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Main Research Question :

How do people with emotional lability think?

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People with emotional lability often feel as if everyone around them is better, than they are. They might have a hard time staying on task or controlling their emotions.

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Emotional lability is characterized by rapid exaggerated changes in mood. You'll feel strong emotions and feel like you can't control your behavior and feelings. You will express your emotions more dramatically than usual. Labile mood symptoms include:

Uncontrollable laughing

Excessive crying

Heightened irritability

Moody temper

Here are some ways that you can deal with emotional lability:

Take a break. Building in breaks during your day can keep you from feeling overwhelmed. When you take a break, you can regain control of your feelings. Your break may be a few minutes or over an hour. It depends on how much time you need. You can take a break by going on a walk or coloring in an adult coloring book. Just do something that takes your mind away from your strong emotions.

Ignore the behavior. Getting others not to acknowledge your emotional lability can also help you ignore the behavior. If you're around someone with emotional lability, you should avoid laughing with the person experiencing it. Also, not bringing too much attention to these emotions and trying to change the topic or ignore the trigger may help.

Cognitive techniques. Using mental strategies can help you manage your emotional lability. You can discuss the proper techniques with your psychologist. Some of these strategies include:

Relaxing and engaging in breathing exercises

Distracting yourself by thinking of a peaceful image or picture

Going for a walk

Having a cold drink‌

Can Mindfulness Help Emotional Lability?

Some studies have shown benefits of mindfulness-based intervention for emotional lability. These practices help promote non-judgemental attention to your present situation. Practicing mindfulness can help you accept challenging circumstances or feelings.

According to some studies, mindfulness seems to be more effective the longer you do it. Rather than getting the true effects in your first session, it takes practice, time, and consistency to see the full benefits. Practicing mindfulness can also help decrease your anxiety and emotional suppression that comes with emotional lability.

Is There Treatment for Emotional Lability?

Emotional lability is not a condition someone typically has their whole life. It is most often a disorder that's developed following a brain injury, which may heal over time. Emotional lability typically comes with a lot of other changes, like the inability to work, drive, and maintain your previous quality of life. These sudden changes can make your emotional lability worse and may also lead to depression and anxiety.

It's best to seek extra support from a therapist or psychologist. You can talk to your doctor about emotional lability treatment. During these times, it's best to surround yourself with a good support group. They'll all be able to help you cope with the changes happening in your life.

Labile Mood Symptoms

According to the DSM diagnostic criteria, affective lability and emotional dysregulation have overlapping symptoms. Affective lability is tied to bipolar disorder, whereas emotional dysregulation is connected to ADHD. Labile mood symptoms include:

Excessive talking

Being easily distracted

Interrupting people and putting oneself in situations one hasn't been invited into

Physical restlessness and fidgeting

Racing thoughts

Trouble maintaining attention

Labile mood symptoms are mostly unpredictable compared to your "normal" reactions. These mood swings can be very dramatic and entirely uncontrollable. It can be hard to tell you're in the middle of an episode because of the randomness of the symptoms.

What Causes Emotional Lability?

Emotional lability is typically a result of damage to your brain that controls your awareness of emotions, ability to control how your feelings are expressed, and intense emotional responses.

Brain injury can cause the loss of emotional awareness. Having weaker emotional control and lower frustration tolerance can also cause extremes in your emotional feelings. You may not be as sensitive to others or your own emotions, which makes it harder to control your behavior.

If you have emotional lability, you may have feelings come out of nowhere and overwhelm you. You may, for instance, start crying for an unknown reason. Emotional lability can also cause you to overreact to people or things happening around you. For example, you may become more emotional at a sad or funny movie.

How Do You Cope With Emotional Lability?

Coping with emotional lability will take time and patience. Understanding your triggers can help you know what to avoid and what will set you off. Triggers may include, but are not limited to:

Fatigue and excessive tiredness

Stress and anxiety

Excess noise and stimulation

Feelings of being under pressure

Very sad or funny situations

Certain topics of discussion

Deaths of loved ones

Public speaking

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Emotional lability is characterized by rapid exaggerated changes in mood. You'll feel strong emotions and feel like you can't control your behavior and feelings. You will express your emotions more dramatically than usual. Labile mood symptoms include: Uncontrollable laughing Excessive crying Heightened irritability Moody temper Here are some ways that you can deal with emotional lability: Take a break.

