Tanya Dutt

Uncontrolled Laughing Or Crying Is Linked To 5 Dangerous Conditions

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Emotions are an organic and essential component of human life. They help individuals convey messages to others, reduce stress, and connect to the surroundings. However, in the case of some people, emotional responses are no longer in their control. Sometimes, the reactions can be excessive, inappropriate, or entirely out of place. This is known as <span>pseudobulbar affect</span>, which refers to an uncontrolled and sometimes exaggerated laughing or crying condition. 

Although PBA itself is not a disease, it is closely related to neurological disorders and brain injuries. The effects of PBA can be distressing, but understanding its causes and treatment options can help manage its impact on daily life.

<h2>What Is Pseudobulbar Affect (PBA)?</h2>

PBA is a neurological condition that causes sudden, involuntary <span>emotional outbursts</span>. These episodes can manifest themselves through excessive laughing or crying that is inappropriate considering the context of the situation. These individuals experience extreme reactions with PBA, such as laughter during serious moments or tears in the absence of sadness, apparently without any emotional precipitate. These outbursts also occur for longer periods than may be expected in normal circumstances and are not easily controlled to see when or how long they occur.

Although PBA is not life-threatening, it can significantly affect a person's social and emotional well-being. People who experience PBA may find themselves embarrassed, frustrated, or isolated, as their emotional responses seem out of sync with their true feelings.

Studies estimate that up to 7 million Americans exhibit symptoms of PBA, and approximately 2 million individuals are diagnosed with the condition. PBA is most often seen in patients who have experienced a <span>brain injury</span> or suffer from neurological diseases. In some cases, PBA symptoms may be mistaken for mood disorders such as depression or <a href="https://www.healthandme.com/health-wellness/what-are-social-anxiety-symptoms-article-151104539" data-type="tilCustomLink" target="_blank">anxiety</a>, but the underlying causes are related to brain dysfunction rather than emotional instability.

The root cause of pseudobulbar affect lies in the dysfunction of the central nervous system (CNS). More specifically, PBA results from damage to the brain's emotional regulation pathways, particularly the areas that control laughter and crying. Damage to these areas leads to involuntary emotional outbursts that are disconnected from the person’s actual feelings. Several <a href="https://www.healthandme.com/health-wellness/migraines-in-women-how-hormones-influence-neurological-health-article-151106517" data-type="tilCustomLink" target="_blank">neurological</a> conditions can disrupt these pathways and increase the likelihood of developing PBA.

Here are five major conditions associated with PBA:

A stroke occurs when blood flow to the brain is interrupted, depriving brain cells of oxygen and leading to their damage or death. This can result in physical disabilities, cognitive impairments, and emotional disturbances. Between 28% and 52% of stroke survivors experience PBA, with those assigned female at birth being at a higher risk. The symptoms of PBA are sometimes hard to differentiate from other effects that a <a href="https://www.healthandme.com/health-wellness/understanding-the-silent-threat-of-stroke-a-growing-concern-across-all-ages-article-151069568" data-type="tilCustomLink" target="_blank">stroke</a> can bring. 

Accurate diagnosis is very important. If you or someone you care about has had a stroke and cannot stop laughing or crying, you need to talk to a doctor, because these symptoms could mean PBA rather than a mood disorder.

Traumatic brain injury often occurs due to external forces such as falls, car accidents, or sports injuries. TBIs can be a concussion or severe damage to the brain, and PBA is a common result of major head trauma. Studies have found that 5-48% of people with TBI develop symptoms of PBA, though this range varies due to underreporting and misdiagnosis. 

Symptoms may be confused with another condition like depression or post-traumatic stress disorder, which can make them discuss emotional changes with a doctor who may have the patient referred for further neurology evaluation.

<a href="https://www.healthandme.com/health-wellness/alarming-rise-in-cancer-cases-among-people-under-50-could-be-the-new-global-epidemic-article-151108989" data-type="tilCustomLink" target="_blank">Also Read: Alarming Rise In Cancer Cases Among People Under-50 Could Be The New Global 'Epidemic'</a>

Multiple sclerosis is an autoimmune disease in which the body's immune system fights against the protective covering of nerve fibers in the CNS, bringing about the disintegration of the communication process between the brain and the body. People with MS are more susceptible to developing PBA and have shown a prevalence rate of 10% from studies among patients with symptoms of involuntary laughter or crying. 

MS-related brain lesions and the utilization of certain drugs can contribute to developing PBA. The lack of predictability of PBA can be especially problematic for an MS patient because it can create problems with social interactions as well as quality of life.

<h4>4. Amyotrophic Lateral Sclerosis (ALS)</h4>

Amyotrophic lateral sclerosis (ALS) is a progressive, <a href="https://www.healthandme.com/health-wellness/i-can-feel-it-in-my-gut-breaking-down-the-gut-brain-axis-and-its-impact-on-health-article-151046902" data-type="tilCustomLink" target="_blank">neurodegenerative</a> disease that affects cells in the nerve responsible for controlling voluntary movements of the muscles. As the motor neurons degenerate, patients begin experiencing muscle weakness, loss of mobility, and eventually, a failure to breathe. About 10% of patients with ALS develop PBA, in which crying is more common than laughing. 

While ALS itself inflicts much physical and emotional stress, PBA can make an already difficult emotional experience even worse for patients and their families to bear.

