REAL PATIENT STORIES FROM THOSE WITH PSEUDOBULBAR AFFECT (PBA)

Experiencing sudden, frequent, uncontrollable episodes of laughing and/or crying can be frustrating for patients. They may not understand why they are laughing or crying, especially when those expressions don’t reflect how they really feel. This can leave them feeling confused, embarrassed, and misunderstood.
The real patient stories below demonstrate how Pseudobulbar Affect (PBA) can impact your patients and residents with neurologic conditions or brain injuries and the importance of making a proper diagnosis to get them the treatment they deserve.
I never knew when it was going to come on. I was teaching and could feel a crying episode. One day, my principal said, ‘You’ve got to stop crying.’ It was horrible.
Carol's PBA Story
- Age: 54
- Occupation: School librarian
- Primary neurologic condition: Traumatic brain injury
- First diagnosis and treatment: Depression and antidepressants
- Follow-up examination revealed: Crying episodes persisted despite depression treatment
- PBA impact: Feeling frustrated and fearful of having an episode in public
- Secondary diagnosis and treatment: Pseudobulbar Affect (PBA) and NUEDEXTA
Since Carol suffered from a traumatic brain injury (TBI), she has experienced uncontrollable crying episodes that leave her feeling frustrated and fearful about having another crying episode in public. Her unpredictable episodes began affecting her work and even the time she was willing to spend with family.
At first, Carol’s doctors thought these crying episodes were a symptom of depression, but the episodes persisted despite treatment with antidepressants. She continued to have involuntary, sudden, frequent crying episodes for more than a year. Finally, after talking to a neurologist, she was diagnosed with PBA.
When I was diagnosed with PBA, I was so relieved there was name for it — it was a real thing that was affecting me.
Carol was prescribed NUEDEXTA, which she takes twice a day, as directed. She continues to experience reduced PBA episodes compared to before her diagnosis and treatment.
After treatment with NUEDEXTA, I could tell it was working because I was having fewer episodes.
I always had that tough military mindset. So it was difficult not being able to manage my crying episodes in front of my buddies, family, even strangers. It has been really hard.
Robert's PBA Story
- Age: 64
- Occupation: Army Veteran
- Primary neurologic condition: Traumatic brain injury
- First diagnosis and treatment: Depression and antidepressants
- Follow-up examination revealed: Crying episodes persisted despite depression treatment
- PBA impact: Not being able to stop crying while with friends, family, and strangers
- Secondary diagnosis and treatment: Pseudobulbar Affect (PBA) and NUEDEXTA
Robert was an Army paratrooper who was wounded during a routine jump in 1991. He suffered multiple injuries, including a traumatic brain injury.
For 25 years after his accident, he experienced uncontrollable crying episodes that were confusing because he did not feel sad. He was diagnosed with depression and prescribed antidepressants, but the crying spells continued. Robert had several unpredictable episodes a day, making him run to the bathroom or pull his car over to wait for his crying to stop.
Robert saw a commercial about PBA that reflected his experience. He made a doctor’s appointment to discuss his symptoms, and he had a crying episode at the appointment. After reviewing his chart and seeing Robert’s episode, his doctor diagnosed him with PBA.
Robert has fewer crying episodes on NUEDEXTA. He encourages others to talk to their doctors about how disruptive these unpredictable, uncontrollable laughing and/or crying episodes can be.
You have to explain what you’re going through as best as you can, so your doctor can help you manage it.
PBA’s Impact on Long-Term Care Residents
Listen to Nurse Jennifer as she shares the patient stories of John and Sharon, two residents with PBA.


Being taken away can be embarrassing in front of the other residents. Here’s this man crying uncontrollably…and so I think it does affect him.
John's PBA Story
- Age: 65
- Primary neurologic condition: Stroke
- First diagnosis and treatment: Depression and antidepressants, and antipsychotics
- Follow-up examination revealed: Crying episodes persisted despite depression treatment
- PBA impact: Being removed from group activities
- Secondary diagnosis and treatment: Pseudobulbar Affect (PBA) and NUEDEXTA
John is a storyteller who loves activities with friends. He suffered a stroke that resulted in uncontrollable crying episodes. Because of the unpredictable episodes, John started limiting his interactions with other residents out of fear that he wouldn’t be able to stop crying in front of friends. He would sometimes be removed from group activities because of disruptive episodes.

After she did start taking NUEDEXTA, we did see a decrease in the number of crying episodes.
Sharon's PBA Story
- Age: 78
- Primary neurologic condition: Stroke
- First diagnosis and treatment: Depression suspected, but after further evaluation, she was diagnosed with Pseudobulbar Affect (PBA) and treated with NUEDEXTA
- PBA impact: Spending less time with family and visitors
Sharon is known as the "town greeter." She enjoys spending time chatting at the nurses’ station and welcoming visitors to the nursing home where she lives. After having a stroke, Sharon started experiencing uncontrollable crying episodes. Since she couldn’t stop herself from crying, her daughter visited less frequently, and Sharon spent less time greeting visitors.