It doesn't happen often, but I do have episodes of uncontrollable laughter and crying. The laughter is particularly unpleasant because my abs really hurt after a while. When it first happened my husband thought it was funny and kept making me laugh - until I told him how uncomfortable it was. On one occasion, uncontrollable crying was triggered by a sad passage in a book. Normally I would stop crying soon after reading such a passage. That time I didn't stop crying until I'd finished the book. Then, when I started reading another book, I started crying over things that normally wouldn't affect me that much. Thankfully the uncontrollable laughter/crying hasn't happened in public. My husband would never consider shutting me away, even if it was a regular occurrence. He'd try to get me the help I needed, although I didn't know that there was a treatment until today. Thanks for the information. I'll keep it in mind in case the situation worsens.
When diagnosed in my early 20s I had optic neuritis, numbness in arms and one leg and was treated with Rebif. I also had symptoms of uncontrollable laughter and crying but didn’t know this was MS related. After a few years an MS nurse who was running a trial I was participating in suggested I see a neuropsychiatrist. I was very reluctant and embarrassed but luckily I went and was diagnosed with what was termed ‘emotional lability’. I was prescribed Citalopram and felt the difference immediately. I took the minimum dose for many years but last year was moved to Sertraline as safety profile better. Having these SSRIs changed my life and explained why I found work so stressful when I couldn’t control my emotions. I wish I had known earlier as I think it is not a well known symptom at all.
I do suffer with uncontrollable crying over the smallest things. Even happy things. It’s really hard to surpress it in company.
I’ve had MS for 20+ years treated at NHNN and it’s never been raised by my neurologist. It’s fantastic professionals like you that raise awareness of the smaller symptoms that can be overlooked when you are coping with everything else. Thank you for informing us.
Yes I have it too. The crying. I had it occasionally at first but this past year a couple of episodes in public and quite a few at home. When I brought it up to Neuro Nurse Practitioner she recommended Nuedexta to take along with the Effexor I’ve been taking for years she said it could also help my overall mood. My pharmacist said it’s being prescribed “off-label” for depression. I am on my fourth week of full dose and I can definitely tell a difference. I’ve had some mild teary spells but none of the full-on sobbing.
And my mood has lifted.
Thanks so much for addressing this subject. Hopefully others will seek treatment.
For years I have struggled with inappropriate crying at the smallest, stupidest things. I only recently realised it is a symptom from reading your blog so thank you! It has significantly impacted my work as a Financial Director for our family business as I cannot have conversations with staff etc without crying. It's also really embarrassing at funerals of people I barely know etc.
Nov 30, 2022·edited Dec 6, 2022Liked by Gavin Giovannoni
I too have had this, and still do on occasion at very low levels I can usually control now. It occurred on my first relapse, which I later learned must have been a small brainstem relapse (unrecognized by doctors because I had no GP, and walk-in doctors and the ER couldn't seem to figure it out, despite pretty severe symptoms). In the end, I asked my MS neuro for something to manage it and explained what I'd been experiencing seemed similar to pseudobulbar affect (after finally getting a neuro from private-paid MRI, to go around the ill-equipped and road blocking walk-in GP-gatekeepers. Got my MS diagnosis then Nero's referral). The neuro agreed and prescribed SSRI, which the MS psychiatrist later changed to SNRI to also help with nerve pain.
For example, I'd be perfectly happy (because "mmmm latte"), and be counting out change at the coffee shop to pay for it... my brain fully occupied by that task, and I'd suddenly have tears rolling down my face. This occurred on my day off, with nothing but happy plans, and was definitely incongruent with actual mood at the time. Laugher I also got regularly, though both got mostly better as the relapse ended. Each still creeps up from time to time, particularly when tired or very, very fatigued, but usually at a manageable level. That first relapse though, I too stopped going out until I got something for it.
There was also a time or two where I felt a surge of inexplicable and intense anger, but that too faded as the relapse faded, and it never returned. At the time I thought that might be part of the grieving process while going through counselling, but if pseudobulbar affect can also cause this, it's likely related as it was quite unreasonable, which is not like me at all. Even in anger my logic-bone is activated by default (am an aspie lol).