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Emotional lability is rapid often exaggerated changes in mood. Emotions are sometimes expressed in a greater way than intended.

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Emotional lability can be caused by brain injury, stroke, Parkinson’s and even stiffening of a tissue or anatomical.

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What Is Emotional Lability?

People with high emotional lability are often described as " sensitive" or having "thin skin."

They may quickly transition between positive emotions like happiness, joy, excitement, enthusiasm, and amusement. But they also tend to experience negative feelings such as sadness more deeply than others.

Emotional Lability

The term comes from the Latin word labilis meaning "to totter, sway, or move in an unstable manner." Other terms for emotional lability include labile mood, labile affect, and reactivity.

Emotional lability is commonly seen in people with personality disorders such as borderline personality disorder but can also occur in conditions like bipolar disorder and post-traumatic stress disorder (PTSD).

Emotional lability is different than moodiness or someone who has a "short fuse." People with high emotional lability experience sudden, dramatic changes that aren't triggered by something specific. Their feelings fluctuate rapidly and unpredictably. They may feel fine one minute, and then angry or sad the next without any warning.

These sudden shifts in mood can be extremely frustrating for family and friends who struggle to understand what triggers these changes and how they might respond when a person with emotional lability is upset.

History of Emotional Lability

The term emotional lability was first introduced by the French psychologist Guillaume Duchenne, author of the book The Mechanism of Human Facial Expression. He used it to describe people who cry easily but also noted other types of emotional lability including laughing, blushing, and trembling.

Later, psychologist Peter McKeller introduced a new concept by identifying individuals with "labile mood" and describing them as having a "labile temperament." McKeller observed that people with labile mood experienced significant changes in self-esteem, sadness, happiness, and anger.

In the 1970s, researchers began to expand on this idea of emotional lability by studying its effects in emotionally sensitive or easily upset children. Not long after, emotional lability was classified as one of the symptoms of borderline personality disorder.

Signs of Emotional Lability

The following are common signs of emotional lability include:

Intense emotions and rapid mood changes. People with high emotional lability experience intense feelings that shift quickly and change frequently throughout the day, even when there's no apparent reason for these shifts to occur.

Inappropriate reactions to events that could affect moods. Emotional lability can also involve inappropriate responses. For example, a person with high emotional lability may laugh at a funeral or become severely depressed if their sports team loses.

Difficulty controlling emotions. People with high emotional lability are unable to control the intensity of their feelings. They can't "snap out" of negative moods quickly even when they want to which can make it harder to maintain friendships and relationships.

Types of Emotional Lability

There are two common types of emotional lability:

1. Dysphoric/labile mood. This type is characterized by sudden, rapid changes in mood. For example, a person may feel happy and excited, then grow depressed or sad without any warning. These shifts can be unpredictable and happen more than twice a week.

2. Manic/hypomanic episodes. These episodes involve sudden, rapid, and persistent changes in mood that last for several days. This type of emotional lability is associated with bipolar disorder and can include feelings of euphoria, irritability, or agitation, along with reduced sleep, racing thoughts, and risky behavior. People who experience these shifts may also engage in reckless behavior such as spending sprees or taking on many new projects.

Causes of Emotional Lability

Pseudobulbar affect. This is a type of emotional lability that may be caused by brain damage or neurological illnesses. It can be triggered by traumatic brain injury, stroke, multiple sclerosis, Parkinson's disease, and other health issues. People with this condition may also experience uncontrolled laughing or crying.

Mood disorders. This includes conditions such as bipolar disorder and depression.

Medication side effects. Some medications can cause emotional lability, including certain antidepressants.

Substance use. Alcohol and illicit drugs such as marijuana, ecstasy, and PCP can all lead to emotional lability.

Borderline personality disorder. People with this condition often experience rapid mood swings and outbursts that can affect their personal, social, and professional relationships. They may also engage in risky behavior such as promiscuity or spending sprees when they're feeling positive.

