Anyone can experience inappropriate laughter, and it is not a medical diagnosis. However, certain medical conditions may make inappropriate laughter harder to avoid.
Inappropriate laughter is laughter that occurs in a situation in which it is not acceptable to laugh. Cultural and social factors may influence whether laughter is inappropriate, as laughing in certain contexts might be acceptable for some people but not for others.
Although inappropriate laughter alone is not necessarily a cause for concern, it can sometimes be a sign of a medical problem. People with a variety of different conditions, such as autism spectrum disorder, schizophrenia, and anxiety, may laugh at inappropriate times. Even without a diagnosis, some people may laugh when they feel emotions other than humor, such as anxiety or contempt.
Neurological disorders can also cause inappropriate laughter. One of the most common, pseudobulbar affect, occurs in many conditions, including dementia, multiple sclerosis, traumatic brain injury, and Parkinson’s disease. It affects communication between the frontal lobe and cerebellum, causing inappropriate laughter.
Keep reading to learn more about inappropriate laughter, including some of the possible medical causes and how to cope with or manage bouts of inappropriate laughter.
What is inappropriate or uncontrollable laughter?
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Inappropriate or uncontrollable laughter means that a person laughs when they do not want to, in a setting in which laughter would not usually be appropriate. What counts as inappropriate laughter is culturally, societally, and personally subjective.
People who laugh inappropriately may also feel unable to control their laughter. Conversely, in some cases, they may not realize that the laughter is inappropriate. It all depends on the cause of the laughter and the individual.
For example, a person with schizophrenia who laughs because of a delusion or hallucination may not realize that laughter is inappropriate for the situation. Meanwhile, a person experiencing nervous laughter typically realizes its inappropriateness.
In some cases, anxiety about inappropriate laughter may actually exacerbate some mental health conditions, including anxiety, making the laughter worse.
Causes
Many different conditions can cause inappropriate laughter. They include:
Anxiety
Some people laugh nervously when they feel anxious. This can happen in high stress situations, such as a funeral or a court hearing. People with generalized anxiety disorder and other anxiety conditions may laugh in a wide range of other circumstances, too.
A 2020 paper argues that nervous laughter is a common response that may help explain all humorous laughter. The author points out that people laugh to relieve tension when situations are incongruous, as is often the case with humor. In this model, anxious laughter is a typical response, and laughing when something is funny is just another type of nervous laughter.
Autism
In a 2021 study involving a focus group discussion, the parents of autistic children reported that they showed inappropriate emotional expressions, including inappropriate laughter. This could be because of differences in perception between autistic and allistic people. An autistic person, for example, might view a situation as funny when another person does not, or they might experience nervous laughter.
Mental health conditions
Various mental health conditions may trigger inappropriate laughter. This is because mental health diagnoses change how a person experiences, processes, and expresses emotion.
People with schizophrenia may laugh at times that seem inappropriate to others. This can happen because they perceive the world differently than others, have difficulty regulating their emotions, or experience hallucinations that are funny or induce anxious laughter.
A manic episode may cause a person to feel very excited or powerful. They may think things are funny or exciting that others do not. This can cause laughter that others deem inappropriate. Bipolar disorder can trigger manic episodes, but so can neurological disorders and brain injuries.
Pseudobulbar affect
Pseudobulbar affect causes inappropriate emotional outbursts, including laughing or crying and sometimes both. It is one of the most common causes of inappropriate laughter. A 2021 paper estimates that 1.8 to 7.1 million people in the United States have this symptom.
People with pseudobulbar affect have an underlying neurological disorder that affects the brain’s ability to control and express emotion. Researchers think the problem might originate when the frontal lobe, which controls emotions, cannot communicate with the cerebellum and brain stem, which play important roles in reflexes.
Some conditions that can cause pseudobulbar affect include:
- stroke
- dementia
- multiple sclerosis
- concussion
- traumatic brain injury
- Wilson’s disease
- growths in the brain, including brain tumors
- Parkinson’s disease
- amyotrophic lateral sclerosis (ALS)
Seizures
A rare type of seizure called a gelastic seizure can cause a person to appear to be laughing uncontrollably. The person does not actually feel happiness and is unable to control the laughing. A related type of seizure called a dacrystic seizure can cause a person to cry out.
