When I Received a Pseudobulbar Affect Diagnosis After Having a Stroke


June 12, 2012 began as any other day. I survived another day of teaching high school freshmen and was ready to go home. I picked up my son from daycare and my daughter from the bus stop. I was in for another night of homework, dinner, baths and bed. Little did I know what I was in for.

For the past week, I was experiencing really bad headaches at the base of my head. I thought nothing about it really. At the time, I had recently lost a ton of weight, exercised every day and watched what I ate. I was in the best shape of my life. Nothing could possibly happen to me.

I started to clean out my car and was hit by a sudden wave of nausea. My left side started to get tingly and I sweated profusely. I didn’t know what was wrong. I knew my body and something just wasn’t right. My husband was luckily on his way home by this time. When he got there, he took one look at me, my body slumped over the steering wheel, my clothes drenched with sweat, and he said he was taking me to the hospital. I didn’t argue.

By the time I got to the hospital, I could move nothing. They placed me on a gurney. I remember looking back at my kids, ages 4 and 6 at the time. I wanted to tell them I loved them and it would all be OK. I tried to form the words but my mouth wouldn’t let me. I watched them as the ER staff whisked me away. Would I ever see my children again?

The next 24 hours happened so rapidly, it was almost like a dream. I was transported from the smaller hospital I went to at first to VCU Medical Center. They ran a series of tests on me while I was in a drug-induced coma, and concluded I had a stroke. The doctors told my family I might be in a “locked in” state for the rest of my life. I might not be able to move anything but my eyes again. I had other things in mind.

The summer of 2012 was one of the hardest of my life. I had to relearn things like walking, talking and swallowing food properly. My 12-week hospital stay was followed by several months of in and outpatient therapy and numerous doctor’s appointments. It was a full-time job just to keep up with everything.

Most people think of the physical healing after a person has a stroke. That was the easy part for me. The hardest part was the emotional part, what people didn’t see. I was the outer shell of who I used to be, but I didn’t feel the same inside.

After talking to many doctors and therapists, what most thought to be depression — which can be a common side-effect of strokes — was something my neurologist pointed out called pseudobulbar affect or PBA. I was experiencing uncontrollable laughing and crying spells that could last up to 30 minutes and for no reason. This was affecting my daily routine and more importantly my family life.

Imagine going to church and laughing so hard at the sermon that everyone hears you and starts turning in their seats to see what’s wrong. Or trying to watch a movie with your family at the theater and laughing so much you disturb others in the room. Or scaring your kids with your crying, more like wailing and gnashing of the teeth, because they think something’s really wrong with you. And you have no control over any of it. It feels like your own body has turned against you.

I felt a weight had been lifted when I received the diagnosis of PBA. My stroke had triggered my emotional network in my brain stem. Knowing there was a reason why this was happening at least gave me some peace. It didn’t solve anything, but at least I knew the cause.

Now my PBA is under control with help from my neurologist. I am by no means cured, but my pseudobulbar affect does not run my life anymore. Most people have never heard of this condition unless I brought it up. Even some of my doctors had never heard of it before. This is why it’s so important to raise awareness of this somewhat new psychological disorder.

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