<h4>5. Parkinson's Disease and Dementia</h4>

Parkinson's disease is a progressive neurological disorder affecting movement. PBA often occurs in advanced Parkinson's disease. The prevalence of PBA symptoms among Parkinson's patients has been reported to be 3.6% to 42.5%. In addition, the cognitive decline in Alzheimer's disease can also lead to PBA, and the prevalence among these patients has been estimated to be as high as 40%. 

These conditions often have fluctuations in mood, which could be mistaken for mood disorders, complicating the diagnosis. Therefore, identification of symptoms of PBA in patients with Parkinson's and <a href="https://www.healthandme.com/health-wellness/this-test-can-predict-your-dementia-risk-article-151100567" data-type="tilCustomLink" target="_blank">dementia</a> is essential to ensure that these patients get proper care and support.

The symptoms of PBA are varied but usually involve:

<ul><li>Increased emotional reactions: Laughter or crying for longer durations or of more intensity than the situation requires.</li><li>Inappropriate crying and laughing: Laughing without a reason, e.g., at a solemn ceremony, or crying without having the feeling of sadness.</li><li>Abrupt start: Episodes of crying and laughing can start without an identifiable emotional trigger.</li><li>Inability to stop the episode: Unlike typical emotional outbursts, individuals with PBA are not able to control or end the episode once started.</li><li>Emotional changes: Crying can change quickly into laughing, or vice versa, without any recognizable trigger.</li></ul>

Although PBA is not a life-threatening condition, it can be very disruptive. There are treatments available to help manage the symptoms. Dextromethorphan/quinidine (Nuedexta) is the only FDA-approved medication specifically for PBA. This drug works by changing the way certain neurotransmitters function in the brain, helping to control emotional outbursts. In addition, antidepressants may be prescribed off-label to help alleviate symptoms in some cases.

Beyond medication, therapy and support groups can be very helpful in managing the social and emotional challenges of living with PBA. Cognitive-behavioral therapy (CBT) may help individuals understand their emotional responses and develop coping strategies to reduce the impact of PBA on their lives.

Pseudobulbar affect is a condition that can result from several serious neurological disorders. While the involuntary laughing and crying symptoms themselves are disturbing, it's the connection of PBA to brain dysfunction that will eventually lead to proper treatment and support for the patient. 

If your loved one or you have sudden uncontrollable outbursts emotionally, it's essential to seek a comprehensive evaluation from the healthcare professional. With the right diagnosis and management plan, individuals with PBA can improve their emotional regulation and continue to live fulfilling lives despite the challenges of their condition.

<a href="https://mymsaa.org/ms-information/symptoms/pba/" data-type="tilCustomLink" target="_blank" rel="noopener nofollow noreferrer" rel= "noopener nofollow noreferrer" target= "_blank">Pseudobulbar affect (PBA).</a>Multiple Sclerosis Association of America. 2010. 

<a href="https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects/pseudobulbar-affect" data-type="externalLink" target="_blank" rel="noopener nofollow noreferrer" rel= "noopener nofollow noreferrer" target= "_blank">Pseudobulbar a</a><a href="https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects/pseudobulbar-affect" data-type="tilCustomLink" target="_blank" rel="noopener nofollow noreferrer" rel= "noopener nofollow noreferrer" target= "_blank">Pseudobulbar affect (PBA)</a>ffect (PBA). American Stroke Association. 