Gelastic seizures are a type of focal seizure, which means that they start in one area of the brain. This type of focal seizure begins in the hypothalamus. Traditional seizure medication does not usually control these seizures well.
Symptoms
Inappropriate laughter can manifest in many different ways, including:
- Nervous laughter: Some people may laugh nervously in uncomfortable situations. This laughter is difficult to control, and the person is aware that their laughter is not appropriate.
- Neurodivergent emotions: Some people with inappropriate laughter experience emotions that differ from those of neurotypical people, causing them to feel happy or experience humor when others do not. For example, a person with schizophrenia may laugh at something others do not perceive as funny or at a hallucination.
- Uncontrolled laughter or crying: People with pseudobulbar affect may have periods of both uncontrolled laughing and uncontrolled crying. They usually recognize that these expressions are inappropriate but may not be able to control them.
- Anxiety about laughter: People who have inappropriate laughter may experience anxiety about continuing to laugh or laughing at future occasions, affecting their social relationships. Sometimes this anxiety causes more inappropriate laughter.
Treatment
The treatment for inappropriate laughter depends on its cause. Some options include:
- medication for mental health conditions, such as schizophrenia and anxiety
- therapy to manage anxiety in social situations
- treatment for underlying brain disorders, such as ALS and multiple sclerosis
- management strategies, such as deep breathing
Pseudobulbar affect
Pseudobulbar affect means that a person laughs inappropriately because of an underlying neurological disorder that affects the way the body controls and expresses emotions. People with this condition may both laugh and cry at inappropriate or inopportune times.
Various neurological conditions can disrupt brain functioning. They can also affect the connections between the frontal lobe, which plays a role in controlling emotions, and areas of the brain that play a role in reflexes, including the cerebellum and brain stem. This can cause reflexive laughing or crying. In these cases, the person cannot control the behavior.
In some situations, a person will know that their laughter is inappropriate, and they may feel anxious or upset. Depending on the severity of the condition and whether other brain structures have sustained damage, though, a person may be unaware of the behavior.
Pseudobulbar affect is distinct from other forms of inappropriate laughter. This is because changes in neurological functioning cause pseudobulbar affect. Other types of inappropriate laughter may stem from a combination of social, mental health, and neurological differences.
How to cope in social situations
Telling others about the inappropriate laughter may help destigmatize it and make the person feel less self-conscious or awkward, especially in small settings with familiar people. Some other strategies to try include:
- breathing deeply to reduce anxiety and control the laughter
- relaxing tensed muscles
- changing body position when an episode feels imminent
- taking a break from the setting to use the bathroom or walk outside
- using distraction techniques, such as thinking about something else or counting nearby objects
- trying to avoid thinking about the laughter, as this can increase anxiety
When to contact a doctor
Occasional inappropriate laughter, such as when a person is nervous or self-conscious, is not always a medical problem requiring treatment. However, a person should speak with a doctor if they:
- experience inappropriate laughter frequently enough to affect social relationships or self-esteem
- have other symptoms, such as intense anxiety, delusions, hallucinations, or significant difficulty making friends
- have a neurological disorder or symptoms of one, such as thinking and memory problems or unusual movements
- experience sudden, unpredictable bouts of inappropriate laughing that do not seem to have a particular trigger
Summary
Inappropriate laughter can cause issues, both for the person experiencing it and for those around them. However, it is important to note that in most cases, it is not a choice and not something that should make a person feel guilty or ashamed.
When inappropriate laughter is due to a medical condition, the right medical support can help. A person may also be able to use self-help strategies to get relief.
People who experience inappropriate laughter should know that they are not alone. Many people experience this symptom, and a wide range of ailments can cause it. A healthcare professional can help with identifying and treating the underlying cause, as well as helping the person develop coping skills to manage it.
Last medically reviewed on February 10, 2022
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