Why would the body stop producing tears?
Tears are not just a leak triggered by sadness; they involve both an emotional response and a physical act of facial muscle control. When that system breaks down, crying can disappear even when a person still feels emotion. A review of crying and psychiatric disorder describes a condition in which the emotional change and the loss of voluntary control of facial muscles do not line up—meaning the face may not do what the feeling would normally produce [2].
In the early nineteenth century, doctors became especially interested in people who produced no tears at all. At the time, tears were sometimes seen as a sign of a diseased or overly sensitive body, but psychiatrists like Jean-Étienne Dominique Esquirol treated the inability to cry as a medical problem that needed a scientific explanation [1]. That history matters because it shows the question is old: the absence of tears has long been recognized as something that can go wrong, not just something a person chooses.
What kinds of conditions are linked to not crying?
Psychiatric disorders can change crying behavior in different directions. The review of crying and psychiatric disorder notes that some conditions involve pathological crying—tears that come too easily or without matching emotion—while others involve a loss of the normal connection between feeling and facial expression [2]. The inability to cry fits into that second pattern: the emotional signal may still be present, but the outward response is blunted or disconnected.
The historical work on pathological tears adds that nineteenth-century psychiatrists saw the absence of lachrymal secretions as a central challenge for their new field [1]. They were trying to explain it through both physiology and psychology, which suggests the cause was not assumed to be purely mental or purely physical. That dual framing still fits what the modern review describes: crying depends on both emotional processing and the muscular machinery of the face [2].
Can someone feel sad and still not cry?
Yes. The key distinction is between the internal feeling and the outward act. The psychiatric review describes a lack of similarly oriented affective change alongside loss of voluntary control of facial muscles [2]. In plain terms, the emotion and the facial response can become uncoupled. A person may experience grief or sadness without the tears that usually accompany it, not because the feeling is absent but because the crying response is disrupted.
This is different from the common idea that not crying means someone is 'holding it in.' Holding back tears implies a working crying system that is being suppressed. The conditions described in these papers point to something more fundamental: the tear response itself may be impaired or reorganized by illness [1][2]. That is why the inability to cry can persist even when a person wants to cry.
Sources used in this answer
Pathological Tears
Early nineteenth-century physicians and psychiatrists, including Esquirol, treated the absence of tears as a pathological condition requiring medical and scientific explanation, involving both physiological and psychological factors.
Crying and psychiatric disorder
A review of crying and psychiatric disorder describes pathological crying patterns, including cases where emotional change and voluntary control of facial muscles are not aligned, which can contribute to a loss of normal crying.