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Emotions are an organic and essential component of human life. They help individuals convey messages to others, reduce stress, and connect to the surroundings. However, in the case of some people, emotional responses are no longer in their control. Sometimes, the reactions can be excessive, inappropriate, or entirely out of place. This is known as pseudobulbar affect, which refers to an uncontrolled and sometimes exaggerated laughing or crying condition. Although PBA itself is not a disease, it is closely related to neurological disorders and brain injuries. The effects of PBA can be distressing, but understanding its causes and treatment options can help manage its impact on daily life.What Is Pseudobulbar Affect (PBA)?PBA is a neurological condition that causes sudden, involuntary emotional outbursts. These episodes can manifest themselves through excessive laughing or crying that is inappropriate considering the context of the situation. These individuals experience extreme reactions with PBA, such as laughter during serious moments or tears in the absence of sadness, apparently without any emotional precipitate. These outbursts also occur for longer periods than may be expected in normal circumstances and are not easily controlled to see when or how long they occur.Although PBA is not life-threatening, it can significantly affect a person's social and emotional well-being. People who experience PBA may find themselves embarrassed, frustrated, or isolated, as their emotional responses seem out of sync with their true feelings.Studies estimate that up to 7 million Americans exhibit symptoms of PBA, and approximately 2 million individuals are diagnosed with the condition. PBA is most often seen in patients who have experienced a brain injury or suffer from neurological diseases. In some cases, PBA symptoms may be mistaken for mood disorders such as depression or anxiety, but the underlying causes are related to brain dysfunction rather than emotional instability.What Causes PBA?The root cause of pseudobulbar affect lies in the dysfunction of the central nervous system (CNS). More specifically, PBA results from damage to the brain's emotional regulation pathways, particularly the areas that control laughter and crying. Damage to these areas leads to involuntary emotional outbursts that are disconnected from the person’s actual feelings. Several neurological conditions can disrupt these pathways and increase the likelihood of developing PBA.Here are five major conditions associated with PBA:1. StrokeA stroke occurs when blood flow to the brain is interrupted, depriving brain cells of oxygen and leading to their damage or death. This can result in physical disabilities, cognitive impairments, and emotional disturbances. Between 28% and 52% of stroke survivors experience PBA, with those assigned female at birth being at a higher risk. The symptoms of PBA are sometimes hard to differentiate from other effects that a stroke can bring. Accurate diagnosis is very important. If you or someone you care about has had a stroke and cannot stop laughing or crying, you need to talk to a doctor, because these symptoms could mean PBA rather than a mood disorder.2. Traumatic Brain Injury (TBI)Traumatic brain injury often occurs due to external forces such as falls, car accidents, or sports injuries. TBIs can be a concussion or severe damage to the brain, and PBA is a common result of major head trauma. Studies have found that 5-48% of people with TBI develop symptoms of PBA, though this range varies due to underreporting and misdiagnosis. Symptoms may be confused with another condition like depression or post-traumatic stress disorder, which can make them discuss emotional changes with a doctor who may have the patient referred for further neurology evaluation.Also Read: Alarming Rise In Cancer Cases Among People Under-50 Could Be The New Global 'Epidemic'3. Multiple Sclerosis (MS)Multiple sclerosis is an autoimmune disease in which the body's immune system fights against the protective covering of nerve fibers in the CNS, bringing about the disintegration of the communication process between the brain and the body. People with MS are more susceptible to developing PBA and have shown a prevalence rate of 10% from studies among patients with symptoms of involuntary laughter or crying. MS-related brain lesions and the utilization of certain drugs can contribute to developing PBA. The lack of predictability of PBA can be especially problematic for an MS patient because it can create problems with social interactions as well as quality of life.4. Amyotrophic Lateral Sclerosis (ALS)Amyotrophic lateral sclerosis (ALS) is a progressive, neurodegenerative disease that affects cells in the nerve responsible for controlling voluntary movements of the muscles. As the motor neurons degenerate, patients begin experiencing muscle weakness, loss of mobility, and eventually, a failure to breathe. About 10% of patients with ALS develop PBA, in which crying is more common than laughing. While ALS itself inflicts much physical and emotional stress, PBA can make an already difficult emotional experience even worse for patients and their families to bear.5. Parkinson's Disease and DementiaParkinson's disease is a progressive neurological disorder affecting movement. PBA often occurs in advanced Parkinson's disease. The prevalence of PBA symptoms among Parkinson's patients has been reported to be 3.6% to 42.5%. In addition, the cognitive decline in Alzheimer's disease can also lead to PBA, and the prevalence among these patients has been estimated to be as high as 40%. These conditions often have fluctuations in mood, which could be mistaken for mood disorders, complicating the diagnosis. Therefore, identification of symptoms of PBA in patients with Parkinson's and dementia is essential to ensure that these patients get proper care and support.Symptoms of PBAThe symptoms of PBA are varied but usually involve:Increased emotional reactions: Laughter or crying for longer durations or of more intensity than the situation requires.Inappropriate crying and laughing: Laughing without a reason, e.g., at a solemn ceremony, or crying without having the feeling of sadness.Abrupt start: Episodes of crying and laughing can start without an identifiable emotional trigger.Inability to stop the episode: Unlike typical emotional outbursts, individuals with PBA are not able to control or end the episode once started.Emotional changes: Crying can change quickly into laughing, or vice versa, without any recognizable trigger.Treatment for PBAAlthough PBA is not a life-threatening condition, it can be very disruptive. There are treatments available to help manage the symptoms. Dextromethorphan/quinidine (Nuedexta) is the only FDA-approved medication specifically for PBA. This drug works by changing the way certain neurotransmitters function in the brain, helping to control emotional outbursts. In addition, antidepressants may be prescribed off-label to help alleviate symptoms in some cases.Beyond medication, therapy and support groups can be very helpful in managing the social and emotional challenges of living with PBA. Cognitive-behavioral therapy (CBT) may help individuals understand their emotional responses and develop coping strategies to reduce the impact of PBA on their lives.Pseudobulbar affect is a condition that can result from several serious neurological disorders. While the involuntary laughing and crying symptoms themselves are disturbing, it's the connection of PBA to brain dysfunction that will eventually lead to proper treatment and support for the patient. If your loved one or you have sudden uncontrollable outbursts emotionally, it's essential to seek a comprehensive evaluation from the healthcare professional. With the right diagnosis and management plan, individuals with PBA can improve their emotional regulation and continue to live fulfilling lives despite the challenges of their condition.Pseudobulbar affect (PBA).Multiple Sclerosis Association of America. 2010. Pseudobulbar aPseudobulbar affect (PBA)ffect (PBA). American Stroke Association. 

uncontrolled laughing or crying is linked to 5 dangerous conditions

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How VR and Gaming Aid Brain Surgery Rehab

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Things are constantly changing and revolutionising in the health system. Thanks to technologies, there are now new ways to "heal". One such way is by indulging yourself in to the world of virtual reality and gaming, writes Dr Sathyanarayana LD, Consultant neurosurgeon at Narayana Health, Bengaluru for South First. 

He notes that many people undergo surgery to remove brain tumors, which are one of the most complex and could be life-altering conditions for someone to face. Brain tumors could be benign or malignant, however, both affects the person's speech, motor function, memory, and their ability to perform day-to-day activities. This is the reason why, post-surgery, patients may be left with impairments, including physical, cognitive, and emotional. But thanks to technological advancement in the field of health, virtual reality (VR) and gaming have become "powerful tools for neurorehabilitation". 

