Joaquin Phoenix’ depiction of The Joker will no doubt garner honours come award season. And one element of his performance that had people talking was his ability to portray the character’s struggle with mental illness. But is the character’s compulsive laughter a real medical condition? Yup, it’s called Pseudobulbar affect (PBA).
What Is Pseudobulbar Affect?
Pseudobulbar affect (PBA), otherwise known as emotional incontinence, is a condition with symptoms that include frequent, involuntary bouts of crying, laughter, or other emotional displays, often not related to their true emotional state.
The condition is typically caused by brain trauma or neurological disorders that can impact how the brain processes emotion. It’s also more common in stroke survivors, as well as people with chronic conditions like dementia, multiple sclerosis and Lou Gehrig’s disease (ALS).
Although people who have PBA feel and experience emotion like anybody else, they often struggle with expressing it, the Mayo Clinic suggests. Symptoms are similar to that of depression and other mental ailments: long spells of laughter can often turn into tears resulting in the condition being mistaken for mood disorders.
Outbursts can last from “a few seconds to a few minutes,” neurologist Dr. Santosh Kesari told Prevention.
How Is It Treated?
Medication is usually the go-to treatment. Doctors will typically recommend anti-depression medication or a combination pill of dextromethorphan and quinidine (a drug commonly used for mental and mood disorders).
However, treatment won’t completely cure the symptoms. Instead they can reduce how often the episodes occur and the severity. Counselling is also an option: teaching the patient how to handle their outbursts can help manage the condition.
“This disease is caused by an underlying problem,” Dr. Kesari continues.
“The medications and behaviour modification will help reduce the incidence and severity, but they don’t completely take it away.”
Watch The Joker in action below.