Impact of Emotional Lability

People with emotional lability often feel as if everyone around them is better or more successful than they are. They may be envious of others who have friends, relationships, or people who respect them.

Being unable to control the intensity of emotions can also impair day-to-day life. For example, people with emotional lability may find it challenging to focus on tasks or stay organized. They may also have problems controlling their emotions when they experience bad news, which can cause them distress and anxiety that makes the situation even worse.

Treatment for Emotional Lability

Treatment for emotional lability depends on the underlying cause. For example, a doctor may prescribe antidepressants to help with mood swings related to depression or bipolar disorder.

In some cases, treatment might involve training in relaxation techniques such as deep breathing and meditation. Therapists can also teach the person to deal with their feelings in a healthy, constructive way.

Coping With Emotional Lability

Coping with emotional lability can be challenging. However, there are healthy ways to deal with this problem:

Do something that makes you feel good. Whether this is going for a walk with a friend or spending time alone, make sure you practice self-care and self-compassion.

Take a break if necessary. Take some time away from people and situations that make you feel uncomfortable.

Tell yourself the truth about your feelings. Realize that your emotions sometimes aren't under your control, and do what's best for you despite them.

Take care of yourself at home and work. Get enough sleep, eat healthy food, and exercise regularly.

Remember that people are on your side. Don't be afraid to ask for help from friends and family who care about you. This can make a huge difference when it comes to dealing with emotional lability effectively.

A Word From Verywell

If the symptoms of emotional lability cause problems for you in social or professional settings, talk to a therapist about treatment options. If you're worried about someone else's mood swings and outbursts, talk to them about getting help from professionals who can provide support.

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People with high emotional lability are often described as " sensitive" or having "thin skin." They may quickly transition between positive emotions like happiness, joy, excitement, enthusiasm, and amusement. But they also tend to experience negative feelings such as sadness more deeply than others.

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Emotional Lability: Symptoms, Stroke, Other Causes, and Treatment

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Treatment for E.L. (emotional lability) depends on the underlying cause and the severity of it. A doctor might give the person medication for their mood or they could also go to a therapist.

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What is emotional lability?

Emotional lability is a neurological condition that causes uncontrollable laughing or crying, often at inappropriate times. It tends to affect people with preexisting neurological conditions or injuries.

It has many other names, including:

pathological laughing and crying

pseudobulbar affect

affective lability

emotionalism

emotional incontinence

involuntary emotional expression disorder

While the symptoms of emotional lability seem psychological, they're actually a result of changes to the part of your brain that's responsible for emotional control.

The main symptoms of emotional lability are uncontrollable outbursts of crying or laughing. These outbursts are usually an exaggerated or inappropriately intense emotional reaction. They can also be completely unrelated to your current emotional state. For example, you might start laughing uncontrollably when you're upset.

Other symptoms of emotional lability include:

short emotional outbursts that don't last for more than a few minutes

mixed emotional outbursts, such as laughing that turns into crying

lack of emotional symptoms between episodes

laughing or crying in situations that other people don't find funny or sad

emotional responses that are over-the-top for the situation

emotional outbursts that are very different from your usual behavior

Emotional lability often occurs after a stroke. According to the National Stroke Association, more than half of stroke survivors have symptoms of emotional lability.

Strokes happen when a blood vessel in your brain bursts or something cuts of your brain's blood supply. This causes brain cells to start dying within minutes, which can damage the parts of your brain responsible for memory, language, and emotion.

Researchers aren't sure about the exact cause of emotional lability after a stroke. However, the most popular theory suggests it's related to damage to the connections between the brainstem and frontal lobes.

In addition to strokes, neurological conditions and traumatic brain injuries (TBIs) can lead to emotional lability.

Common neurological conditions that can cause emotional lability include:

Types of TBIs that can cause emotional lability include:

Emotional lability is often misdiagnosed as depression or another mental health condition. To make getting a diagnosis easier, try to keep a journal of your symptoms, including when they occur and how long they last. If possible, note your general mood and emotional state between outbursts. If you don't notice any emotional symptoms between episodes, it's a good indicator that you likely have emotional lability, rather than a psychological condition.

