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YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

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YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Old 03-16-18, 05:32 PM
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YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Among my congeries of mental illnesses is this disorder, more familiarly known as emotional incontinence. Those who have this disorder react inappropriately in situations, such as laughing or crying uncontrollably and intensifyingly when there's no cause.
I've had this my entire life, and with me it manifested exclusively as laughing, usually when someone was talking to me and looking at me intently. I avoid funerals, lest I burst out laughing. It sounds like a minor behavioral condition, but I have found it extremely socially debilitating, and it's probably one of the reasons I have always been so shy and socially disinclined. I can't emphasize enough how mortifying it is to laugh in someone's face during a serious conversation. The laughter didn't strike all the time, but I never knew when it would.
I should mention that, thank goodness, I haven't had an episode of pseudobulbar affect in more than 15 years, ever since I started taking Clonazepam, which is an anti-seizure and anti-anxiety medication. I think it would return if I stopped taking the medication. A side effect of the medication is that it seems to suppress all emotion, including happiness.

Anyone else here know of this illness?


It's like in this hilarious video, which is fake and actually an old skit for a Dutch comedy show. For this guy, the trigger was the guest's funny vocal mishap:
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Old 03-16-18, 05:45 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

I've seen the Danny Glover advertisement about it, but that's all I know.
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Old 03-16-18, 05:47 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Yankit
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Old 03-16-18, 06:16 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by Deadman31 View Post
Yankit
It already looks like a handlebar grip.
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Old 03-16-18, 08:52 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Yet Another NKI Thread...

Need Kinky Input? I suppose you could get that here.

Nobody Knows It? They do now.

Neuro Kinesthetic Intelligence?
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Old 03-16-18, 09:13 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Yet another....I got nothing!

Sorry to hear you suffer from this, Norm. I've definitely heard of it but don't know anyone that has it (as far as I know). After all these years could there possibly be a different medication with less side effects that may help you?
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Old 03-16-18, 09:21 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by cultshock View Post
Yet another....I got nothing!

Sorry to hear you suffer from this, Norm. I've definitely heard of it but don't know anyone that has it (as far as I know). After all these years could there possibly be a different medication with less side effects that may help you?
Yet another 'this' reply. What's NKI again?
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Old 03-16-18, 10:11 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by cultshock View Post
Yet another....I got nothing!

Sorry to hear you suffer from this, Norm. I've definitely heard of it but don't know anyone that has it (as far as I know). After all these years could there possibly be a different medication with less side effects that may help you?
YANKIT means nothing other than following in a long line of "Yet Another... Thread" titles. But, you know, you can yank it if you like.

The thing about the medication is that I started taking it for anxiety, and it works very well. It was actually a happy accident that it took care of my emotional incontinece as well.

I watched the Danny Glover ad. As much as I like and respect the guy, he's pretty poor at acting out this illness. It's too forced. The Dutch video above made waves a few years ago (and I've posted it here a few times in the Video thread) because people, including me, thought it was real.

Edit: By the way, I have never been officially diagnosed with the disorder, but what else would it be when you have a compulsion to laugh at the wrong times?
I have also noticed that PBA is linked to neurological diseases such as Parkinson's, Alzheimer's, and, I assume, Huntington's. My dad died of Huntington's, and I have a 50/50 chance of having inherited it. I haven't been tested, and have no desire to be, but I'm 43 and have no overt signs (movements) of it other than chronic depression, which might or might not be related.

Last edited by Norm de Plume; 03-16-18 at 10:18 PM.
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Old 03-16-18, 10:37 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

I'm going to make a snap diagnosis and say you don't have pseudobulbar affect.

You have anxiety triggered laughter. Lots of people do. Anti-anxiety meds will, of course, help with that.

I agree with you, Danny Glover doesn't sell the concept.
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Old 03-17-18, 01:58 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

I had heard of this disorder.

Whether you actually have it, or what Mrs. Danger is suggesting, it's got to be awful. I recall going to a wedding and a friend and I were sitting, trying desperately not to laugh, during the ceremony. As it was, we were stifling small laughs. We dared not even look at each other, or it would've been over.

Reminds me of the 'giggle loop' from the UK show, Coupling.

