What is emotional lability: causes, symptoms and treatment

What is emotional lability: causes, symptoms and treatment

Emotional lability


  • 1 What is emotional lability
  • 2 Main causes of emotional lability
  • 3 Signs and symptoms
  • 4 Difference between emotional lability and depression
  • 5 Consequences of emotional lability
  • 6 Treatment of emotional lability

What is emotional lability?

Emotional lability or emotional incontinence is a neurological disorder characterized by involuntary episodes of crying, laughing or other emotional manifestations uncontrollable. Victims can start laughing uncontrollably at something that is barely funny or burst into tears over events or situations that are not truly sad. In more severe cases, emotions may not match the circumstances.

They are what could be called extreme reactions to daily events. For example, a moderately funny or sarcastic comment could trigger an attack of uncontrollable laughter. A television show or even an ad with emotional content can lead to an extreme crying response for quite some time.

People who suffer from this disorder are not able to end that emotion for several minutes. Feelings of anger or frustrations can also be a reason for the subject to cry or laugh uncontrollably.

Main causes of emotional lability

The main causes of emotional lability are neurological diseases such as dementia, a head injury, a stroke or multiple sclerosis.

Emotional lability or emotional incontinence occurs when the brain injury damages and prevents:

  • Understanding the emotions of oneself and others.
  • The ability to manage how to express emotional sensations.
  • The ability to slow down or stop the result of these sensations.

The disorder is caused by the disruption of the intellectual and emotional circuit that exists in the brain. In a healthy brain there is a neuronal "gateway" that controls the connections between the intellectual response to a circumstance and the consequent emotional response. Healthy people are able to feel sad without crying or feel happy without laughing. When, for some reason, this neuronal door is broken, the emotional response is no longer under the control of the individual.

In addition to the uncontrolled emotional response, a inability to control impulses. This is evident in individuals who, before the injury, were very educated with others and after the accident they are unable to control their emotions, making inappropriate statements in a conversation or showing a tendency to act without thinking about the consequences.

These types of behaviors can be very disconcerting, uncomfortable and difficult to recognize for the person, and even for others.

Signs and symptoms

People with emotional lability show episodes of laughter, crying or screaming without obvious motivation or in response circumstances that would not have triggered such an expressive response.

In some patients the behavior may even be the opposite of that expected, the affected person could laugh after receiving bad news or crying in response to a joy, they may even change spontaneously and unexpectedly from laughter to tears or vice versa.

The signs of emotional lability can become serious, with constant and chronic episodes. The main features are:

  • The beginning is abrupt and random, as if it were an attack.
  • The incidents last a few seconds or a few minutes.
  • The episode can be repeated many times a day.

Some patients claim that they recognize the inadequacy of their emotions and that they are out of place, but that they are not able to control them. The influence of this disorder can be very serious, with chronic and lasting signs that can immobilize patients and significantly influence the living conditions of caregivers.

Difference between emotional lability and depression

Sometimes, Emotional Lability is misdiagnosed as clinical depression, but there are many differences that distinguish both disorders.

Crying is naturally an indicator of sadness in depression and pain processes, but in emotional lability pathological manifestations of crying occur, since they are usually abrupt, exaggerated and out of place, but it is not a generalized mood.

Another important key to discrimination between depression and emotional lability is the duration of sadness. In depression, crying and sad mood is somewhat prolonged and strongly related to the original mood, while emotional lability incidents are sudden and occur periodically.

The possibility of controlling the onset of crying is different in depression and emotional lability. In depression, emotional expressions, especially crying, can be adapted to the situation, which means it can be controlled. While in the emotional lability controlling episodes of crying or laughing is absolutely impossible.

In the same way, in depression the activation of crying is related to the original temperament of the individual, while in emotional lability the triggers of crying episodes are usually inaccurate, minimal and inappropriate for the situation.

In certain cases, depressed mood and emotional lability can coexist. In fact, depression is considered one of the most frequent emotional transformations in patients with neurodegenerative syndrome or after suffering a stroke.

Consequences of emotional lability

Consequences for victims of emotional lability include thoughts of emotional tiredness and often, Social isolation. Without understanding that they have a neurological disorder, people with emotional lability often change their lives to stay away from things that trigger situations, including work, friends and even family. With this separation from social life there are still more harmful emotions that may become obvious like major depression.

Treatment of emotional lability

Unfortunately, as we have seen, emotional lability severely destroys social relationships, isolating those who suffer from it in an important way, which can have a harmful effect on the living conditions of the affected people and their families.

Teaching affected people, caregivers and families what this disorder is about is very important so that these people feel more understood and accepted by those around them.

On the other hand, the antidepressant drugs like fluoxetine, sertraline, nortriptyline, amitriptyline or citalopram, they are quite useful. However, Dextromethorphan, commercial name is Nuedexta, is the first accepted medication to treat emotional lability. Medication with dextromethorphan-quinidine significantly decreases the occurrence of laughter and crying in individuals affected with ALS, that is, amyotrophic lateral sclerosis or MS or multiple sclerosis.