Make sure to tell your doctor about any recent head injuries or underlying conditions. You might also find it helpful to bring along a loved one who's observed your emotional outbursts.

While there's no specific test for diagnosing emotional lability, your doctor will ask you a series of questions about your medical history and moods to confirm the diagnosis.

More mild cases of emotional lability may not need treatment. However, if it causes significant stress, certain medications can help to reduce the severity and frequency of your outbursts. This can make the condition much more manageable and less destructive in social situations.

Medications often used to treat emotional lability include:

Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta)

Nuedexta is currently the only medication approved by the Food and Drug Administration (FDA) to specifically treat emotional lability. Clinical studies in people with neurological conditions found that it reduced the frequency of emotional outbursts by about half.

Antidepressants

Low doses of antidepressants may reduce the intensity of your emotional outbursts and make them occur less often.

Although antidepressants can alleviate the symptoms of emotional lability, they aren't approved by the FDA to treat the condition. When a drug is used to treat a condition it hasn't received FDA approval for, it's known as off-label drug usage.

Living with emotional lability can be frustrating, especially if it makes it hard for you to participate in social situations or those close to you don't understand your condition.

Here are a few tips for coping with emotional lability:

Take frequent breaks from social situations to calm yourself.

Look for a local support group or online community to meet other people dealing with the condition that caused your emotional lability.

Practice slow breathing techniques and focus on your breath during episodes.

Figure out what triggers your episodes, such as stress or fatigue.

Distract yourself from rising emotions with a change of activity or position.

Distract yourself by counting objects in the room or counting your breath.

If you have an episode, try to move on with your day and avoid dwelling on it.

Prepare a short explanation to give to people who may be confused by your behavior, such as: "Since my stroke, I giggle sometimes. Just ignore it."

The long-term outlook for people with emotional lability depends on the underlying cause. If you have permanent brain damage from a stroke, you may continue to have outbursts for the rest of your life. However, over time, you may be able to identify things that trigger your outbursts or come up with ways to distract yourself when you feel one coming on.

If your episodes start to cause you a lot of stress, medication may also help. Work with your doctor to find treatment options that work best for you.

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Emotional Lability: Symptoms, Stroke, Other Causes, and Treatment

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What is emotional lability? Emotional lability is a neurological condition that causes uncontrollable laughing or crying, often at inappropriate times. It tends to affect people with preexisting neurological conditions or injuries.

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Emotional Lability: Symptoms, Stroke, Other Causes, and Treatment

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Whether E.L. is permanent or not depends on the severity of the cause, If the person has permanent brain damage from a stroke, they may continue to have outbursts for the rest of your life.

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What is emotional lability?

Emotional lability is a neurological condition that causes uncontrollable laughing or crying, often at inappropriate times. It tends to affect people with preexisting neurological conditions or injuries.

It has many other names, including:

pathological laughing and crying

pseudobulbar affect

affective lability

emotionalism

emotional incontinence

involuntary emotional expression disorder

While the symptoms of emotional lability seem psychological, they're actually a result of changes to the part of your brain that's responsible for emotional control.

The main symptoms of emotional lability are uncontrollable outbursts of crying or laughing. These outbursts are usually an exaggerated or inappropriately intense emotional reaction. They can also be completely unrelated to your current emotional state. For example, you might start laughing uncontrollably when you're upset.

Other symptoms of emotional lability include:

short emotional outbursts that don't last for more than a few minutes

mixed emotional outbursts, such as laughing that turns into crying

lack of emotional symptoms between episodes

laughing or crying in situations that other people don't find funny or sad

emotional responses that are over-the-top for the situation

emotional outbursts that are very different from your usual behavior

Emotional lability often occurs after a stroke. According to the National Stroke Association, more than half of stroke survivors have symptoms of emotional lability.

Strokes happen when a blood vessel in your brain bursts or something cuts of your brain's blood supply. This causes brain cells to start dying within minutes, which can damage the parts of your brain responsible for memory, language, and emotion.

