Understanding Emotional Lability

1 FACT SHEET: Category: Understanding Emotional Lability Behaviour Introduction Audience: Acquired brain injury can change parts of the brain that regulate or control Emotional behaviour and feelings. Family and Emotional Lability refers to rapid, often exaggerated changes in mood, where strong emotions or feelings (uncontrollable laughing or crying, or Support Workers heightened irritability or temper) occur. These very strong emotions are sometimes expressed in a way that is greater than the person's emotions.

2 What causes Emotional Lability ? Emotional Lability occurs because of damage to parts of the brain that control: For more information contact Awareness of emotions (ours and others). the Acquired Brain Injury Ability to control how emotions are expressed so ability to inhibit or Outreach Service (ABIOS) stop emotions coming out Stronger Emotional responses PH: (07) 3406 2311. Email: When a person is emotionally labile emotions can be out of proportion to the situation or environment the person is in.

3 For example, a person Address: PO Box 6053, Buranda 4102 may cry, even when they are not unhappy they may cry just in response to strong emotions or feelings, or it may happen out of the blue without warning. A person may have little control over the expression of these strong emotions, and they may not be connected to any specific event or person. The State of Queensland Following brain injury an individual may also lose Emotional awareness (Queensland Health) 2017. and sensitivity to their own and other's emotions, and therefore their capacity to control their Emotional behaviour may also be reduced.

4 They may overreact to people or events around them conversations about particular topics, sad or funny movies or stories. Weaker Reviewed Aug 2017 Emotional control and lower frustration tolerance, particularly with fatigue and stress can also result in more extreme changes in Emotional responses. For review Aug 2018. ABIOS Neuropsychologist The person may express their emotions in situations where previously they would have been able to been restrained or in control (in quiet situations, in church, listening to a concert, the library).

5 These behaviours can be confusing, embarrassing, and difficult Page 1 of 3. to understand for the person with brain injury and for others. Emotional responses after an injury Ignore the behaviour Emotional reactions may be appropriate Try to ignore the Emotional Lability as much in the situation, but the behaviour or as is possible. Try to get others to ignore it expression may be stronger, louder or last too and continue on with the conversation longer than would be usual for that person. or task.

6 For example, a person may be genuinely Focussing on the Lability or giving the happy, but once the laughter has started person too much attention when it is they may be unable to stop or regulate the happening can reinforce and increase the behaviour, laughing too loud, too much, problem. It is important that other people or for too long. don't laugh too, as this will also reinforce After brain injury an individual may also and increase the behaviour. show extreme but genuine Emotional responses, including sadness and grief, Change the topic or task ABIOS Fact Sheet: Understanding Emotional Lability despair, frustration and irritability, anger, Changing the topic or activity (redirection anxiety and depression, and even joy, and distraction) can reduce stimulation or happiness, and pleasure.

7 These may be stress (particularly if the topic was a appropriate and normal Emotional trigger). responses. Try to distract or divert the person's attention by engaging them in a different Coping with Emotional Lability activity or task. Become aware of triggers Provide information and education Be aware of triggers for Emotional Lability Uncontrolled crying or laughing can be and try to avoid these when you can. upsetting, frightening or confusing for other Triggers can include: people if they don't understand.

8 Excessive fatigue or tiredness Encourage the person to provide simple stress, worry or anxiety explanations or information to other high stimulation (too demanding, too people about the Lability , for example, noisy, too many people) too much I cry a lot since I had my stroke don't pressure worry about it or Sometimes when I am strong emotions or demands from others nervous I get the giggles . very sad or funny situations (such as Let people what they can do, for jokes, movies, certain stories or books) example Just ignore me and it will stop.

9 Discussing certain topics driving, loss of job, relationships, death of a Plan ahead family member When there is severe Emotional Lability , speaking on the telephone or in front of one-to-one, brief and fun activities in a a group or where a person feels under quiet environment will be better. pressure Try to avoid putting the person in stressful situations or environments Have a Break noisy, busy, high levels of activity or that Have a short break away from the situation are too demanding. so the person can regain control of Plan activities that are within the emotions, and to give the opportunity for person's ability.

10 Emotions to settle. Plan more demanding activities or Sometimes a break of a few minutes or a appointments after rests, or when the longer period is enough to regain control person has the most energy. of emotions taking a short walk, doing a Plan for rests between activities. different activity all can help to cope with these strong emotions. The State of Queensland (Queensland Health) 2017. Acquired Brain Injury Outreach Service PO Box 6053 Buranda 4102 Page 2 of 3. Reviewed Aug 2017 For Review Aug 2018: ABIOS Neuropsychologist Use cognitive techniques Some simple cognitive strategies can Resources also assist in managing Emotional See other Acquired Brain Injury Outreach Lability : Service (ABIOS) Information sheets at Relaxation and breathing exercises to reduce tension and stress Using distractions thinking of something else, imagining a peaceful image or picture, counting Doing an activity (going for a walk), Notes.