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Ask the Mental Health Expert Archives 2001-2004

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Q. I am a 33-year-old female and I have had a recurring situation which happens every few years. What happens is that I will see something very funny and laugh until I am teary eyed and the 'funny' seems to disappear and I'm crying and filled with sorrow. This also happens when I'm frightened - I will cry and then and then alternate between laughing and crying uncontrollably.

It happened tonight for the first time in ages and my husband also saw it for the first time. I am pregnant and it matters to me to find out what was going on. I don't want my child to witness it because it is quite bizarre. Have you heard of this before and do you know why and what can help?

A. I've certainly heard of folks having unusual emotional reactions in the context of intense fear or even in humorous situations. Just think of the popular expressions, "I laughed till I cried," and "We had better laugh, lest we cry." Sometimes, there is an element of sadness or pathos that we suddenly become aware of, even in the presence of a seemingly funny incident. (We sometimes speak of the tragicomic in this context). And sometimes, a seemingly innocuous incident might trigger a deeply submerged memory (perhaps from childhood) that was tinged with both humor and sadness.

It's also quite common for women to experience some emotional lability during pregnancy, or during premenstrual days. It would be interesting to know if your episodes have occurred in these contexts. It's also possible that what you have experienced over the years is an unusual form of an anxiety or panic attack. Speaking with your obstetrician about these issues is probably a good idea. A problem that pops up literally once "every few years" is unlikely to be a major psychiatric or medical disorder, all other things being equal (of course, I'm not sure they are, in your case).

There is, to be sure, a very rare form of epilepsy called gelastic epilepsy, in which a seizure may be accompanied by uncontrollable laughter. If these episodes have increased in frequency over the past two or three years or so, you and your doctor might consider seeking a neurological opinion. (Even if they haven't increased in frequency, this might be prudent).

Additionally, if you find that you are becoming unusually emotional for no apparent reason, or experiencing frequent mood swings, you might find it useful to explore this with a mental health professional. This would be particularly important if the sorrow you sometimes feel is accompanied by persistent changes in your sleep, appetite, energy, or cognitive abilities; or by feelings of low self-esteem, guilt, or hopelessness. That might point to a mood disorder of some type.

I do hope you get to the bottom of this in a way that enhances your emotional and psychological life.

July 2002

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