I don't see a way to embed it, since it's not YouTube, but it's here:

https://www.snotr.com/video/6244/The_Giggle_Loop
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Old 03-17-18, 12:22 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

I've worked with patients who experience that, usually after having a stroke or brain injury. I didn't realize it was so common with PD (never seen that in real life). It's got to be awful in an outside setting. In the nursing homes where I work, often it's the least of people's problems on a big laundry list of things going wrong. I'm glad yours is controlled, Norm, whether it's PBA or from anxiety.
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Old 03-17-18, 05:45 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Could be, Mrs. Danger. I have had it since I was a little kid. For some reason I never discussed it (the uncontrolled laughter) with my long-time shrink, who died in '01, nor either of the two I saw in the years after his death. Weird, that. Maybe it wasn't as bad as I remember. I think it only occurred from time to time, but when it did, I just wanted to crawl into the nearest hole. It happened several times in high school, when I went in for extra help with my math teacher. I would sit there howling with laughter while he was explaining something, and to his great credit, he went on as if nothing were amiss. He must have thought I was insane.
Also in high school, there was a nice kid who had a stutter, and that set me off. I felt so bad for him. It happened often with my parents as well. One time, summer of '90, my dad and I spent three weeks at the coittage by ourselves. One evening we were sitting across from each other eating dinner. I had a sudden episode and spat onion soup in his face. Can you imagine doing that to someone you love? I could have killed myself right there and then. But, my dad being the preternaturally equanimous, abiding person he was, took it in stride.

andicus, your story reminds me of something that happened to my sister years ago. She and three or four colleagues were at a funeral, when suddenly some woman at the end of their pew began caterwauling some hymn or something. It took all their effort for my sister and her colleagues not to lose their shit. My sister told me the bench was shuddering with internalized guffaws. She said her belly hurt afterwards.

Thanks for your insight as well, tasha. Are you an occupational therapist?
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Old 03-18-18, 10:13 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Speech therapist
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Old 03-18-18, 02:32 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by Norm de Plume View Post
Could be, Mrs. Danger. I have had it since I was a little kid. For some reason I never discussed it (the uncontrolled laughter) with my long-time shrink, who died in '01, nor either of the two I saw in the years after his death. Weird, that. Maybe it wasn't as bad as I remember. I think it only occurred from time to time, but when it did, I just wanted to crawl into the nearest hole. It happened several times in high school, when I went in for extra help with my math teacher. I would sit there howling with laughter while he was explaining something, and to his great credit, he went on as if nothing were amiss. He must have thought I was insane.
Also in high school, there was a nice kid who had a stutter, and that set me off. I felt so bad for him. It happened often with my parents as well. One time, summer of '90, my dad and I spent three weeks at the coittage by ourselves. One evening we were sitting across from each other eating dinner. I had a sudden episode and spat onion soup in his face. Can you imagine doing that to someone you love? I could have killed myself right there and then. But, my dad being the preternaturally equanimous, abiding person he was, took it in stride.

andicus, your story reminds me of something that happened to my sister years ago. She and three or four colleagues were at a funeral, when suddenly some woman at the end of their pew began caterwauling some hymn or something. It took all their effort for my sister and her colleagues not to lose their shit. My sister told me the bench was shuddering with internalized guffaws. She said her belly hurt afterwards.

Thanks for your insight as well, tasha. Are you an occupational therapist?
That sounds about right!
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Old 03-18-18, 07:32 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by tasha99 View Post
Speech therapist
Ah. My dad saw a speech therapist in the late-'90s. I'm sure you have dealt with HD patients before.
I imagine working in a nursing home must be one of the most heartbreaking of jobs, what with people constantly dying. My dad was in a nursing home for 9 years. I still keep in touch with one of his personal support workers.
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Old 05-25-19, 11:10 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Further adventures in mental illness: 4-6 weeks ago, under a psychiatrist's guidance, I weaned myself off the antidepressant Cymbalta, which I had been taking for 10 years.
Unexpectedly, I began to have flareups of emotional incontinence, the old uncontrollable laughter, and after years of being completely free of it, I was reminded how demoralizing and mortifying it is. One feels like one is crazy, out of control, a loathsome jerk for laughing at someone for no reason, even though one knows one is helpless. So I guess it was in actuality the Cymbalta, not the Clonazepam (which I still take), that stifled this disorder.
I'm now on a starting dose of something called Vyvance, which is not an antidepressant but a stimulant, and I haven't had an outburst in several days (which might or might not be attributed to the drug; I don't know), but the medication seems to be providing no other benefits so far. However, I'm under the care of a doctor who seems to have a lot of tricks under his sleeve, and seemingly a strong desire to help me despite an overfull roster of patients, so I'm hoping desperately one of his treatments will work.

