The reason why the Joker has that laugh (and it's nothing funny)

Have you seen the movie that everyone talks about? 'Joker'continues to dominate the Spanish box office every weekend. In its first weekend alone, it raised 4.4 million euros in cinemas. Directed by Todd Phillips and starring Joaquin Phoenix, accumulates more than 600 million dollars worldwide.

If you have not had the opportunity, you know what you should do. However, if you have already gone to see the movie you will know that (quietly there is no spoiler) the character of Arthur Fleck have inopportune moments in which he gives the uncontrollable laughter (caused by a previous brain injury). It is not an invention of the actor, it is a real disorder and it is called pseudobulbar syndrome

Phoenix has revealed in several interviews that was inspired by videos of people suffering attacks of runaway laughter that they could not control, but specifically he noticed a patient who while laughing out loud, held his neck in pain, as if he were drowning.

What is it about?

According to the Mayo Clinic, pseudobulbar syndrome is a disease characterized by episodes of sudden laughter or crying, out of control and out of place. It usually occurs in people with certain neurological diseases or injuries They can affect the way the brain controls emotional expression. If you know someone who suffers from it, they will experience emotions normally, but sometimes they will express them in an exaggerated way or without any sense. As a consequence, the condition can be embarrassing and disturbing to everyday life.

It is often not diagnosed because confused with mood disorders. However, when the syndrome is located it can be controlled with medication. The first symptoms are exaggerated attacks of cries or laughter that are not usually connected with emotional state. Laughter usually turns into tears and humor seems normal between episodes that occur at any time, although Crying seems to be a more frequent sign.

These attacks they can last several minutes and the emotional response to different situations may change in the way you would have done before. It is very common to be confused with depression, but the difference is that the syndrome has brief episodes and the other causes a persistent feeling of sadness.


Check with your doctor (to refer you to the neuropsychologist, neurologist or psychiatrist) if you think you have any symptoms. What are the most frequent causes of this syndrome also called emotional lability? The main ones are strokes, amyotrophic lateral scleroris (ALS), multiple sclerosis (MS), traumatic brain injuries, Alzheimer's or Parkinson's.

Severe signs of emotional lability (PBA) can cause shame, social isolation, anxiety and depression. This disorder could interfere with the ability to work and perform daily tasks, especially when you already have a neurological disease.

Usually, specialists recommend using antidepressant drugs or a combination of dextromethorphan and quinidine. Advising the patient on how to handle the episodes when they occur is also part of the solution.

Treatment will not necessarily eliminate symptoms, but it can work to reduce the frequency with which the outbreaks occur and their severity. "Medications and behavior modification will help reduce the incidence, but they don't eliminate it completely. Being calm and understanding the problem is very useful," says the neurologist to 'Prevention' Santos Kesari.