Laughter out of context to a situation or exaggerated is called paradoxical laughter. It’s related to schizophrenia and other neurological disorders, but there are treatment options.
Laughter can help cope with upsetting life events. For example, if you make a silly mistake but can laugh it off, it may show that you don’t take yourself too seriously.
On the other hand, there may be times when your laughter might be inappropriate to the situation.
Inappropriate laughter or laughter for no reason can be confusing. If you experience this symptom, you may wonder why this is happening, especially if you are the only one laughing in a situation.
If you find yourself laughing unprompted, you may wonder what this is called or why this happens. Laughter that comes from nowhere or is exaggerated is often referred to as paradoxical laughter.
Paradoxical laughter may also be referred to as:
- pathological laughter
- pseudobulbar affect (PBA)
- inappropriate laughter
While paradoxical laughter may occur as part of PBA, people with the condition may also experience uncontrollable crying.
What is paradoxical laughter?
Paradoxical laughter is laughter that occurs uncontrollably, unprompted, or out of context to a person’s emotional state or circumstance. If someone has paradoxical laughter, they might laugh without a humorous prompt or during serious situations.
Paradoxical laughter has different causes. Some reasons for paradoxical laughter include mental health conditions and medical conditions.
Schizophrenia
Schizophrenia is a mental health condition in which an individual experiences disorganized thinking, hallucinations, and delusions.
Schizophrenia can cause paradoxical laughter for various reasons. For example, the person could be experiencing a hallucination or delusion that spurs uncontrolled laughing that may be out of context to others.
People with schizophrenia may also experience laughter for no reason due to challenges in understanding social cues.
Symptoms of schizophrenia include:
- a decline in activities of daily living
- delusions
- disorganized behavior
- hallucinations
- lack of emotional expression
- lack of or reduced motivation
- social withdrawal
- spontaneous speech
- unprompted laughter
Pseudobulbar Affect (PBA)
The PBA is a condition in which uncontrollable laughter or crying occurs. The laughter and crying often happen when there are no external stimuli to cause the laughing or crying. This condition usually occurs as a result of psychiatric or medical disorders.
The PBA affects approximately 2 million to 7 million Americans but is underrepresented frequently due to being misdiagnosed as a mood disorder.
In addition, some 2017 research suggests that individuals with PBA experience embarrassment due to being aware of social cues and knowing that their symptoms are out of context.
PBA has been associated with conditions such as:
- schizophrenia
- mania
- Parkinson’s disease
- Alzheimer’s disease
- traumatic brain injury (TBI)
- stroke
- amyotrophic lateral sclerosis (ALS)
- psychosis
gelastic seizures - multiple sclerosis
- cerebral lupus
The treatment of PBA often involves a combination of medication and self-care strategies. You can do this by:
- educating yourself on PBA
- talking with a doctor about medication
- employing self-care strategies
Educate yourself on PBA
There is a lack of knowledge among the general public on PBA. Even in the healthcare profession, PBA is often misdiagnosed as depression or anxiety rather than PBA.
Educating yourself on the causes and treatment of the condition is a helpful first step in understanding how to cope with it.
Medication
Talking with a doctor about the right medication for you is crucial in getting the appropriate treatment for PBA. Some common types of medications prescribed for PBA include:
- tricyclic antidepressants
- selective serotonin reuptake inhibitors (SSRIs)
- dextromethorphan/quinidine/hydrobromide (Nuedexta)
The third from the list is the combination of three medications. Nuedexta is the only medication approved by the Food and Drug Administration (in 2010) used for treating PBA.
Self-care strategies
One 2020 qualitative study of 820 people who had experienced PBA symptoms explored self-care strategies. Before gaining the knowledge from a PBA educational program, participants in the program described self-care strategies that worked for them, such as:
- accepting symptoms as a part of life to adapt to
- practicing deep-breathing
- movement of their bodies
- distraction techniques
These self-care strategies may help provide relief to those with PBA in addition to medication and education.
If you have periods where you’re experiencing emotional ups and downs in the form of uncontrollable laughter or crying and don’t know why this is happening, it may be time to talk with a doctor. Management of paradoxical laughter may help reduce the occurrence of inappropriate laughter and the embarrassment it may cause.
Paradoxical laughter, aka pathological laughter, is related to pseudobulbar affect. Psychiatric or medical conditions can cause it. Schizophrenia is one psychiatric disorder in which pathological laughter occurs frequently.
You may feel scared if you don’t know why uncontrollable laughing occurs. A doctor can help you find the cause and explore treatment options.
Self-care strategies, medication, and education are all ways to cope with PBA symptoms.