Nov 30, 2022·edited Nov 30, 2022Liked by Gavin Giovannoni
Having been diagnosed in 1999 I have to date not been asked about any laughing/crying but am aware of it from some unusual impulses I have got. Especially crying witnessing something dramatic or hearing sirens.
I don’t think it’s severe or even noticed by people around me.
I had a few episodes of uncontrollable crying - the first decades before my diagnosis. The worst occasion was at a conference dinner - I was mortified. Another time was on a packed train. Every time it was confusing, and I had no idea that it was associated with MS until after my diagnosis. It hasn't happened in years but I'm concerned it may be an indicator of poor prognosis. Fortunately I've had alemtuzamub.
Even before I was diagnosed I remember being told that sometimes my laughter wasn't always appropriate (especially not discussing death and dying with a patient). Now I tend more to tears easily.
I had a right hemisphere bleed stroke 10 years ago and was subsequently diagnosed with the stroke illness CAA, which is progressively getting worse. From the start, I have had a problem with inappropriate emotionality, unable to talk about often mundane things, and certainly upsetting things, without being on the verge of tears, which is very embarrassing socially. I have never sought help, because I was told by the stroke nurse that "it's a common feature of stroke damage" and something you have to learn to live with, like all the other damage. Compared to progressive mobility and cognition problems, it somehow seemed like something I would have to accept and cope with. Maybe now I can talk to my GP about trying the medication mentioned, if he's up for going off-licence, especially if it might help with mood problems too.
I have had low levels (a 5 on a scale of 10, never outside my ability to control in public) of this with my MS. I think it is what I call "emotional dysregulation" where my emotions come on suddenly. Mostly it is sadness. When I had optic neuritis in my early 30's and MS was ruled out at the time, I started working with a counselor for my stress and depression/anxiety, and was on Celexa for a few years to help. Before my recent (2021) diagnosis, my anxiety/emotional dysregulation had returned, but I thought it was a return of my stress. Now I recognize it as part of my MS. My naturopath who is supervising my Coimbra Protocol treatment, prescribed Pregnenolone which had helped my emotional regulation quite a bit. If it was at a 5 before, it is at a 1 or 2 now and very manageable.
So I think about this, and I guess the key word is “inappropriate”. Does one still have the judgment and self awareness to know that their crying and laughing is out of place? Sounds from the comments thus far the answer is yes. But to flip the issue, just as a reminder, having MS is tough and pulls at many of the strings tied to negative emotion. Perhaps that’s what the diagnostic questionnaire helps establish. I cried deeply and at great length a few times back in the day. It was relieving and helped me face things, talk to myself and others about my reality, etc. Doing so gave me emotional freedom that I was unaware I was lacking. So if I had been prescribed meds for this kind of affect, would the meds have squelched it, and would I think therefore I had needed the meds? I never experienced too much laughing, that may be part of the key differential diagnosis. This is quite clinical stuff.
And furthermore to the related down side, while working in an unethical situation, the obvious (to me) nature of decision making that was put upon me and affected my working destiny was heart wrenching, and if I ever showed that at work, that would have been more evidence that I couldn’t work for them (is that gaslighting?).
So just a comment, in my opinion, that many of us from time to time have a lot to feel sorry about and crying can be a relief. Just find a good place to do it, let it out till it stops, wash your face with cold water, and jump back in. There’s nothing wrong with you. Too much laughing and crying for no good reason (key) and you are lucky enough to be aware, then a new symptom and do something about it. This disease is relentless. Be careful of the gas-lighting, however.
Yes I have this, I discovered it through an MS trust booklet, I was never asked or screened for it by my MS team, I was never given any questionairre, nor did they give me any meds to help. I cry, its embarrassing and I have brainstem lesions. I did finally get a diagnosis, after getting a second opinion on another under diagnosed issue with MS, Autonomic dysreflexia, picked up by a fantastic out of hours GP, initially dismissed by my MS team because I didn't have lesions in the right place, but had all the symptoms.
I think I've had inappropriate crying once or twice that I can remember. Especially one time when I just couldn't stop crying although I didn't know why I was crying.
How awful to keep someone at home like that, for me working in local government I would see that as a safeguarding issue (neglect).
