What somatic delusions mean for your mental health

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 false beliefs that something is wrong with your body — even when there’s little or no medical evidence to support the concern. These beliefs can cause significant distress and may affect a person’s mental health, relationships, and daily functioning.

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.

Dig deeper:

• Is it bipolar disorder, schizophrenia, or both?

Somatic delusions are sometimes confused with other mental health conditions. 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.

Symptoms of 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.

Common themes of somatic delusions can include:

• 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.

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.

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 health conditions.

What you can do about somatic delusions

Somatic delusions can feel very real and distressing. While professional treatment is often helpful, there are also steps you can take to manage these experiences in daily life. These strategies for self-help can help you reduce stress and gain perspective.

You might try:

• Pausing and questioning the belief: Ask yourself if there is clear medical evidence supporting the concern.

• Seeking trusted information: If you’re worried about a health issue, speak with a medical provider instead of relying on repeated self-checking or online searches.

• Practicing grounding techniques: Deep breathing, mindfulness, or focusing on your surroundings can help calm intense thoughts.

• Talking to someone you trust: Sharing your concerns with a friend, family member, or support group may help you feel less alone.

• Practicing 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. 

These steps may not remove the belief completely, but they can help you cope with distress and create space for clearer thinking. If these thoughts continue to affect your life, seeking professional support can be an important next step.

Clinician’s take

From my experience, somatic delusions can be deeply distressing because the physical sensations and fears feel completely real to the person experiencing them. The encouraging news is with the right support, many clients are able to better understand these experiences and find meaningful relief.

Brandy Chalmers, LPC

Clinical reviewer