Somatic delusions: Causes, symptoms, and finding support

Delusions are false beliefs that are not based in reality. There are various types of delusions that influence how people think about themselves and others. Somatic delusions are a specific category of delusions characterized by falsely believing that something is wrong with your own body. 

What are somatic delusions?

Somatic delusions are false beliefs that are focused on the physical body. People experiencing somatic delusions are convinced that they have a physical defect or health complication, even when medical testing concludes that everything is just fine. Somatic delusions are most often observed in people with psychotic disorders like schizophrenia, delusional disorder, and mood disorders like major depressive disorder and bipolar disorder.

Somatic delusions are sometimes confused with other mental health issues. For example, somatic delusions are different from hypochondriasis, a persistent fear of having a serious medical condition, or body dysmorphic disorder, a preoccupation with perceived defects or flaws in one’s appearance. 

How to spot somatic delusions

Somatic delusions are unique to each person, but the common denominator is that there’s no medical evidence to support a person’s concerns and false beliefs. Some somatic delusions mirror valid health concerns, while others aren’t based on actual possibilities. For example, believing that your liver isn’t functioning properly is a non-bizarre delusion, while claiming that your liver is missing or was never there to begin with is considered a bizarre delusion.

For someone who’s never experienced a delusion, here are other common examples of somatic delusions.

• You believe that you’re giving off a bad odor.
• You’re concerned that there’s a foreign object inside your body.
• You’re convinced that you’re infested by parasites.

Symptoms of somatic delusions can include the following:

• Complaints without medical proof: People with somatic delusions believe there’s something physically or medically wrong with them, despite professional reassurances or medical evidence proving that the problem doesn’t exist. 
• Unrealistic claims: Unusual or unrealistic medical claims may be a sign that a person’s health concerns are not valid. Examples of bizarre somatic delusions include having twisted bones, being invaded by aliens, or having eggs underneath the skin.
• Anxiety and depression: Because folks with somatic delusions genuinely believe in their physical problems, they may be less likely to seek mental health support. As they grow more distressed over their medical concerns, they may be at increased risk for anxiety, depression, and other mental health symptoms.
• Social withdrawal: Certain delusions may cause people to avoid other people or social situations. For example, if your somatic delusion is that you have a foul or offensive body odor, you may choose self-isolation to protect yourself. 

Causes of somatic delusions

Like many mental health concerns, there’s no clear cause of somatic delusions. Instead, they likely occur due to a variety of biological, psychological, and environmental factors. Similar to other types of mental illness, research suggests that there may be a genetic component to developing somatic delusions. For example, a study found that people were more likely to experience delusions if they had a family history of psychotic disorders such as schizophrenia. 

Another theory is that trauma and stress can trigger delusions, with some research showing a link between childhood exposure to trauma and delusions among people with psychosis. Delusions may also stem from unhealthy substance use, neurological conditions, or psychological factors like social isolation.

How to treat delusions

Treating somatic delusion symptoms may involve a combination of talk therapy, medication management, and lifestyle changes.

1. Psychotherapy

The first step in treating symptoms of somatic delusions is meeting with a trained mental health professional. For people with somatic delusions, it can be tough to accept mental healthcare because they are so convinced of their physical symptoms.

Psychotherapy is an opportunity for people to share their delusions and feelings in a safe, judgment-free environment. During therapy, folks will have a chance to develop the skills to better understand and cope with their condition and circumstances. Cognitive-behavioral therapy (CBT), in particular, is used to help people identify and change unhelpful thought patterns and behaviors. 

And if a person’s delusions begin to impact other people in their life, a therapist might suggest family therapy. Family therapy is a great tool for strengthening family communication skills and learning how to support loved ones who are experiencing delusional thoughts and behavior patterns.

2. Medication management 

Providers will sometimes use a combination of talk therapy and medication management to treat delusions. The exact medication depends on the person, but antidepressants and antipsychotic medications are considered effective forms of treatment for delusions and associated mental illnesses. 

3. Lifestyle changes and self-help strategies

Lifestyle changes and self-help strategies can help people to better manage the stress and anxiety associated with delusions. Below are a few practices to try at home.

• Establish a routine: Following a consistent routine offers a sense of stability and predictability. For someone suffering from delusions, it may be reassuring to have set meal times and to go to sleep and wake up at the same time each day. 

• Consider stress management techniques: Having a medical problem that no one else sees or understands can be incredibly stressful. Mindfulness, breathing, and muscle relaxation techniques can help people to manage stress, reduce anxiety, and prevent being overwhelmed by their surroundings. 

• Practice self-care: Self-care is another effective tool for coping with symptoms of distress that may accompany delusions. Self-care can be anything that’s considered a positive outlet for relaxation and self-expression. A few ideas include journaling, listening to music, making art, and nature walks. 

Find mental health support with Rula

If you or someone you care about is struggling to manage mental health symptoms, know that help is available. 

At Rula, we make it easier to access safe, supportive, and judgment-free care from the comfort of your home. Using Rula, you can find therapists who accept your insurance and understand your unique needs in less than 30 seconds. And if medication ends up being part of your treatment plan, we can also connect you with psychiatric support to help you feel your best.

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