Do you struggle to cry? Here's what that says about your health

Crying is a natural bodily response to emotions like sadness or joy, as well as stress and pain. It's completely normal and nothing to be ashamed of, but crying doesn't come easily for everyone.

Ever wondered to yourself, "Why can't I cry?" Here's what to know about the science of why crying happens, the health benefits and if it's a problem if you struggle to tear up.

What is crying?

"Tears and crying serve biologic function," Dr. Michelle Andreoli, clinical spokesperson for the American Academy of Ophthalmology (AAO), tells TODAY.com.

The eyes continuously make tears, which help keep them healthy and maintain vision, and are dispersed throughout the eye every time we blink. Tears contain mucus to help them stick to the eye, saltwater to hydrate and protect the eye, and oil to keep them from evaporating. The eye needs a specific ratio of all three to be healthy.

The salt water in tears is produced by the lacrimal, aka tear, gland. The mucus and oil come from other glands.

When we cry, the body is making a higher volume of saltwater than it does at baseline. “If we make enough tears, they overwhelm the tear drain, which is in the lower eyelid, and pour out of the eyes down the cheeks,” says Andreoli. Tears also drain into the nose, per the National Eye Institute — hence the runny nose when we cry.

There are different types of tears, per the AAO. Basal tears are present in the eye at all times to help lubricate and protect the surface of the eye (the cornea) from dust and debris, says Andreoli.

Reflex tears are formed in response to irritants such as onions and smoke or allergens. These help irrigate and flush out the eye, Andreoli adds.

Emotional tears are what most people are referring to when they think of "crying." These tears are a reaction or response to an emotional state, Dr. Ad Vingerhoets, a clinical psychologist and professor at Tilburg University in the Netherlands, tells TODAY.com.

Crying is often associated with sadness, but it can also be triggered by emotions like happiness, fear, surprise, anger and stress. Crying may also be a reaction to physical pain, attachment-related pain, compassion, and moral sentiments, per the AAO.

"We know there's a certain nucleus in the brain that triggers the tear glands," says Vingerhoets. These emotional states can stimulate the same nucleus in the brain, which tells the tear glands to start producing more tears, he explains.

Emotional crying includes not only the shedding of tears but also the physical phenomena of sobbing or weeping, he adds, which is unique to humans.

Is crying good for you?

Crying is a normal and common human behavior. It may have some health benefits, too. Research suggests that crying can help clear our vision, relieve stress, boost mood and strengthen social bonds.

“It is thought that tears are overproduced to keep our vision clear (and protect our eyes) in times of stress or fear," says Andreoli. There’s some evidence that additional stress hormones and proteins are present in emotional tears, Andreoli says.

It's possible that releasing these hormones through crying can help regulate the body's stress levels, but more research is needed, Andreoli notes. Crying may also help release feel-good endorphins like oxytocin, which can help ease physical pain and promote relaxation, per the Cleveland Clinic.

In a 2014 study on the self-soothing effects of crying, researchers found that people may experience an enhanced mood and relief after crying, however, these findings were inconsistent. Other studies on the mental benefits of crying are mixed. While some people report feeling better after crying, others report feeling no difference or even worse after crying episodes, Vingerhoets adds.

On an interpersonal level, crying can communicate our emotions to others. "I think the main benefit of crying is that it's a very strong signal to others. ... It triggers feelings of empathy," he says.

Crying shows vulnerability and lets others know we need help or support, the experts note. It can also help communicate that we are in pain or injured.

People also cry together as a way to grieve and bond. Throughout history, there have been examples of humans coming together to cry, often in times of adversity or loss, to facilitate feelings of social coherence, Vingerhoets notes.

Tthat said, crying is not the same for everyone. Whether crying is beneficial depends on several factors, says Vingerhoets. These include a person's underlying psychological state, the reason they are crying and how others respond.

