Some people with Alzheimers, as the disease progresses and cognitive functions decline, may cry excessively whether or not they are unhappy. He or she cannot control the display of emotions, and sometimes finds it difficult to regain normal composure.
We all have periods when our emotions take over, and we cry tears from 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 or her.
Along with excessive crying, the individual's moods may become unstable and change constantly. He or she senses instability in his or her surroundings and overreacts to inconsequential events.
These exaggerated episodes may indicate what is called "emotional lability" or "emotional incontinence." The cause is the progression of the disease and often not true emotions being felt by the affected individual.
Nonetheless, crying episodes can be challenging for the caregiver. Usually, the person who is crying is actually calm and not feeling sadness, so the caregiver can be supportive and reassuring until the episode passes.
However, there might be physical, environmental or psychological reasons for persistent crying. The affected person may be trying to communicate a need, such as being hungry or thirsty or needing to go to the bathroom or even that he or she is experiencing physical pain.
Environmental factors can be as simple as a room with too much glare or too cluttered or too much background noise.
He or she might be crying if they are bored, depressed, anxious or lonely and in need of some social or mental stimulation.
Crying excessively may also indicate a condition known as the pseudobulbar effect. PBA is a neurological condition characterized by sudden and uncontrolled and exaggerated outbursts of crying and/or laughing. It occurs in those with neurological diseases such as Alzheimer's, stroke or traumatic brain injury. Avanir Pharmaceuticals, makers of Nuedexta, have produced studies that show this medication substantially reduced symptoms of PBA in those with Alzheimer's disease or dementia.
In any case, the person crying excessively needs and wants attention, and the tears may be a coping mechanism for him or her. The caregiver needs to acknowledge their feelings and redirect in such a way that they will again feel safe and comfortable.
Should the crying be constant and unwavering, it could be depression or other mental health issues and the person should be thoroughly checked by a physician or neuropsychiatrist.