Dr Sathyanarayana notes that these means are not just for entertainment anymore. Since these means offer a more immersive and interactive experience, they have the potential to enhance the effectiveness of the treatment and also speed up the healing process, post-surgery. 

The doctor notes that recovering from brain surgery is an intricate and lengthy journey. The brain does not return to full function immediately after the procedure; instead, it must gradually rebuild and rewire itself to regain what was lost.

This remarkable ability of the brain to reorganize and adapt, shaped by continuous learning and experience, is called neuroplasticity. It is through neuroplasticity that the brain creates new neural pathways to compensate for damaged areas and restore lost capabilities. In this complex process of rebuilding, gaming and virtual reality (VR) are emerging as powerful allies.

VR places patients in immersive, computer-generated environments that stimulate multiple senses at once—sight, sound, and even body awareness, known as proprioception. These rich sensory experiences actively engage different areas of the brain, sparking changes at the synaptic level, where neurons communicate with each other.

By simultaneously activating motor, sensory, and cognitive regions of the brain, VR encourages synaptic plasticity and broader neural reorganization. This multi-layered engagement fosters a more cohesive and efficient path to recovery, helping the brain rebuild its networks in a meaningful and impactful way.

<h4>Relearning Movement Through Virtual Play</h4>

Post-surgery, many patients face motor impairments like weakness or poor coordination. Virtual reality offers a safe and stimulating space to relearn movement through repetition and task-specific training—key elements for motor recovery.

For instance, VR games that simulate cricket—batting, catching, or goalkeeping—encourage repeated use of the shoulder, arm, and hand, helping restore motor skills. These games also adapt in difficulty and provide real-time feedback, keeping patients motivated while preventing fatigue.

Watching and participating in virtual activities also stimulates mirror neurons—cells involved in motor learning—which may strengthen communication between remaining healthy brain circuits and support recovery.

<h4>Training the Brain to Think Again</h4>

Beyond physical rehabilitation, brain surgery often impacts attention, memory, decision-making, and problem-solving. Gaming and VR can simulate real-life tasks in a structured, repeatable way, challenging cognitive functions in an enjoyable format.

Games involving memory recall, puzzles, and strategic decision-making push the brain to stay active. Over time, this improves working memory, executive function, and mental sharpness—key components of cognitive healing.

<h4>Emotional Healing in a Virtual World</h4>

Recovery is not just physical or cognitive—it’s deeply emotional too. Patients may feel anxious, depressed, or lose confidence. Immersive VR experiences can provide psychological comfort by offering calming spaces or achievement-oriented challenges.

These environments give patients a chance to see their progress, rebuild self-esteem, and stay hopeful—factors that are vital for long-term motivation and adherence to recovery routines.

<h4>Why VR and Gaming Work in Neurorehab</h4>

<strong>Repetition with engagement</strong>: Games make repetitive rehab feel enjoyable, which is essential for promoting neuroplasticity.

<strong>Customized progress: </strong>VR systems offer real-time biofeedback and adaptive difficulty, ensuring that challenges remain effective and engaging without overwhelming the patient.

<strong>Affordable and scalable: </strong>Innovations from institutions like IIIT Hyderabad’s Serious Games Lab are making VR solutions accessible and low-cost, even for rural and public healthcare settings.

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Things are constantly changing and revolutionising in the health system. Thanks to technologies, there are now new ways to "heal". One such way is by indulging yourself in to the world of virtual reality and gaming, writes Dr Sathyanarayana LD, Consultant neurosurgeon at Narayana Health, Bengaluru for South First. He notes that many people undergo surgery to remove brain tumors, which are one of the most complex and could be life-altering conditions for someone to face. Brain tumors could be benign or malignant, however, both affects the person's speech, motor function, memory, and their ability to perform day-to-day activities. This is the reason why, post-surgery, patients may be left with impairments, including physical, cognitive, and emotional. But thanks to technological advancement in the field of health, virtual reality (VR) and gaming have become "powerful tools for neurorehabilitation". Dr Sathyanarayana notes that these means are not just for entertainment anymore. Since these means offer a more immersive and interactive experience, they have the potential to enhance the effectiveness of the treatment and also speed up the healing process, post-surgery. How Does It Work? Why Does It Work?The doctor notes that recovering from brain surgery is an intricate and lengthy journey. The brain does not return to full function immediately after the procedure; instead, it must gradually rebuild and rewire itself to regain what was lost.This remarkable ability of the brain to reorganize and adapt, shaped by continuous learning and experience, is called neuroplasticity. It is through neuroplasticity that the brain creates new neural pathways to compensate for damaged areas and restore lost capabilities. In this complex process of rebuilding, gaming and virtual reality (VR) are emerging as powerful allies.VR places patients in immersive, computer-generated environments that stimulate multiple senses at once—sight, sound, and even body awareness, known as proprioception. These rich sensory experiences actively engage different areas of the brain, sparking changes at the synaptic level, where neurons communicate with each other.By simultaneously activating motor, sensory, and cognitive regions of the brain, VR encourages synaptic plasticity and broader neural reorganization. This multi-layered engagement fosters a more cohesive and efficient path to recovery, helping the brain rebuild its networks in a meaningful and impactful way.Relearning Movement Through Virtual PlayPost-surgery, many patients face motor impairments like weakness or poor coordination. Virtual reality offers a safe and stimulating space to relearn movement through repetition and task-specific training—key elements for motor recovery.For instance, VR games that simulate cricket—batting, catching, or goalkeeping—encourage repeated use of the shoulder, arm, and hand, helping restore motor skills. These games also adapt in difficulty and provide real-time feedback, keeping patients motivated while preventing fatigue.Watching and participating in virtual activities also stimulates mirror neurons—cells involved in motor learning—which may strengthen communication between remaining healthy brain circuits and support recovery.Training the Brain to Think AgainBeyond physical rehabilitation, brain surgery often impacts attention, memory, decision-making, and problem-solving. Gaming and VR can simulate real-life tasks in a structured, repeatable way, challenging cognitive functions in an enjoyable format.Games involving memory recall, puzzles, and strategic decision-making push the brain to stay active. Over time, this improves working memory, executive function, and mental sharpness—key components of cognitive healing.Emotional Healing in a Virtual WorldRecovery is not just physical or cognitive—it’s deeply emotional too. Patients may feel anxious, depressed, or lose confidence. Immersive VR experiences can provide psychological comfort by offering calming spaces or achievement-oriented challenges.These environments give patients a chance to see their progress, rebuild self-esteem, and stay hopeful—factors that are vital for long-term motivation and adherence to recovery routines.Why VR and Gaming Work in NeurorehabRepetition with engagement: Games make repetitive rehab feel enjoyable, which is essential for promoting neuroplasticity.Customized progress: VR systems offer real-time biofeedback and adaptive difficulty, ensuring that challenges remain effective and engaging without overwhelming the patient.Affordable and scalable: Innovations from institutions like IIIT Hyderabad’s Serious Games Lab are making VR solutions accessible and low-cost, even for rural and public healthcare settings.

