Uncontrollable Crying in Women: Causes, Treatment, and Coping Strategies

Understanding Uncontrollable Crying in Women

It's not uncommon for women to experience sudden and uncontrollable bouts of crying. Known medically as pseudobulbar affect (PBA), this condition can cause excessive or inappropriate episodes of crying that don't match how a person is feeling. While PBA episodes may appear similar to depression at first glance, there are some key differences between these two conditions.

What is Pseudobulbar Affect (PBA)?

Pseudobulbar affect is characterized by frequent, sudden, and uncontrollable crying or laughing episodes that are exaggerated or don't match a person's internal emotional state. These crying outbreaks can occur several times a day, often without warning, in response to stimuli that wouldn't elicit such an emotional reaction in most people.

PBA occurs due to a disruption in the brain pathways that regulate emotional expression. This can happen after a stroke, traumatic brain injury, multiple sclerosis, Alzheimer's disease, or other neurological conditions. The crying episodes are involuntary and may feel embarrassing or out of the person's control.

Signs of PBA in Women

Women with PBA may experience the following signs and symptoms:

• Frequent crying spells that occur many times throughout the day
• Crying that is sudden and uncontrollable
• An overly emotional reaction that feels disconnected from inner feelings
• Inappropriate bouts of crying in response to minor events
• A sense of building tension or pressure before crying uncontrollably
• Feeling embarrassed or frustrated by inability to control crying

These PBA episodes cause significant distress and impairment in daily functioning. The crying can disrupt conversations, social activities, work performance, and relationships. Women with PBA report that the crying spells feel involuntary and don't fully match their inner emotional state.

How PBA Differs from Depression

Uncontrolled crying is a hallmark symptom of major depressive disorder. However, the crying patterns seen in depression differ from those caused by PBA in several key ways:

• Triggers - In PBA, crying can be triggered by minor events that normally wouldn't warrant such an emotional reaction. Depression tears are more often caused by thoughts, feelings, or major life events.
• Frequency - PBA crying occurs in brief, sudden episodes many times per day. Depressive crying is less frequent and not as abrupt in onset/offset.
• Appropriateness - PBA crying is seen as excessive and disconnected from inner mood state. Depression tears are appropriate for the individual's emotional state.
• Controllability - Those with PBA feel unable to control or regulate their crying spells. Depressive tears are more controllable.

In some cases, PBA and depression can co-occur. Experiencing frequent, uncontrolled crying spells can understandably lead to or worsen depressive symptoms. The key is identifying whether an underlying neurological issue like PBA is causing severe, unprompted crying apart from typical depression markers.

Other Causes of Excessive Crying

In addition to PBA and depression, other conditions that can cause increased crying in women include:

• Mood disorders like bipolar disorder or anxiety
• Hormonal imbalances
• Grief or loss
• Post-traumatic stress disorder (PTSD)
• Personality disorders such as borderline personality disorder

If frequent crying occurs outside of major emotional events and feels involuntary, pursuing an evaluation with a doctor is wise to determine any underlying medical conditions. Sudden, unprompted crying can result from neurological issues other than PBA as well.

Getting an Accurate Diagnosis

Since excessive crying can occur with various conditions, getting an accurate diagnosis is crucial for effective treatment. Here are some tips for assessing PBA versus other causes of frequent crying:

Track Episodes

Keeping a diary to track crying episodes can help identify key features. Note the date/time, any triggers, episode length, level of controllability, and associated feelings. Look for patterns of frequent, involuntary, inappropriate crying unrelated to actual emotions or situation.

Get Lab Tests

Blood tests can help rule out a hormonal imbalance or vitamin deficiency as the cause. Thyroid disorders, menopause, and premenstrual dysphoric disorder can trigger excessive crying.

Assess Medications

Review current medications with the doctor. Certain prescription drugs, from antidepressants and sedatives to heart medications, can potentially cause increased crying as a side effect.

Consider Neurological Causes

Sudden crying spells may result from an underlying neurological condition. PBA, strokes, dementia, and multiple sclerosis affect pathways between the brain's frontal lobes and limbic system.

Screen for Mental Health Disorders

Excessive crying can be symptomatic of depression, anxiety, bipolar disorder, PTSD, and other mental health conditions. Psychological screening tools can help assess mood disorders.

Discuss Quality of Life Impact

Share how the uncontrolled crying affects relationships, social life, and daily activities. PBA-related impairment indicates a serious issue needing solutions.

Treatment Options for PBA

If evaluation confirms PBA as the cause of severe, inappropriate crying, several treatment approaches may help.

Medication

The FDA has approved Nuedexta, a combined drug containing dextromethorphan hydrobromide and quinidine sulfate, specifically to treat PBA crying episodes. Other antidepressant or anti-anxiety medications may also be prescribed off-label.

Psychotherapy

Counseling helps individuals with PBA better understand and manage their condition. Cognitive behavioral therapy can teach coping strategies to apply when crying spells occur.

Relaxation Techniques

Breathing exercises, mindfulness, yoga, and meditation can help calm the body and mind during a PBA episode. Having go-to relaxation practices helps regain composure.

Support Groups

Connecting with others experiencing PBA provides support and reminds individuals they aren't alone. Support groups share tips for managing symptoms.

Avoid Triggers

Preventing PBA crying episodes involves avoiding known triggers when possible. This may mean limiting alcohol, sleep deprivation, stress, or certain medications that induce tears.

Coping with PBA Crying Spells

Living with frequent, unpredictable crying episodes caused by PBA poses daily challenges. The following strategies help women cope when a crying spell strikes:

• Use pre-agreed upon hand signals or code words to alert others discreetly.
• Have a private space to ride out episodes alone when needed.
• Carry earplugs or headphones to drown out noise triggers in public.
• Splash cold water on the face or take deep breaths to calm the body.
• Shift focus to positive thoughts or a happy memory.
• Listen to soothing music or meditative recordings.
• Excuse yourself politely from conversations or situations when possible.

Let loved ones know the best ways to show support when tears cant be controlled. Over time, coping strategies and treatments can help reduce PBA episode severity and frequency.

When to Seek Medical Care

If frequent bouts of excessive, unprompted crying are disrupting your life, consult a doctor. Sudden, frequent, intense crying spells should be evaluated, especially when they:

• Feel involuntary and disconnected from actual emotions
• Occur without an obvious trigger or reason
• Happen multiple times per day
• Cause embarrassment or relationship problems

A doctor can check for underlying medical conditions, screen for mental health disorders, and discuss treatment options that can help restore emotional regulation and quality of life. With proper diagnosis and care, PBA can be successfully managed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.