It doesn't happen often, but I do have episodes of uncontrollable laughter and crying. The laughter is particularly unpleasant because my abs really hurt after a while. When it first happened my husband thought it was funny and kept making me laugh - until I told him how uncomfortable it was. On one occasion, uncontrollable crying was triggered by a sad passage in a book. Normally I would stop crying soon after reading such a passage. That time I didn't stop crying until I'd finished the book. Then, when I started reading another book, I started crying over things that normally wouldn't affect me that much. Thankfully the uncontrollable laughter/crying hasn't happened in public. My husband would never consider shutting me away, even if it was a regular occurrence. He'd try to get me the help I needed, although I didn't know that there was a treatment until today. Thanks for the information. I'll keep it in mind in case the situation worsens.
When diagnosed in my early 20s I had optic neuritis, numbness in arms and one leg and was treated with Rebif. I also had symptoms of uncontrollable laughter and crying but didn’t know this was MS related. After a few years an MS nurse who was running a trial I was participating in suggested I see a neuropsychiatrist. I was very reluctant and embarrassed but luckily I went and was diagnosed with what was termed ‘emotional lability’. I was prescribed Citalopram and felt the difference immediately. I took the minimum dose for many years but last year was moved to Sertraline as safety profile better. Having these SSRIs changed my life and explained why I found work so stressful when I couldn’t control my emotions. I wish I had known earlier as I think it is not a well known symptom at all.
I do suffer with uncontrollable crying over the smallest things. Even happy things. It’s really hard to surpress it in company.
I’ve had MS for 20+ years treated at NHNN and it’s never been raised by my neurologist. It’s fantastic professionals like you that raise awareness of the smaller symptoms that can be overlooked when you are coping with everything else. Thank you for informing us.
I don’t know if this is the same but if I get MS fatigue I definitely cry for no reason.
Yes I have it too. The crying. I had it occasionally at first but this past year a couple of episodes in public and quite a few at home. When I brought it up to Neuro Nurse Practitioner she recommended Nuedexta to take along with the Effexor I’ve been taking for years she said it could also help my overall mood. My pharmacist said it’s being prescribed “off-label” for depression. I am on my fourth week of full dose and I can definitely tell a difference. I’ve had some mild teary spells but none of the full-on sobbing.
And my mood has lifted.
Thanks so much for addressing this subject. Hopefully others will seek treatment.
For years I have struggled with inappropriate crying at the smallest, stupidest things. I only recently realised it is a symptom from reading your blog so thank you! It has significantly impacted my work as a Financial Director for our family business as I cannot have conversations with staff etc without crying. It's also really embarrassing at funerals of people I barely know etc.
I too have had this, and still do on occasion at very low levels I can usually control now. It occurred on my first relapse, which I later learned must have been a small brainstem relapse (unrecognized by doctors because I had no GP, and walk-in doctors and the ER couldn't seem to figure it out, despite pretty severe symptoms). In the end, I asked my MS neuro for something to manage it and explained what I'd been experiencing seemed similar to pseudobulbar affect (after finally getting a neuro from private-paid MRI, to go around the ill-equipped and road blocking walk-in GP-gatekeepers. Got my MS diagnosis then Nero's referral). The neuro agreed and prescribed SSRI, which the MS psychiatrist later changed to SNRI to also help with nerve pain.
For example, I'd be perfectly happy (because "mmmm latte"), and be counting out change at the coffee shop to pay for it... my brain fully occupied by that task, and I'd suddenly have tears rolling down my face. This occurred on my day off, with nothing but happy plans, and was definitely incongruent with actual mood at the time. Laugher I also got regularly, though both got mostly better as the relapse ended. Each still creeps up from time to time, particularly when tired or very, very fatigued, but usually at a manageable level. That first relapse though, I too stopped going out until I got something for it.
There was also a time or two where I felt a surge of inexplicable and intense anger, but that too faded as the relapse faded, and it never returned. At the time I thought that might be part of the grieving process while going through counselling, but if pseudobulbar affect can also cause this, it's likely related as it was quite unreasonable, which is not like me at all. Even in anger my logic-bone is activated by default (am an aspie lol).