Researchers aren't sure about the exact cause of emotional lability after a stroke. However, the most popular theory suggests it's related to damage to the connections between the brainstem and frontal lobes.

In addition to strokes, neurological conditions and traumatic brain injuries (TBIs) can lead to emotional lability.

Common neurological conditions that can cause emotional lability include:

Types of TBIs that can cause emotional lability include:

Emotional lability is often misdiagnosed as depression or another mental health condition. To make getting a diagnosis easier, try to keep a journal of your symptoms, including when they occur and how long they last. If possible, note your general mood and emotional state between outbursts. If you don't notice any emotional symptoms between episodes, it's a good indicator that you likely have emotional lability, rather than a psychological condition.

Make sure to tell your doctor about any recent head injuries or underlying conditions. You might also find it helpful to bring along a loved one who's observed your emotional outbursts.

While there's no specific test for diagnosing emotional lability, your doctor will ask you a series of questions about your medical history and moods to confirm the diagnosis.

More mild cases of emotional lability may not need treatment. However, if it causes significant stress, certain medications can help to reduce the severity and frequency of your outbursts. This can make the condition much more manageable and less destructive in social situations.

Medications often used to treat emotional lability include:

Dextromethorphan hydrobromide and quinidine sulfate (Nuedexta)

Nuedexta is currently the only medication approved by the Food and Drug Administration (FDA) to specifically treat emotional lability. Clinical studies in people with neurological conditions found that it reduced the frequency of emotional outbursts by about half.

Antidepressants

Low doses of antidepressants may reduce the intensity of your emotional outbursts and make them occur less often.

Although antidepressants can alleviate the symptoms of emotional lability, they aren't approved by the FDA to treat the condition. When a drug is used to treat a condition it hasn't received FDA approval for, it's known as off-label drug usage.

Living with emotional lability can be frustrating, especially if it makes it hard for you to participate in social situations or those close to you don't understand your condition.

Here are a few tips for coping with emotional lability:

Take frequent breaks from social situations to calm yourself.

Look for a local support group or online community to meet other people dealing with the condition that caused your emotional lability.

Practice slow breathing techniques and focus on your breath during episodes.

Figure out what triggers your episodes, such as stress or fatigue.

Distract yourself from rising emotions with a change of activity or position.

Distract yourself by counting objects in the room or counting your breath.

If you have an episode, try to move on with your day and avoid dwelling on it.

Prepare a short explanation to give to people who may be confused by your behavior, such as: "Since my stroke, I giggle sometimes. Just ignore it."

The long-term outlook for people with emotional lability depends on the underlying cause. If you have permanent brain damage from a stroke, you may continue to have outbursts for the rest of your life. However, over time, you may be able to identify things that trigger your outbursts or come up with ways to distract yourself when you feel one coming on.

If your episodes start to cause you a lot of stress, medication may also help. Work with your doctor to find treatment options that work best for you.

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Emotional Lability: Symptoms, Stroke, Other Causes, and Treatment

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What is emotional lability? Emotional lability is a neurological condition that causes uncontrollable laughing or crying, often at inappropriate times. It tends to affect people with preexisting neurological conditions or injuries.

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Let's Talk Emotional Lability with Dr Giles Yeates

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There are two types of E.L. the first one is sudden outbursts of emotions  (typically) laughing or crying without reason. The second one is having reasonable emotions to a situation but over exaggerating them.

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Let's Talk Emotional Lability with Dr Giles Yeates

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Emotional Lability | Personality Traits Psychology Series #11

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Emotional Lability | Personality Traits Psychology Series #11

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Episode 053: Frontal Lobe Damage: Treating Patients through Grief, Acceptance and Growth - Psychiatry & Psychotherapy Podcast

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There are no conflicts of interest for this episode.

The Case Of Phineas Gage

THE HISTORY OF THE STUDY OF FRONTAL LOBE DAMAGE

Phineas Gage was a railroad construction worker who experienced a massive frontal lobe injury in 1848 in New England. He was efficient, capable, and full of energy prior to his accident. During an explosion at work, a 13 pound iron bar was launched through his face at close range, up through his skull. It entered his left cheek, went through his eye, and came out of the top of his skull, landing 100 feet away.

