Inappropriate Laughter - Causes, Symptoms, and Treatment

What Is Inappropriate Laughter?

Inappropriate laughter can be defined as uncontrollable laughter when a person laughs in an inappropriate setting. Often the person is not able to control their laughter and can be the exact opposite of what they may be feeling. Laughing in certain contexts is not acceptable in many social and cultural situations and may cause embarrassment. It is also called nervous laughter as it makes one experience an emotion even when the situation does not necessarily call for it. Inappropriate laughter, however, need not be a medical diagnosis but can be made harder to avoid in certain medical conditions.

What Causes Inappropriate Laughter?

Many mental health conditions can cause inappropriate laughter. It can be a sign of being emotionally overwhelmed or an underlying neurological condition. It is important to identify the causes of inappropriate laughter. Some of the causes include

• Anxiety - Sometimes, high-stress situations like anxiety can make a person laugh nervously even when they are feeling anxious. It can happen in an intense, awkward situation, such as a funeral or a court hearing. People tend to laugh to relieve their tension when the situation is incongruous (not in harmony with the surrounding).

• Neurological Disorders - Certain conditions of the brain and neurological system are associated with pseudobulbar affect (involuntary laughing and crying due to a nervous system disorder), such as in amyotrophic lateral sclerosis (a rare disease that weakens nerve cells), extrapyramidal and cerebellar disorders (neural lesions causing movement disorders), epilepsy, stroke, traumatic brain injury, multiple sclerosis (disease affecting the central nervous system), and Alzheimer disease (a brain disorder that destroys thinking skills).

• Autism - It is seen that autism (a developmental disability that impairs the ability to communicate) people are more likely to experience inappropriate laughter in response to painful and frightening situations. It can be because of the difference in perception between autistic and allistic (not affected by autism) people.

• Other Health Conditions - Certain mental health conditions may trigger inappropriate laughter, such as people with schizophrenia (a mental condition characterized by impairment in perceiving reality and changes) may laugh as they perceive situations differently and have difficulty controlling emotions. A manic episode in a person with bipolar disorder (extreme mood swings) can cause excitement and make them laugh.

• Medications - Certain drugs, like Dextromethorphan, Quinidine, or Quinidine-like drugs can exaggerate uncontrollable episodes of crying and laughing that do not match the feeling one has.

• Dysregulation of Neurotransmitters - Dysregulation of chemical messengers, like neurotransmitters serotonin can be associated with inappropriate laughter.

What Are the Symptoms of Inappropriate Laughter?

Researchers have suggested that extreme emotions can make one feel physiologically overwhelmed and produce dimorphous expressions (two distinct forms), such as laughing when feeling sad. Laughter helps to restore emotional balance. Inappropriate laughter can be displayed in many different ways, including

• Laughter or Crying - There are periods of both uncontrollable laughter and crying that the person recognizes is inappropriate but is not able to control their emotions.

• Nervous - Some people laugh at nervous situations and are aware of their inappropriate laughter.

• Neurodivergent Emotions - Schizophrenic patients may laugh at a hallucination or something that they find humor in when others do not.

• Anxiety - Some people experience anxiety and may continue to laugh at situations that affect their social relationships.

The main symptoms are often laughing and crying that do not match the situation and the intensity of one’s mood. It can be unpredictable, sudden, and involuntary. It may be triggered out of proportion and may happen for no apparent reason. Sometimes, involuntary outbursts of anger or frustration may occur.

How to Treat Inappropriate Laughter?

Treatment of inappropriate laughter usually depends on the cause and severity of mental health conditions. Some options for treating inappropriate laughter include

• Consult a healthcare professional to determine the cause of the inappropriate laughter. If the laughter is due to a medical condition, treating the underlying condition may help alleviate the inappropriate laughter. Treating medical health conditions, like schizophrenia, anxiety, and bipolar disorders by medications.

• Cognitive behavioral therapy (CBT) to manage anxiety. The therapist may use distraction techniques, such as engaging in talk or other activities to avoid thinking about the laughter.

• Treatment of underlying brain disorders, like amyotrophic lateral sclerosis, multiple sclerosis, stroke, epilepsy, and Alzheimer’s disease.

• Managing deep breathing exercises can reduce anxiety and control laughter. Relaxing tensed muscles by changing positions when an episode is impending can be effective.

• Effective antidepressants including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are effective in treating inappropriate laughter. Combining Dextromethorphan and Quinidine can be used in treating the pseudobulbar effect.

How to Help a Person Cope With Inappropriate Laughter?

It can be difficult to cope with everyday life, especially social situations due to inappropriate laughing. Often, it can cause embarrassment, leading to isolation which can impact a person’s mental health. It is, therefore, important to distinguish between an underlying neurological condition and a sign of emotional overwhelm. A person should try to balance the mind and body. Also, it is essential to remember that inappropriate laughter is a symptom that can be managed with the appropriate treatment.

• Speaking to a family member, friend, therapist, or doctor can be helpful, if one feels that inappropriate laughing is significantly affecting their everyday life. Therapists can help to find the underlying issue and suggest treatment accordingly.

• Engaging in distracting activities, such as taking a break from the setting or counting nearby objects can help distract one from laughing.

• Inappropriate laughter can be misunderstood and may cause social discomfort or misunderstandings. Educating others about the cause of the laughter can help reduce any negative reactions and make social situations more comfortable.

Conclusion:

Inappropriate laughing can be embarrassing for the person experiencing it and for those around them. It can be a sign of being emotionally overwhelmed or due to an underlying neurological issue. The right medical support is helpful to guide the person to use self-help strategies to get relief. Health professionals should be able to identify the cause and provide treatment accordingly. People should be educated to accept the symptoms and try to adapt their life to them by practicing deep breathing and adopting distraction techniques.