Shit, to laugh in one's mother's face because one is triggered by some silly, inconsequential behavioral manifestation of her elderliness... One of the only times I ever felt even lower was during another episode of emotional incontinence in Florida almost 25 years ago, when my cherished dad, rendered physically uncoordinated by Huntington's, immediately fell down on the tennis court while wanting desperately to prove it was still safe for him to play, which clearly it was not. He was not physically hurt other than a scraped knee, but to laugh at his clumsiness and the greater tragedy that underlay it is painful beyond description. My parents have always taken everything in stride and been endlessly supportive of me, but it's hard to forgive oneself for the inadvertent callousness. Fuck this life.
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Old 05-26-19, 07:46 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Damn Norm, I'm sorry you are afflicted with this condition. I hope you find the right combo of meds to get the chemicals in your brain in balance.
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Old 05-26-19, 10:19 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Same here. I feel for you Norm, I hope you manage to get things under control.

Somewhat off topic but oddly enough, I take Clonazepam for acid reflux before going to bed. It prevents chest pain caused by oesophagal spasms, so it must act as some sort of relaxant. The funny thing, the label on the bottle says "anxiety" and even the pharmacist was confused.
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Old 05-26-19, 11:52 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Oh Norm, I'm so sorry you're going through this again, and I hope the Vyvance helps long term. Glad you have a doctor who knows his stuff about this.

Last edited by tasha99; 05-26-19 at 01:42 PM.
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Old 05-26-19, 09:00 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Thank you for your kind words, Vin, eXcentris, and tasha! Your compassion is appreciated.

Originally Posted by eXcentris
Somewhat off topic but oddly enough, I take Clonazepam for acid reflux before going to bed. It prevents chest pain caused by oesophagal spasms, so it must act as some sort of relaxant. The funny thing, the label on the bottle says "anxiety" and even the pharmacist was confused.
Wow, I have never heard it used for acid reflux. I think it was developed as a treatment for epileptic seizures. I've been on it since 2001, and it sure helps with my anxiety, but since it's a controlled substance one cannot get more than one month's worth at a time, which I sometimes find a great inconvenience. My GP gave me a 5-day window to get it a little early if need be, but he and my pharmacist both said he could lose his license if he stretched the rules further.
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Old 05-29-19, 11:58 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by eXcentris View Post
Same here. I feel for you Norm, I hope you manage to get things under control.

Somewhat off topic but oddly enough, I take Clonazepam for acid reflux before going to bed. It prevents chest pain caused by oesophagal spasms, so it must act as some sort of relaxant. The funny thing, the label on the bottle says "anxiety" and even the pharmacist was confused.
It's likely esophageal dysmotility which can lead to spasms which is oftentimes caused by anxiety. Therefore the clonazepam. Definitely don't mix with alcohol especially before going to bed.
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Old 05-30-19, 12:01 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Have you tried Nuedexta Norm? It's relatively new drug for PBA. We've used it in some of our post-stroke and trauma patients and I believe it works pretty well.

Also why did you wean off of the Cymbalta? Obviously I know nothing about your medical history but Vyvanse isn't for depression at all. It's basically like Ritalin for ADHD. If you aren't on anything else it means you're not taking any kind of antidepressant?
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Old 06-13-19, 12:55 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by tanman View Post
Have you tried Nuedexta Norm? It's relatively new drug for PBA. We've used it in some of our post-stroke and trauma patients and I believe it works pretty well.