Gage was carted to a local doctor where he got out of the cart and walked into the doctor's office. As the doctor treated him for a few weeks, brain matter and infections, bone particles and tissue were oozing out of his head. Still, Gage survived, with relatively little physical injury after he was healed, with the exception of his left eye.

The main effect of Gage's injury was in his behavior. He was studied, a medical marvel of survival, and is now reputed to be one of the first, and therefore most important, cases dealing with frontal lobe damage and its effect on behavior. After his accident, Gage was belligerent, fitful and profane. He lost the balance between his emotions and his intellectual ability to function.

OTHER SYMPTOMS OF BROAD TEMPORAL FRONTAL LOBE DAMAGE CAN BE:

Depression

Anterior ( Stuss 1986) and Lateral lobes ( Paradiso 1999)

Left lesions more likely to lead to depression than right lesions ( Rogers 1998)

Postmortem neuropathology of depressed patients indicated generalized prefrontal diminution ( Cotter 2005)

Euphoria ( Grafman 1986)

Sporadic or recurrent and resembles the effect of the hypomanic state (nervous, irritable, sometimes paranoid)

Usually accompanied by compulsive, shallow, childish humor

Distractibility and hyperactivity

Motion and Emotion

Hypokinesia (dorsolateral lesions) ( Heilman 1991)

Hyperkinesia- aimless/excessive motility (orbitofrontal lesions) ( Meyer 1948,)

Emotional Lability and disinhibition (orbitofrontal lesions)

Social Behavior

Grief, Acceptance and Growth

STEVEN'S STORY

Steven had five strokes and tinnitus. It was also not physical trauma, and Gage's was much worse. His decline led him to spend five hours a day researching his health conditions.

He was suffering from anxiety, depression, fear and grief in reaction to his health condition, and Steven did something about it. He came to my outpatient group.

At his worst, Steven's tinnitus caused him to lock up the guns in his house so he wouldn't think of ending his life, and he says he "took xanax like candy." He felt as if he was mourning and grieving losing who he was. He'd had a successful career previously, but he no longer found the same meaning in his life.

During his struggles with his mental health, Steven joined the day treatment program that I am the medical director of. When he first came to the program, he didn't think he would fit in. When he introduced himself on the first day of meetings, he told the others his name, and then described his illness. When the entire room finished introducing themselves, the therapist kindly pointed out that they had all introduced themselves through the lens of their illnesses. "Aren't you people? Humans? You are not your diagnosis," the therapist said. Steven said it changed his life to see it that way.

As he became more comfortable being his "new" self, more comfortable with his emotions and frustrations about his limitations, he became more aware of how he was speaking and thinking about himself. He learned to accept his illness instead of battling it. When he accepted it, he was alright with moving on and being a whole person, just in an entirely different way. He says he became more self confident, healthy, and less stressed. His wife has commented on his increased empathy as well.

STEVEN'S DIAGNOSIS - RIGHT SIDE ACA STROKES

After Steven's stroke, he felt "flooded." He would become overwhelmed with audio and visual stimulation, which caused him to have to retreat into a dark room for up to 24 hours.

ACA STROKE/FRONTAL LOBE DAMAGE SYMPTOMS

1. Accounts for 0.3 to 4.4% of total stroke cases. Males are more commonly affected than females, and most of these strokes occur between the age of 59 and 75. ACA strokes arise on the left hemisphere more commonly than the right. ( Kang and Kim 2008, Arboix, Garcia-Eroles et al. 2009)

2. Most common presentation is motor deficits characteristically involving the contralateral lower extremity; present in 86.3-90% of ACA strokes ( Kumral 2002)

3. Other motor disorders related to ACA infarcts include hypometria, bradykinesia, global akinesia, loss of reciprocal coordination, parkinsonian gait, tremor, dystonia, and motor neglect ( Nagaratnam, Davies et al. 1998, Kobayashi, Maki et al. 2011)

