Somatic Delusions: Sensing The Signs

By Nadia Khan

Updated December 17, 2018

Reviewer Emily Genever

Have you ever said that an athlete is "deluded" about their physical abilities? That a famous performer or political figure is suffering from "delusions of grandeur"? That a co-worker "must be delusional" if they expect to get a large raise at the end of the year?

Many people use this word quite casually without connecting it to its original meaning. This is an unfortunate mistake since the delusional disorder is a genuine medical condition that exerts a powerful influence on the mind. One manifestation of delusional disorder, the somatic delusion, can even cause a person to distrust their senses and fear their bodies.

Before delving into the specifics of somatic-type delusions and their symptoms, it is helpful to understand the broader scope of delusional disorder. Read on to learn more about this rare psychiatric condition and discover the treatment options available.


What Is Delusional Disorder?

Although people often casually use the word "delusion" to refer to any incorrect or unusual belief, the psychological definition of the term refers to a firmly held yet deeply abnormal conviction that persists without any support from reality.

All delusions can be labeled either "mood-congruent" or "mood-incongruent." A "mood-congruent" delusion is consistent with a particularly depressed or manic mental state. People in a depressed state may believe, entirely mood-congruently, that their loved ones are going to desert them; people in a manic state may believe, also mood-congruently, that their prodigious talents are going unrecognized.

In contrast, "moon-incongruent" delusions feel utterly disconnected from the sufferer's general mental state. Because they so radically depart from their overall mood, many people who suffer from these types of delusions often suspect that their thoughts and feelings are being placed in their mind by an outside force. They may believe that other people, groups, or supernatural entities are taking over their minds, following a belief pattern that psychologists call "thought insertion."

Some people experience "bizarre" delusions, which are practically implausible and may be very difficult for other people to comprehend or process. For instance, a person who has bizarre somatic delusions might believe that aliens have removed the major organs from their body without leaving any scars, or that lifelike humanoid robots have replaced their family members.

However, not all somatic delusions are this far-fetched. Many common delusions, which are classified as "non-bizarre" by psychiatrists, are theoretically possible but highly unlikely. Holding on to these delusions, despite a lack of evidence, is the common theme that unites all cases of the delusional disorder. Here are a few of the most commonly experienced delusions:

  • A belief that the government, police, or some other powerful entity is following you and collecting information about your activities
  • A belief that the world is soon coming to an end, whether through supernatural forces, natural disasters, or human warfare
  • A belief that your significant other has been unfaithful, despite a lack of supporting evidence
  • A belief that you have unusual, unrecognized talents or accomplishments, such as an exceptional skill as a classical pianist or an unacknowledged talent for scientific research

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While these beliefs are not always likely to be true, many of them are technically possible. Many people are unfaithful to their spouses; the police track some people; and many talents and skills go unrecognized for many years. It is only when these beliefs develop in the complete absence of evidence that they are considered delusions.

For this reason, it can be very difficult to determine whether a "non-bizarre" delusion is congruent with their everyday experience. To outside observers, most people with these "non-bizarre" beliefs do not immediately appear to be "delusional." Many can live entirely normal lives, while their delusions functionally debilitate others.

Delusions are also classified according to their general theme. Many delusions naturally group around the themes of jealousy, persecution, and grandiosity. Somatic delusions are those who cluster around physical sensations, bodily disruptions, and appearance. Most cluster around the belief that a person's body is diseased, abnormal, or altered in some way.

No matter the type and severity, most people with delusional disorder share a few common characteristics. They often find it difficult to trust other people and sometimes even appear hostile or aggressive when their beliefs are directly challenged. Many can point to an illuminating experience during which they finally "understood" what was causing their symptoms.

In contrast, some people are preoccupied with their delusions. This can cause significant distress and distraction during their day-to-day lives. In rare cases, people with the delusional disorder may extremely change their lifestyle. They may break up with a significant other, move to a new place, change their job, or even alter their appearance in an attempt to rid themselves of the delusion.

What Are Somatic Delusions?