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When Canada first passed its assisted dying legislation, also known as the Bill C-14 in 2016, it soon became a landmark in healthcare and personal autonomy. It is officially known as Medical Assistance in Dying (MAID) and was initially available only to those adults who were terminally ill. The eligibility criteria had strict parameters: the person had to be suffering from a "serious and incurable illness", be in an "advanced sate of irreversible decline", experience "intolerable suffering", and crucially their natural death had to be "reasonable foreseeable". 

This legal threshold was also known as Track 1. This was modeled on end-of-life care and largely served people with terminal cancer or other severe illness who wanted control over their dying process. Track 1 is a relatively swift procedure, with some patients receiving MAID within a day of applying. 

However, many Canadians live with severe, non-terminal conditions and they felt left out. These were people with degenerative diseases, chronic pain, or spinal injuries. They had and continued to suffer deeply, but were not imminently dying. They also began to request for MAID, however, were routinely denied.

<strong>ALSO READ: <a href="https://www.healthandme.com/health-wellness/what-are-the-dutch-guidelines-of-active-euthanasia-and-the-countries-that-allow-it-article-151101970" data-type="tilCustomLink">What Are The Dutch Guidelines Of Active Euthanasia And The Countries That Allow It</a></strong>

This led to a legal challenge by Jean Truchon, reports The New York Times. He is a man with spastic cerebral palsy whose suffering wasn’t deemed terminal. In 2019, a Quebec court ruled that the “reasonably foreseeable death” clause was unconstitutional. This case prompted the introduction of Bill C-7 in 2021, which created Track 2 — extending MAID eligibility to people with serious, incurable conditions causing enduring suffering, even if their deaths weren’t foreseeable.

Track 2 includes additional safeguards: a 90-day assessment period, evaluation by two independent clinicians, and consultation with specialists if necessary. Applicants must also be informed of other ways to alleviate their suffering and show they’ve seriously considered those options. While mental illness alone was technically included under Track 2, implementation has been delayed until 2027 due to concerns about inadequate mental health infrastructure.

Despite its tighter process and ethical complexities, Track 2 MAID has steadily gained use. In 2023, there were 622 deaths under Track 2 compared to 14,721 under Track 1. Still, Track 2 has ignited national debate, with critics claiming it opens the door to premature death among vulnerable populations — and supporters defending it as a compassionate choice for those trapped in non-terminal agony.

<h4>Paula Ritchie And The Doctor Who Stepped Forward To Assess Track 2 Patients</h4>

A 52-year-old woman from Smith Falls, Ontario had a far from simple case, assessed by Dr Matt Wonnacott, who agreed to assess Track 2 patients. He believed that these patients too had the right to autonomy and must be able to guide care decision, including the right to choose death when suffering becomes unbearable, reports The New York Times. 

Paula had a long history of chronic pain and mental health challenges: fibromyalgia, chronic fatigue syndrome, migraines, depression, PTSD, borderline personality disorder, and more. But things got worse in early 2023 after a head injury. She began experiencing vertigo, migraines, uncontrollable muscle movements, and an overwhelming dizziness that made even basic tasks impossible.

Doctors failed to find a physical cause. Some attributed her symptoms to psychological distress, while others diagnosed post-concussion syndrome. Treatments ranged from Percocet and Ativan to acupuncture and reiki, but nothing worked. Paula’s life shrank to a single room, her body wracked with pain, her mind spinning. She tried to end her life — and failed.

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Frustrated by her inability to access help or relief, Paula began pursuing MAID. Her first request was denied. But she persisted, calling the regional MAID coordination center daily until she was finally reassessed by Wonnacott and a psychiatrist, Dr. Elspeth MacEwan.

During the assessment, Wonnacott asked if she would wait five years for a hypothetical cure. Paula said no — she could barely get through a day. She felt tortured. A veterinarian, she told a friend, would euthanize a dog in better shape.

