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Can Delusions Be Felt as Physical Pain?

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the U.S.: Is it possible for a person with persecutory delusional disorder to feel actual physical pain that they believe is being inflicted upon them by a distantly located source?  This would consist of burning sensations, poking, and (electrical) shocks, all of which they are experiencing (wincing and trying to shake off the pain when they occur, and being extremely sleep-deprived), not to mention, this supposed source is also “spying” on their every move.

Thank you very much,
Family trying hard to understand and help our elderly loved one

Can Delusions Be Felt as Physical Pain?

Answered by on -


Absolutely it is possible. Studies show that about 40% or more of people with schizophrenia or depression with psychotic features report experiencing pain. The most common complaints are headaches or backaches or leg pain. Sometimes people with psychosis also experience tactile hallucinations — like the feeling of things crawling on their body or “pins and needles.”

Sometimes pain is a real symptom of an undiagnosed medical problem. Too often, especially in the past, reports of pain by people with chronic mental illness were written off as part of the mental illness. Sometimes yes. But sometimes there is a real and debilitating neurological issue or medical disorders that can contribute to symptoms of psychosis in the elderly. These include thyroid disease, diabetes. Vitamin B12 deficiency and dehydration, as only a few examples.

Complicating things further is that sleep deprivation and pain can become a vicious cycle. Pain keeps the person up, depriving them of sleep. Sleep deprivation reduces tolerance to pain, which makes it harder to sleep the next night and so on.

You didn’t mention if your family member is also suffering from dementia. If she hasn’t been evaluated for dementia, please get her assessed. There are medications that can be helpful when apparent psychotic symptoms are part of the clinical picture for someone with dementia.

If you haven’t already, I suggest you confer with a psychiatrist who specializes in geriatrics. This is too complicated to figure out on your own. With professional guidance, you may be able to get your family member relief from pain.

I wish you well.
Dr. Marie

Can Delusions Be Felt as Physical Pain?

Therapists live, online right now, from BetterHelp:

Dr. Marie Hartwell-Walker

Dr. Marie is licensed as both a psychologist and marriage and family counselor. She specializes in couples and family therapy and parent education. Follow her on Facebook or Twitter.

APA Reference
Hartwell-Walker, D. (2020). Can Delusions Be Felt as Physical Pain?. Psych Central. Retrieved on October 21, 2020, from
Scientifically Reviewed
Last updated: 9 Jul 2020 (Originally: 9 Jul 2020)
Last reviewed: By a member of our scientific advisory board on 9 Jul 2020
Published on Psych All rights reserved.