Also why did you wean off of the Cymbalta? Obviously I know nothing about your medical history but Vyvanse isn't for depression at all. It's basically like Ritalin for ADHD. If you aren't on anything else it means you're not taking any kind of antidepressant?
Sorry for the late reply to your thoughtful post, tanman, but I was away. I have not tried Nuedexta, but I did mention it to the psychiatrist when I first saw him (having looked up pseudobulbar treatments online), and he looked at it and said it was worth future consideration. He was, it seemed to me, not terribly well-versed in pseudobulbar affect, but perhaps that was just a false impression on my part.

No, you're right about Cymbalta and Vyvanse. They serve entirely different purposes, though possibly to the same end. This psychiatrist is a new one for me. I had read an article about him last year in a hospital magazine my mother gets as a donor, and asked my GP to refer me to him essentially as a last stab at some semblance of happiness.
He specializes in a procedure called focused ultrasound, which is, among other uses, for chronically, intractably depressed people who have unsuccessfully tried many other medications and treatments. This psychiatrist told me I might be eligible for the focused ultrasound, but that he wanted to try some new meds first, to which I was and am totally agreeable. Since the Cymbalta seemed to be doing nothing after ten years of use (which I now see was wrong; at least it was subduing the pseudobulbar affect), we decided to discontinue it.
I told him of my inability to "get anything productive going in life", despite high intelligence and a number of talents, etc., we noted my virtually nonexistent motivation, and so forth, and so we decided together that a fruitful course of action might be a stimulant instead of an antidepressant.
I have so far tried a couple of them, dexedrine and Vyvanse, and neither has had any noticeable effect, other than slightly increased agitation and irritation. Both were in very low doses, so there's no saying whether a higher dose might work, but I spoke with him the other day, and he was a bit puzzled, saying I should have detected something in terms of increased energy on the 20 mg of Vyvanse.

Anyway, I'm off the Vyvanse and back on the Cymbalta for the time being; at least the pseudobulbar should be fully under control. At my request, we have suspended further treatment until the late-fall, at which point we will try again. I should be relatively stable until then. One of the problems is that he really has no patient openings, so he has been sort of fitting me in briefly here and there when he can, which I appreciate.
Apart from the focused ultrasound, I have also heard of life-changing success against major depression using monthly injections of ketamine, which the doctor told me is also available in his department, but every patient is different, and what works for so-and-so might not work for me. But this doctor has the full gamut of treatment options at his disposal, which gives me a bit of hope, but really very little. A feeling of unassailable hopelessness is part of what afflicts me, especially as the years go by. I'm now in middle age with no signs of progress on any front.
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Old 06-13-19, 03:29 AM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Glad you're back on the Cymbalta. That was just a weird suggestion to switch from an anti-depressant to a stimulant. Have you ever discussed ECT with a physician?
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Old 06-13-19, 03:54 PM
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Re: YANKIT: Anyone else have pseudobulbar affect, or know someone who does?

Originally Posted by tanman View Post
Glad you're back on the Cymbalta. That was just a weird suggestion to switch from an anti-depressant to a stimulant. Have you ever discussed ECT with a physician?
Well, in my discussion with him, I underscored that my creative dormancy is something I find almost unbearably disheartening, and that perhaps my depression would lift if I could reignite my creative and cerebral industry, which has never really been able to take flight and find success. I'm not sure that's true, but it's worth a try, and if I do find myself with the energy to do things that give me satisfaction, even if I still have some lingering depression based on brain chemistry, I could probably live with it. That was the reason for going away from the Cymbalta (which makes one lethargic) and trying something in the stimulant family. I don't think it will work, based on results heretofore, but maybe I just haven't found the right one yet.

As far as ECT, yes, he did cite it as being transformatively beneficial to some people, but I immediately quashed the idea. I probably have written somewhere in here and in other threads that Huntington's runs in my family on my dad's side (who eventually died of it, or rather gradually withered away to the extent that his body could not fight off the Norwalk Virus). My aunt, his sister, who lived in the States, underwent ECT in the 1960s, long before she was diagnosed with HD and doctors were trying to treat her eccentric behaviour with blinders on. Though we have no proof other than my parents' first-hand observation that she went downhill fairly rapidly thereafter, and was ready for a nursing home in her late-40s (much earlier than my dad), we strongly suspect the ECT procedure profoundly exacerbated her condition. I have not been tested for HD, but if I were to ever consider ECT, I would get tested first to ensure I don't have it.
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