I would suspect this is a not so common effect in MS? I have never experienced this and don't know anyone else with MS who has.
Having been diagnosed in 1999 I have to date not been asked about any laughing/crying but am aware of it from some unusual impulses I have got. Especially crying witnessing something dramatic or hearing sirens.
I don’t think it’s severe or even noticed by people around me.
I had a few episodes of uncontrollable crying - the first decades before my diagnosis. The worst occasion was at a conference dinner - I was mortified. Another time was on a packed train. Every time it was confusing, and I had no idea that it was associated with MS until after my diagnosis. It hasn't happened in years but I'm concerned it may be an indicator of poor prognosis. Fortunately I've had alemtuzamub.
Even before I was diagnosed I remember being told that sometimes my laughter wasn't always appropriate (especially not discussing death and dying with a patient). Now I tend more to tears easily.
I had a right hemisphere bleed stroke 10 years ago and was subsequently diagnosed with the stroke illness CAA, which is progressively getting worse. From the start, I have had a problem with inappropriate emotionality, unable to talk about often mundane things, and certainly upsetting things, without being on the verge of tears, which is very embarrassing socially. I have never sought help, because I was told by the stroke nurse that "it's a common feature of stroke damage" and something you have to learn to live with, like all the other damage. Compared to progressive mobility and cognition problems, it somehow seemed like something I would have to accept and cope with. Maybe now I can talk to my GP about trying the medication mentioned, if he's up for going off-licence, especially if it might help with mood problems too.
I have had low levels (a 5 on a scale of 10, never outside my ability to control in public) of this with my MS. I think it is what I call "emotional dysregulation" where my emotions come on suddenly. Mostly it is sadness. When I had optic neuritis in my early 30's and MS was ruled out at the time, I started working with a counselor for my stress and depression/anxiety, and was on Celexa for a few years to help. Before my recent (2021) diagnosis, my anxiety/emotional dysregulation had returned, but I thought it was a return of my stress. Now I recognize it as part of my MS. My naturopath who is supervising my Coimbra Protocol treatment, prescribed Pregnenolone which had helped my emotional regulation quite a bit. If it was at a 5 before, it is at a 1 or 2 now and very manageable.
So I think about this, and I guess the key word is “inappropriate”. Does one still have the judgment and self awareness to know that their crying and laughing is out of place? Sounds from the comments thus far the answer is yes. But to flip the issue, just as a reminder, having MS is tough and pulls at many of the strings tied to negative emotion. Perhaps that’s what the diagnostic questionnaire helps establish. I cried deeply and at great length a few times back in the day. It was relieving and helped me face things, talk to myself and others about my reality, etc. Doing so gave me emotional freedom that I was unaware I was lacking. So if I had been prescribed meds for this kind of affect, would the meds have squelched it, and would I think therefore I had needed the meds? I never experienced too much laughing, that may be part of the key differential diagnosis. This is quite clinical stuff.
And furthermore to the related down side, while working in an unethical situation, the obvious (to me) nature of decision making that was put upon me and affected my working destiny was heart wrenching, and if I ever showed that at work, that would have been more evidence that I couldn’t work for them (is that gaslighting?).
So just a comment, in my opinion, that many of us from time to time have a lot to feel sorry about and crying can be a relief. Just find a good place to do it, let it out till it stops, wash your face with cold water, and jump back in. There’s nothing wrong with you. Too much laughing and crying for no good reason (key) and you are lucky enough to be aware, then a new symptom and do something about it. This disease is relentless. Be careful of the gas-lighting, however.
Yes I have this, I discovered it through an MS trust booklet, I was never asked or screened for it by my MS team, I was never given any questionairre, nor did they give me any meds to help. I cry, its embarrassing and I have brainstem lesions. I did finally get a diagnosis, after getting a second opinion on another under diagnosed issue with MS, Autonomic dysreflexia, picked up by a fantastic out of hours GP, initially dismissed by my MS team because I didn't have lesions in the right place, but had all the symptoms.
I think I've had inappropriate crying once or twice that I can remember. Especially one time when I just couldn't stop crying although I didn't know why I was crying.
How awful to keep someone at home like that, for me working in local government I would see that as a safeguarding issue (neglect).