Importantly, Wonnacott found her reasoning sound. She was not acting out of untreated mental illness or impulsivity. She had sought treatment. She had given it time. And she had thought carefully about her request. MacEwan agreed. Paula met the criteria under Track 2.

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right to die with dignity

When Canada first passed its assisted dying legislation, also known as the Bill C-14 in 2016, it soon became a landmark in healthcare and personal autonomy. It is officially known as Medical Assistance in Dying (MAID) and was initially available only to those adults who were terminally ill. The eligibility criteria had strict parameters: the person had to be suffering from a "serious and incurable illness", be in an "advanced sate of irreversible decline", experience "intolerable suffering", and crucially their natural death had to be "reasonable foreseeable". This legal threshold was also known as Track 1. This was modeled on end-of-life care and largely served people with terminal cancer or other severe illness who wanted control over their dying process. Track 1 is a relatively swift procedure, with some patients receiving MAID within a day of applying. However, many Canadians live with severe, non-terminal conditions and they felt left out. These were people with degenerative diseases, chronic pain, or spinal injuries. They had and continued to suffer deeply, but were not imminently dying. They also began to request for MAID, however, were routinely denied.ALSO READ: What Are The Dutch Guidelines Of Active Euthanasia And The Countries That Allow ItThis led to a legal challenge by Jean Truchon, reports The New York Times. He is a man with spastic cerebral palsy whose suffering wasn’t deemed terminal. In 2019, a Quebec court ruled that the “reasonably foreseeable death” clause was unconstitutional. This case prompted the introduction of Bill C-7 in 2021, which created Track 2 — extending MAID eligibility to people with serious, incurable conditions causing enduring suffering, even if their deaths weren’t foreseeable.Track 2 includes additional safeguards: a 90-day assessment period, evaluation by two independent clinicians, and consultation with specialists if necessary. Applicants must also be informed of other ways to alleviate their suffering and show they’ve seriously considered those options. While mental illness alone was technically included under Track 2, implementation has been delayed until 2027 due to concerns about inadequate mental health infrastructure.Despite its tighter process and ethical complexities, Track 2 MAID has steadily gained use. In 2023, there were 622 deaths under Track 2 compared to 14,721 under Track 1. Still, Track 2 has ignited national debate, with critics claiming it opens the door to premature death among vulnerable populations — and supporters defending it as a compassionate choice for those trapped in non-terminal agony.Paula Ritchie And The Doctor Who Stepped Forward To Assess Track 2 PatientsA 52-year-old woman from Smith Falls, Ontario had a far from simple case, assessed by Dr Matt Wonnacott, who agreed to assess Track 2 patients. He believed that these patients too had the right to autonomy and must be able to guide care decision, including the right to choose death when suffering becomes unbearable, reports The New York Times. Paula had a long history of chronic pain and mental health challenges: fibromyalgia, chronic fatigue syndrome, migraines, depression, PTSD, borderline personality disorder, and more. But things got worse in early 2023 after a head injury. She began experiencing vertigo, migraines, uncontrollable muscle movements, and an overwhelming dizziness that made even basic tasks impossible.Doctors failed to find a physical cause. Some attributed her symptoms to psychological distress, while others diagnosed post-concussion syndrome. Treatments ranged from Percocet and Ativan to acupuncture and reiki, but nothing worked. Paula’s life shrank to a single room, her body wracked with pain, her mind spinning. She tried to end her life — and failed.YOU MAY WANT TO READ: Plea of Chilean Woman With Muscular Dystrophy Sparks National Debate on Euthanasia BillFrustrated by her inability to access help or relief, Paula began pursuing MAID. Her first request was denied. But she persisted, calling the regional MAID coordination center daily until she was finally reassessed by Wonnacott and a psychiatrist, Dr. Elspeth MacEwan.During the assessment, Wonnacott asked if she would wait five years for a hypothetical cure. Paula said no — she could barely get through a day. She felt tortured. A veterinarian, she told a friend, would euthanize a dog in better shape.Importantly, Wonnacott found her reasoning sound. She was not acting out of untreated mental illness or impulsivity. She had sought treatment. She had given it time. And she had thought carefully about her request. MacEwan agreed. Paula met the criteria under Track 2.

can right to die be practiced by non-terminally ill patients?

Impulsive Teens May Not Be Like This Due To Their Choices, THIS Could Be The Reason Why

impulsive teens may not be like this due to their choices, this could be the reason why

Ayurveda

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As teens across the globe fall into later bedtimes, a growing body of research suggests this seemingly harmless habit could be more than just a phase. According to a recent study presented at the American Academy of Sleep Medicine (AASM), teenagers who identify as “night owls” may be biologically predisposed to impulsive and even self-destructive behaviors—raising red flags about adolescent mental health, sleep hygiene, and broader lifestyle risks.

Teenagers who prefer staying up late and waking up late exhibit a higher tendency for impulsiveness, particularly when experiencing negative emotions, the study found. Led by Riya Mirchandaney, a doctoral candidate in clinical-health psychology at the University of Pittsburgh, the research analyzed 210 teenagers across two studies. Participants completed sleep pattern surveys, wore wrist trackers for a week, provided saliva samples to measure melatonin levels, and underwent impulsivity assessments.

