Pseudobulbar Affect

Pseudobulbar affect (PBA) can be difficult to diagnose. Healthcare providers often misdiagnose it as a mood disorder — especially depression or bipolar disorder.

Currently, there’s no definitive test to diagnose PBA. Healthcare providers base a diagnosis on a thorough understanding of your:

• Symptoms.
• Medical history, especially neurological conditions.
• Mental health history.
• Finding from a physical exam.

Why is pseudobulbar affect misdiagnosed as depression?

Pseudobulbar affect (PBA) tends to be misdiagnosed as a type of mood disorder, especially depression.

This often happens when crying is the affect you more commonly experience in PBA. People with PBA may also have depression, either due to other causes or as a result of PBA. However, compared to depression, PBA leads to crying episodes that:

• Are more explosive in onset.
• Are of shorter duration.
• Usually aren’t associated with longstanding internal sadness.

Even though people with depression have a persistent mood of sadness, they don’t tend to have frequent crying episodes. If they do, they last much longer than PBA episodes. In addition, other symptoms of depression, such as sleep disturbances or eating changes, don’t occur in PBA.