Everyone sometimes worries about catching a contagious disease or developing a rare illness, but somatic-type delusions are much more convincing, consistent, and compelling than these fleeing fears. Most people who experience them find it impossible to acknowledge that they are not real, and sometimes resort to extreme measures to find a "cure" or "fix." They also tend to resist any facts that contradict or undermine their delusional belief, even if these facts can be conclusively proven.

There are many different types of somatic delusions, which stretch across a wide range of severity and intensity. Here are a few of the most common:

  • The feeling that there are bugs, parasites, or worms embedded in the body. Many people report that these "infestations" have bitten or stung them, left scars on their bodies, or even built nests or laid eggs under their skin. In rare cases, sufferers of this delusion have inflicted extreme self-harm to drive the infestation away. This sensation is by far the most common somatic type delusion.
  • The belief that certain body parts are misshapen, ugly, or missing entirely. This somatic-type delusion can prompt sufferers to cover up the afflicted body parts, withdraw from social situations, or even attempt to remove the offensive area of their body. Although these types of somatic delusions can be very dangerous, they are relatively uncommon.
  • Other people perceive the belief that the body is giving off an unpleasant or offensive odor, which may or may not. Many people are suffering from this particular somatic-type delusion attempt to purge the odor through excessive bathing or use of deodorant and perfume. Some may find it difficult to leave their homes or socialize with others for fear of ridicule.
  • Some relatively rare somatic-type delusions cause sensations to depart radically from the expectations that they typically entail. A hot stove may feel completely cool to the touch, a soft blanket may feel prickly and rough, or a spoonful of sweet ice cream may taste bitter.

Because they are so convinced of the authenticity of their symptoms, however, many people who suffer from somatic-type delusions do not realize that they need psychiatric treatment. Instead, they tend to seek help from dermatologists, dentists, and even infectious disease specialists, who are unable to offer them any useful advice or treatment for this entirely psychological condition.

What Causes Somatic-Type Delusions?


Since this condition is fairly rare, and since not many extensive research studies have been performed, psychiatrists have struggled to identify a cause of somatic-type delusions or delusional disorder as a whole. This condition is likely dependent on a broad range of genetic, environmental, neurological, emotional, and psychological factors. While people with a family history of schizophrenia are not more likely to develop some delusional disorder, some research has suggested that this condition often coexists alongside a predisposition to paranoid personality disorder.

Are Somatic Delusions A Symptom Of Hypochondriasis?

In some cases, people with somatic delusions are incorrectly labeled as hypochondriacs. Interestingly, the somatic-type delusional disorder is sometimes even referred to as "Monosymptomatic hypochondriacal psychosis." However, the two conditions are extremely different. Those who suffer from hypochondriasis are usually able to recognize their condition and at least entertain the possibility that they are not genuinely sick. Somatic-type delusions are so convincing that they are impossible to disregard or ignore.

Are Somatic Delusions A Sign Of Schizophrenia?

Although delusional disorder may present some of the same symptoms that people with schizophrenia experience, it is an entirely distinct condition. In fact, the delusional disorder cannot be positively diagnosed once the criteria for schizophrenia have also been met. Delusions are often signs that point to a much deeper problem. Sometimes, delusions signify serious mental and emotional issues, such as psychotic disorders (like schizoaffective disorder, schizophreniform disorder, or shared psychotic disorder), bipolar disorder, major depressive disorder, delirium, or dementia. In comparison with the prevalence of these conditions, however, the simple delusional disorder is quite rare.


Where Can I Find Help For My Somatic Delusions?

Thankfully, a wide variety of somatic-type delusions have responded positively to psychiatric and psychopharmacological treatments. Many people can achieve complete remission through a comprehensive, well-rounded therapeutic approach that includes medication, cognitive behavioral therapy, and other promising antipsychotic treatments.

If any of these unpleasant somatic-type delusions sound familiar to you, understand that what is happening in your mind may not be tied to reality. A psychologist or other mental health professional can help you determine whether your symptoms are connected to a legitimate medical ailment or a mental issue, such as delusional disorder.

Sometimes personal discussions of these thoughts can feel too sensitive. If this is the case for you, then please consider speaking with a close friend or an online mental health professional like the ones at BetterHelp. There are plenty of resources available to help you deal with these harmful thoughts and live a free, unburdened future.

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