Interestingly, the findings challenge long-standing assumptions about melatonin and circadian rhythm. Researchers did not find a significant correlation between dim light melatonin onset—a common measure of the body’s internal clock—and impulsive behavior. Instead, the teens' self-reported preference for staying up late was more strongly associated with behaviors like quitting challenging tasks prematurely or acting out when distressed.

"Surprisingly, we did not find a significant link between dim light melatonin onset and impulsivity in our sample," Mirchandaney stated. "This suggests that there may be unmeasured psychological or behavioral factors influencing both impulsivity and the self-assessment of circadian preference."

The implications of these findings go beyond mood swings and grumpy mornings. Sleep plays a pivotal role in adolescent brain development, physical health, and emotional regulation. When teens fall short of the recommended 8–10 hours of nightly sleep, the ripple effects can touch every corner of their lives—from the classroom to the emergency room.

Research by the Centers for Disease Control and Prevention (CDC) has long pointed out that teens who sleep less than the recommended amount are at greater risk of engaging in dangerous behaviors such as substance use, unprotected sex, reckless driving, and even physical violence. Lack of sleep also affects the prefrontal cortex—the part of the brain responsible for judgment and impulse control—making adolescents more prone to risk-taking without fully considering consequences.

What’s Causing the Delay in Teen Sleep Patterns?

The shift toward a night owl schedule in adolescence isn’t purely behavioral—it has biological roots. As teens enter puberty, their circadian rhythms naturally shift. Melatonin, the hormone that promotes sleep, begins releasing later in the evening, making it difficult for teens to fall asleep early, even if they try.

This internal shift clashes with rigid school start times, often requiring students to wake up around 6 or 7 a.m., long before their biological clock is ready. Over time, this chronic misalignment leads to what sleep scientists call “social jetlag,” a condition linked to increased stress, depression, anxiety, and now, potentially, impulsive tendencies.

There’s a well-documented, bidirectional relationship between poor sleep and mental health issues. Teens who don’t sleep well are more likely to report anxiety, depression, and suicidal ideation. At the same time, those experiencing mental health challenges often find it harder to fall and stay asleep.

This loop can create a dangerous feedback cycle: emotional instability leads to sleep disturbances, which in turn worsen mental health. With impulsivity now added to the equation, the concern grows deeper. Reckless decisions made in moments of emotional volatility—especially when amplified by sleep deprivation—could have life-altering consequences.

Physical Development and Chronic Illness Risk

Sleep is essential for hormonal regulation, immune function, muscle recovery, and overall growth—all crucial during the adolescent years. Poor sleep habits have been linked to increased risk of developing chronic conditions such as Type 2 diabetes, obesity, and cardiovascular disease. The metabolic profile of sleep-deprived teens, including elevated blood pressure and cholesterol, mirrors that of adults on the path to chronic illness.

The short answer: no. According to the CDC, approximately 70% of high school students in the United States do not get enough sleep on school nights. The numbers are even more troubling for girls, older teens, and students from Black, Asian, or multiracial backgrounds.

A combination of early school schedules, excessive academic and extracurricular demands, and digital device usage—often past midnight—makes consistent, high-quality sleep an elusive goal for most adolescents.

Teens today are more connected than ever. Phones, tablets, and laptops are often a constant companion—even in bed. The blue light emitted by screens interferes with melatonin production, delaying sleep even further. Notifications and alerts disrupt sleep cycles, and the mental stimulation from social media can keep teens emotionally activated long after they’ve turned off the lights.

Meanwhile, the stress of juggling academics, sports, part-time jobs, and social obligations only adds fuel to the fire. Many teens end up sacrificing sleep in order to meet all their commitments, not realizing the cognitive and emotional toll this can take.

Start with Awareness: Parents should regularly talk to teens about their sleep habits and observe changes in mood, focus, or risk-taking behaviors.

Promote Good Sleep Hygiene: Encourage consistent sleep schedules, wind-down routines, screen-free bedrooms, and calming nighttime environments.

Advocate for Policy Change: Several studies have shown that delaying school start times improves attendance, academic performance, and reduces teen car accidents. Parents can work with school boards to push for healthier schedules.

Manage Expectations and Time: Help teens prioritize their activities and make sure they’re not overscheduled. A balanced life makes room for sleep.

Professional Support: If poor sleep is affecting a teen’s daily functioning, consult a pediatrician or sleep specialist. Cognitive behavioral therapy for insomnia (CBT-I) has shown promise in helping adolescents reset sleep patterns.

The new findings about night owls and impulsivity add yet another layer to our understanding of adolescent sleep. It’s not just about how many hours teens sleep—it’s when and how they sleep that matters. As researchers continue to uncover the profound impacts of circadian rhythm disruptions, one thing is clear: improving sleep in teenagers is no longer optional—it’s essential for safeguarding their future.