4. Sensory deficits less common; ~25%, and always correlate with weak extremity (Kang 2008)

5. Abulia (willpower, assertiveness), agitation, motor perseveration, memory impairments, emotional lability, anosognosia are neuropsychological features reported in ACA infarcts (Kang and Kim 2008)

6. Altered consciousness and speech disorders identified in up to 43.1% of ACA infarcts (Arboix, Garcia-Eroles et al. 2009)

7. Transcortical motor aphasia and transcortical mixed aphasia ( Nagaratnam, Davies et al. 1998, Kumral, Bayulkem et al. 2002)

The main part of the brain that is typically affected by this kind of stroke is the prefrontal cortex region, which makes up 29% of human brain matter. Humans are unique in that the prefrontal cortex is significantly larger than in other species. This region of the brain is responsible for temporal organization, executive memory and executive attention.

Temporal organization is the most general and characteristic of all prefrontal functions in the primate and enables the organization of actions and thought within the domain of time. This temporal organization facilitates the capacity for elaborate behaviors, speech fluency, higher reasoning, and creative activities.

Executive memory is the idea of taking formed prior experiences and being able to learn from them and make decisions about the future. This ability effectively organizes the present in order to prepare for the future

Executive attention deals with using short term active memory to apply to the immediate here and now. Within executive attention, there are a few main functionalities:

The preparatory set is the part of the brain that reconciles sensory cues and coordinates past memories to prepare the body for active response-like a runner gearing up for a race.

Inhibitory interference control enhances contrast to different information. The brain filters out what it needs in the immediate, and is able to dampen down everything else that doesn't matter. In Steven's case, this part of his brain was damaged because he had a lack of control over what information was inhibited or processed as important by his brain.

Also in Steven's case, I opted to focus on increasing his sensorium by lowering his xanax intake to help him increase his executive functioning so he could become more himself.

The fascinating thing is that the brain can change itself. If you have a loss of movement from a stroke, you want a program that is 5 days per week and really intensive. That's why partial programs can be helpful to guide the patient in developing the brain in a way that would be most healing for a loss of psychological function.

THE IMPORTANCE OF EMOTIONAL CONGRUENCY

One of the main things we focus on in the program Steven was part of is implementing the importance of congruence. Congruency is about making sure who you are on the outside reflects who you are on the inside. When people are incongruent, they put undue psychological stress on their personality to perform and feel the need to appease others. Steven adaptively relied on his ability to tell funny stories, and when he felt he could finally just "be" and not "perform" for others to make them feel more comfortable, he felt he could take that part of his personality off. He became more congruent with what his inner state felt like.

As Steven shed his need to please, he became more assertive. He also learned to handle his tinnitus with self compassion and lower anxiety. Now, he lives with it and it causes him little emotional distress.

Within the program, doctors helped our patients develop congruence through their writing, drawing and talk therapy. We can often see incongruencies in those different modalities and begin to talk about them. Another way we help them with their mental health is by encouraging them to start doing strength training.

MOVING ON

Steven's passion is now helping connect others who need support through their chronic illnesses. He wanted to find a support group where he lived, but he couldn't, so he started his own on Facebook. He opened it to more than stroke victims, and he has been successful in creating that group, having guest speakers who are mental health professionals, and building a supportive community within it. He says he wants to bring hope and encouragement to people with chronic illness.

Watching Steven change and heal has been a pleasure. He has moved through the grief, acceptance, and growth that is possible for many of our patients.

Treating Patients With Frontal Lobe Damage

Other than therapy, I find that optimizing a patient's sensorium is incredibly important to restore normalcy of life.

You can improve sensorium by improving sleep, diet, and strength training. Also, having meaning and purpose, having friendships and an internal locus of control, can also optimize sensorium.
Consider listening to this one next:

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Episode 053: Frontal Lobe Damage: Treating Patients through Grief, Acceptance and Growth - Psychiatry & Psychotherapy Podcast

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In this episode of the podcast, I interview Steven Prince, one of my patients who had a rare form of a stroke-in the right orbital frontal cortex. He participated in a psychiatric program that I run. He tells his story of how his function and emotions changed, and how he dealt with it.