Why can't I cry?

Originally Published: March 18, 2011
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Dear Alice,

For the last year or so, I haven't been able to cry anymore. And when I do, absolutely no tears come out. My eyes just water up, but there are no tears. Is this normal? Should I be worried?

—Confused

Dear Confused,

Crying because of sadness (rather than to clear out debris and moisten the eyes) is a uniquely human phenomenon. Some evolutionary biologists think this function developed as a distress call of sorts. Human beings can "fake" all other emotions, but crying is more likely to be reflective of genuine emotion. It signals to others around that something is really, really wrong. Tears often stimulate a nurturing response in others, which, for a creature as socially interdependent as people are, can be a key to survival. For more information about crying, read "Why cry?"

So what's going on when someone can't cry? There are a few possible explanations. You mentioned that not being able to cry is a recent change. Have you noticed other changes along with the decrease in tear production? Have your eyes felt dry in general? Have you experienced dry mouth in addition to tearlessness? Have you experienced a shift in your emotional state? These are questions a health care provider might ask you when attempting to figure out what's going on. Making an appointment to visit with your healthcare provider may be your best bet in this situation. 

While it's impossible to know why your tears have dried up (especially without more information about potential additional symptoms), it's possible that a health care provider might screen you for Sjögren's syndrome. This is an autoimmune disease in which the body's white blood cells attack moisture-producing glands like tear ducts. What causes the syndrome is unclear, but it occurs most commonly in women over 40 and onset is usually triggered by a major bacterial or viral infection. Symptoms can include dry and itchy eyes, dry mouth, dry skin, arthritis, and fatigue, though not every person with the syndrome has all the symptoms.

While there is no cure for Sjögren's, it is manageable. But it is important to diagnose it because the syndrome can put you at risk for more serious conditions such as:

  • Liver problems
  • Dental cavities
  • Joint pain and/or deterioration
  • Skin rashes
  • Chronic yeast infections
  • In rare cases, cancer of the lymph nodes

It may be a good idea to make a list of any symptoms in addition to lack of tears that you may be experiencing. You may also want to visit a health care provider who can determine if this is what's at the root of your dry cries or if there is something else causing it. Tests may include an eye moisture measurement (which involves holding a small paper on your lower eyelid for a short time), blood tests, and occasionally, x-rays or biopsies. If it is Sjögren's, treatment usually depends on which symptoms you are experiencing. A medication that helps stimulate saliva production or moisturizing eye drops may be prescribed, for example.

Best of luck unraveling the mystery of your tearless peepers.

Take care,

Alice