Not crying is not inherently unhealthy or a problem, but it can be a sign of a medical condition or mental health condition.

Why can't I cry?

If you find it difficult to cry even when you want to, you're not alone. There are several physical and psychological reasons why people may not be able to cry.

Medical conditions

Certain medical conditions can inhibit tear production and make it difficult to cry. The most common is keratoconjunctivitis sicca, or dry eye syndrome, which occurs when the glands don't produce enough tears or the right type of tear film, says Andreoli.

"People have some relative lack or disproportionate secretion of saltwater, oil, or mucus," says Andreoli. When this happens, the tears may not function properly or evaporate too quickly.

In addition to not being able to cry, dry eye syndrome may cause redness, burning, irritation or blurriness, Andreoli adds. Dry eyes can be caused by certain diseases and autoimmune disorders, such as thyroid disease or rheumatoid arthritis, per the AAO.

Inflamed eyelids or tear glands, allergies, and vitamin A deficiency can also cause or worsen dry eyes, according to the Mayo Clinic. Dry eyes more commonly affect people who wear contact lenses, says Andreoli, as well as people who stare at screens for long periods and people who live in harsh dry or windy climates.

Medications

Certain medications can cause or worsen dry eyes, says Andreoli. These include diuretics, beta-blockers, antihistamines, decongestants, hormone replacement therapy, acne medication, and birth control, per the Mayo Clinic.

Anxiety and depression medications, such as selective serotonin reuptake inhibitors (SSRIs) can also cause or worsen dry eye.

Aging

People tend to produce fewer tears as they age, so tearing up and crying may become more difficult for older individuals. Dry eyes are more common in people over 50 and women, especially if they experience hormonal changes, according to the Mayo Clinic.

"Menopausal women specifically can find that their eyes are a little bit on the dry side," says Andreoli.

Mental health conditions

While some mental health conditions such as depression can make people cry more often, they can also cause a lack of emotion or make it more difficult to cry.

"We know that if people are traumatized, they can lose the capacity to cry," says Vingerhoets. "The same occurs when people are severely depressed."

Suppressed emotions

When toddlers feel overwhelming emotions, they often cry or tantrum to communicate frustration or discomfort without words, TODAY.com previously reported.

As we get older, we generally get better at communicating with words and controlling our emotional reactions. Sometimes, people will bottle up their emotions, and actively avoid experiencing or responding to them.

Some people have an actual fear of feeling sadness or crying, Vingerhoets notes. "There are people who don't want to go to funerals or visit a friend suffering from a terminal disease or any kind of sad situation," he explains.

Social stigma

"It might be related to kind of social stigma, for example, when you are bullied as a child because you cry a lot," says Vingerhoets. Research has shown that people prefer to cry when they are at home alone, or in the presence of a partner or family member, for example.

"Generally, we don't like to cry in the presence of strangers," says Vingerhoets. Some people suffer from extreme shame or feelings of embarrassment when they cry in front of others, he adds.

Cultural and social pressures can also inhibit a person from crying. "A lot of people will think that it's important to pretend to have a certain image. ... People don’t always want to show their weakness, and crying is often seen as a sign of weakness,” Vingerhoets notes.

Is not crying unhealthy?

"It's a widely held belief that crying is healthy, so if you don't cry, are there any serious consequences for your health?" says Vingerhoets.

Crying may have benefits, but there isn't evidence that not crying is inherently unhealthy. In a 2018 study comparing people who lost the ability to cry to normal criers, researchers found no major differences in well-being, says Vingerhoets, though normal criers did report feeling more empathic and connected to others.

If you are concerned about not being able to cry or your eye health, talk to your doctor. "If anything is affecting your vision, seek care from an ophthalmologist immediately," says Andreoli. There are a number of ways to treat and prevent dry eye syndrome.

People who aren't able to cry and have concerns about their mental health or expressing their emotions should speak to a mental health professional.

This article was originally published on TODAY.com