What to Do When You're Crying Uncontrollably

Have you ever experienced episodes of uncontrollable crying? It may feel like you're crying for no reason, and you can't seem to stop. If so, you might feel worried about why you are crying and unable to control it.

While uncontrollable crying can be a symptom of some mental health disorders, it can also be a sign of an underlying neurological issue. As a result, your treatment options and coping strategies will differ depending on the cause.

Signs of Uncontrollable Crying

Are you unsure whether your uncontrollable crying is normal or a problem? Have a look at this list of signs that something might be wrong or more than just normal tears:

• You have uncontrollable episodes of crying, laughter, or both
• Your crying seems to happen without an obvious trigger or in relation to something that doesn't seem like a natural trigger
• Your crying does not seem to relate to feelings of sadness
• Your laughter easily turns into crying
• You avoid being around people for fear of crying or having an outburst
• Your crying episodes are unpredictable

Why You May Be Crying Uncontrollably

If you frequently cry for no apparent reason, you have nothing to be ashamed of. It is not a sign of weakness or moral failure. It could simply mean you're dealing with an underlying physical or mental health condition. Here are some of the most common explanations behind your uncontrollable crying.

Neurological Causes

If you find yourself uncontrollably crying during a happy event or laughing hysterically during a sad event, you may have a condition called pseudobulbar affect (PBA).

PBA is a neurological disorder, meaning that it is caused by damage to the nervous system. It is characterized by sudden, uncontrollable, and inappropriate crying or laughing. PBA usually occurs as a result of a traumatic brain injury or another neurological condition such as:  

• Alzheimer's disease
• Amyotrophic lateral sclerosis (ALS)
• Brain tumor
• Multiple sclerosis
• Parkinson's disease
• Stroke

Many people with PBA are unaware that they have a real condition and rarely tell a doctor about their symptoms (so they don't receive treatment). Doctors also don't usually screen for PBA because many don't know about it. However, the condition has been documented for over 100 years.

There are different theories about which brain structures are involved in PBA. One theory is that there is damage to the cerebro-ponto-cerebellar pathways, which adjust laughter or crying to match the situation. Another theory is that there is damage to pathways in motor areas of the cerebral cortex that inhibit laughter and crying.

Mental Health Causes

Frequently crying for no reason may also be a sign of a mental health issue. Crying can be a symptom of various forms of grief. Acute grief resulting from a situation such as the loss of a loved one is one type. In addition, there is chronic grief, usually related to an ongoing situation in your life (e.g., infertility).

Major depression and bipolar depression also involve crying; however, it has other features such as sleep issues, lack of enjoyment of usual activities, and appetite changes. PBA is sometimes also mistaken for depression. One way to distinguish them is based on the trigger; PBA seems to lack a trigger or be triggered in inappropriate ways.

Hormones

Fluctuations in hormones can also influence emotional reactions and uncontrollable crying. This may occur naturally in the case of pregnancy and menstruation, with more severe episodes in an underlying condition known as premenstrual dysphoric disorder (PMDD).

PMDD is a syndrome that some women experience approximately one week before their menstrual cycle, which subsides when menstruation begins. Crying spells are accompanied by headaches, mood swings, low energy, irritability, and general body pain.

Effects of Uncontrollable Crying

Uncontrollable crying can have negative effects on your life. Below are some of the things you might experience:

• Social embarrassment over your inability to control your crying
• Distress in social situations, the workplace, and with family
• Feeling emotionally exhausted
• Choosing to isolate yourself due to your crying
• Changing your life to avoid things that might trigger your crying
• Secondary depression resulting from chronic, untreated, uncontrollable crying

Treating Uncontrollable Crying

The treatments for uncontrollable crying depend on the underlying cause. Complicated grief and depression are usually treated with therapy and/or medication.

PBA may be treated with low doses of tricyclic antidepressants such as amitriptyline and selective serotonin reuptake inhibitors (SSRIs) such as citalopram or fluoxetine.

There is also one drug, Nuedexta (dextromethorphan hydrobromide and quinidine sulfate), that is approved by the Food and Drug Administration (FDA) for treating PBA. It was actually discovered quite accidentally while testing it to treat ALS patients. While it was never approved specifically for ALS, it was later approved for PBA.

This drug contains the active ingredient dextromethorphan, which is found in many cough syrups; however, you can't self-medicate with cough syrup, as it has a different formulation.

An occupational therapist can also help people with PBA learn how to cope in everyday life.

Coping With Uncontrollable Crying

There are also several things you can do on your own to cope with uncontrollable crying that is interfering with your life. Below are some ideas:

• Explain the problem to others so they are not surprised or confused.
• Speak to other people with the same problem and ask for advice.
• Distract yourself with something the opposite of crying, like having someone tell you a funny joke.
• Practice deep breathing and relaxation techniques.
• Getting up and walking around to change your position.
• Keep a diary of your episodes to track the triggers, length, related emotions, and ill effects.
• Examine life stressors and how you can address them.

Final Thoughts

If you are living with uncontrollable crying that is interfering with your daily life, it's important to seek answers from your doctor. We usually think of mood disorders when it comes to crying spells, but some neurological conditions are also a concern. You may be living with neurologic conditions, such as PBA, stroke, brain tumor, and so on.

On the other hand, if you have grief that is adversely impacting your life or a depressive disorder, medication or therapy may help. Regardless of the cause, your doctor will be able to prescribe the best course of action.