teen sleep habits

impulsive teens

teen mental health

adolescent sleep deprivation

teen bedtime study

reckless teen behavior

teenage brain development

As teens across the globe fall into later bedtimes, a growing body of research suggests this seemingly harmless habit could be more than just a phase. According to a recent study presented at the American Academy of Sleep Medicine (AASM), teenagers who identify as “night owls” may be biologically predisposed to impulsive and even self-destructive behaviors—raising red flags about adolescent mental health, sleep hygiene, and broader lifestyle risks.Teenagers who prefer staying up late and waking up late exhibit a higher tendency for impulsiveness, particularly when experiencing negative emotions, the study found. Led by Riya Mirchandaney, a doctoral candidate in clinical-health psychology at the University of Pittsburgh, the research analyzed 210 teenagers across two studies. Participants completed sleep pattern surveys, wore wrist trackers for a week, provided saliva samples to measure melatonin levels, and underwent impulsivity assessments.Interestingly, the findings challenge long-standing assumptions about melatonin and circadian rhythm. Researchers did not find a significant correlation between dim light melatonin onset—a common measure of the body’s internal clock—and impulsive behavior. Instead, the teens' self-reported preference for staying up late was more strongly associated with behaviors like quitting challenging tasks prematurely or acting out when distressed."Surprisingly, we did not find a significant link between dim light melatonin onset and impulsivity in our sample," Mirchandaney stated. "This suggests that there may be unmeasured psychological or behavioral factors influencing both impulsivity and the self-assessment of circadian preference."The implications of these findings go beyond mood swings and grumpy mornings. Sleep plays a pivotal role in adolescent brain development, physical health, and emotional regulation. When teens fall short of the recommended 8–10 hours of nightly sleep, the ripple effects can touch every corner of their lives—from the classroom to the emergency room.Research by the Centers for Disease Control and Prevention (CDC) has long pointed out that teens who sleep less than the recommended amount are at greater risk of engaging in dangerous behaviors such as substance use, unprotected sex, reckless driving, and even physical violence. Lack of sleep also affects the prefrontal cortex—the part of the brain responsible for judgment and impulse control—making adolescents more prone to risk-taking without fully considering consequences.What’s Causing the Delay in Teen Sleep Patterns?The shift toward a night owl schedule in adolescence isn’t purely behavioral—it has biological roots. As teens enter puberty, their circadian rhythms naturally shift. Melatonin, the hormone that promotes sleep, begins releasing later in the evening, making it difficult for teens to fall asleep early, even if they try.This internal shift clashes with rigid school start times, often requiring students to wake up around 6 or 7 a.m., long before their biological clock is ready. Over time, this chronic misalignment leads to what sleep scientists call “social jetlag,” a condition linked to increased stress, depression, anxiety, and now, potentially, impulsive tendencies.There’s a well-documented, bidirectional relationship between poor sleep and mental health issues. Teens who don’t sleep well are more likely to report anxiety, depression, and suicidal ideation. At the same time, those experiencing mental health challenges often find it harder to fall and stay asleep.This loop can create a dangerous feedback cycle: emotional instability leads to sleep disturbances, which in turn worsen mental health. With impulsivity now added to the equation, the concern grows deeper. Reckless decisions made in moments of emotional volatility—especially when amplified by sleep deprivation—could have life-altering consequences.Physical Development and Chronic Illness RiskSleep is essential for hormonal regulation, immune function, muscle recovery, and overall growth—all crucial during the adolescent years. Poor sleep habits have been linked to increased risk of developing chronic conditions such as Type 2 diabetes, obesity, and cardiovascular disease. The metabolic profile of sleep-deprived teens, including elevated blood pressure and cholesterol, mirrors that of adults on the path to chronic illness.Are Teens Actually Getting Enough Sleep?The short answer: no. According to the CDC, approximately 70% of high school students in the United States do not get enough sleep on school nights. The numbers are even more troubling for girls, older teens, and students from Black, Asian, or multiracial backgrounds.A combination of early school schedules, excessive academic and extracurricular demands, and digital device usage—often past midnight—makes consistent, high-quality sleep an elusive goal for most adolescents.Role of Technology and Lifestyle ChoicesTeens today are more connected than ever. Phones, tablets, and laptops are often a constant companion—even in bed. The blue light emitted by screens interferes with melatonin production, delaying sleep even further. Notifications and alerts disrupt sleep cycles, and the mental stimulation from social media can keep teens emotionally activated long after they’ve turned off the lights.Meanwhile, the stress of juggling academics, sports, part-time jobs, and social obligations only adds fuel to the fire. Many teens end up sacrificing sleep in order to meet all their commitments, not realizing the cognitive and emotional toll this can take.Start with Awareness: Parents should regularly talk to teens about their sleep habits and observe changes in mood, focus, or risk-taking behaviors.Promote Good Sleep Hygiene: Encourage consistent sleep schedules, wind-down routines, screen-free bedrooms, and calming nighttime environments.Advocate for Policy Change: Several studies have shown that delaying school start times improves attendance, academic performance, and reduces teen car accidents. Parents can work with school boards to push for healthier schedules.Manage Expectations and Time: Help teens prioritize their activities and make sure they’re not overscheduled. A balanced life makes room for sleep.Professional Support: If poor sleep is affecting a teen’s daily functioning, consult a pediatrician or sleep specialist. Cognitive behavioral therapy for insomnia (CBT-I) has shown promise in helping adolescents reset sleep patterns.The new findings about night owls and impulsivity add yet another layer to our understanding of adolescent sleep. It’s not just about how many hours teens sleep—it’s when and how they sleep that matters. As researchers continue to uncover the profound impacts of circadian rhythm disruptions, one thing is clear: improving sleep in teenagers is no longer optional—it’s essential for safeguarding their future.

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Can Right To Die Be Practiced By Non-Terminally Ill Patients?

Teens Who Stay Up Late May Be Wired for Recklessness and Impulsiveness, Study Finds

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Can Right To Die Be Practiced By Non-Terminally Ill Patients?

Teens Who Stay Up Late May Be Wired for Recklessness and Impulsiveness, Study Finds