Is excessive crying normal in Alzheimer’s disease?

As the disease progresses and cognitive functions decline, some affected individuals may cry excessively, oblivious as to whether it is an inappropriate expression of emotion or not. He/she cannot control the display of emotions and sometimes finds it difficult to regain normal composure.

The crying may or may not represent unhappiness from the individual with Alzheimer’s disease. We all have periods in our lives where our own emotions take over us, and we release tears of overwhelming joy or sadness. In the same way, individuals with Alzheimer’s release these emotions, but it is more excessive and dramatic and the emotional state can be very confusing for him/her.

Along with the excessive crying the person’s moods can be unstable and forever changing. They may sense instability in his/her surroundings and overreact to inconsequential events. Sudden, excessive crying spells may indicate what is called “emotional lability” or “emotional incontinence.”

Understanding that the cause of this emotional lability is the disease and not the true emotions being felt by the affected individual is challenging for the caregiver, but responding in a comforting manner is the best way to manage and tolerate the outbreaks.

Usually the person expressing the tears is calm and not feeling sadness, so the caregiver can just be supportive until the episode passes. Yet, if the crying is constant and unwavering, then the individual may be experiencing depression or other health issues and should be checked by a physician or neuropsychiatrist.

Crying excessively may also indicate a condition known as pseudobulbar affect, or PBA. This neurological condition is characterized by sudden and uncontrolled and exaggerated outbursts of crying and/or laughing and occurs in individuals with neurological diseases such as Alzheimer’s, stroke or traumatic brain injury. Avanir Pharmaceuticals, makers of the drug, Nuedexta, have produced studies that showed this medication treatment substantially reduced symptoms of PBA in individuals with Alzheimer’s disease or dementia.

In any case, the individual that is crying excessively needs and wants attention. The affected individual’s world is very fearful and disoriented, so the caregiver needs to make an extra effort to acknowledge the feelings of that person and redirect in such a way that they feel safe and comfortable again.

Questions about Alzheimer’s disease or a related dementia disorder? Contact Dana Territo, the Memory Whisperer, Director of Services at Alzheimer’s Services of the Capital Area, (225) 334-7494, advice@alzbr.org, or visit the organization at 3772 North Blvd., Baton Rouge.