head
  • oxygen deprivation
  • swelling in the brain
  • infection in the brain
  • an injury that penetrates the skull and impacts the brain
  • skull fracture
  • hematoma

There are several ways to cope, treat emotional lability, or help a loved one cope with the condition.


There are not many medications approved for use, either directly or off-label. Off-label means a doctor may use a medication to treat a condition not initially tested for because it has a generally positive effect on the condition.

The only Food and Drug Administration (FDA) approved medication is a combination of dextromethorphan hydrobromide and quinidine sulfate, known as dextromethorphan.

The clinical trials showed a statistically significant effect in reducing the number of laughing and crying episodes compared to placebo groups.

A doctor may also prescribe low doses of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs).

Find and avoid triggers

Triggers are any type of exposure that causes the symptoms of laughing or crying. Identifying your triggers can help you avoid them or develop coping strategies that may help when exposed.

Some triggers can include:

  • stress
  • anxiety
  • funny or sad situations
  • excessive tiredness
  • being in a pressure-filled situation, such as public speaking or talking on the phone

Take a break

If something sets off your laughing or crying, you may find that taking a break from the situation helps to relax the emotional response. You can then take the time necessary to regulate your responses.

Educate those around you

Sometimes speaking up may be your best option. When you tell people you are around about your emotional responses, you can help a person understand better why you may start to laugh or cry at random times.

You don’t have to share more than you’re comfortable with, but you may find it comforting to know that the person or people you are with will know why you may start to laugh or cry at certain times when you are together.

Change topics or activities

Suppose a certain topic of conversation or activity triggered your laughing or crying.

In that case, you may find that switching your topic of conversation or doing a new activity may help by diverting your attention away from the stimulating issue.

Try some cognitive techniques

Many strategies used or taught during cognitive therapy may help with emotional lability. Some techniques to try can include:

  • doing a physical activity like walking
  • breathing and relaxation exercises
  • distractions such as picturing a place in the world that helps you feel calm and relaxed

Take time to plan ahead

Planning can help you, or a loved one avoid activities or situations that may trigger emotional lability. You can plan shorter, quiet activities in a calm environment to help prevent triggers and make yourself feel more comfortable.

Consider counseling

Counseling may be a good option for you if you are dealing with many emotions following the onset of a sudden injury or stroke or when coping with MS.

Counseling can help you work through your emotions and provide additional coping strategies to help with emotional lability.

Emotional lability occurs due to an injury or neurological issue that causes disruptions in how your brain processes emotions. It often causes you to experience periods of laughing or crying that occur at inappropriate times or are excessive.

Potential emotional lability causes include traumatic brain injury, stroke, and MS.

You can take steps to treat or manage your emotional lability. If you have moderate to severe cases, you may find that taking medication may help. You may also find that coping skills, such as distractions, planning ahead, and avoiding triggers, can help.