False Pregnancy, Also Known As Pseudocyesis

One of the stranger phenomena of women's (and sometimes men's) health is pseudocyesis, a condition of appearing to be pregnant without actually being pregnant. The abdomen grows, the breasts enlarge, menstruation ceases, pregnancy spots may appear on the skin, the belly button inverts itself, there may be morning sickness, there is a "lordotic" (sway-backed) posture during walking, appetite increases, and weight is gained. All of these symptoms appear, however, without a fetus. The only sign of pregnancy missing is the baby.

Physicians typically group pseudocyesis with other conversion disorders, conditions with symptoms that suggest a general medical condition or a brain injury without physical evidence of disease.

Other conversion disorders include "hysterical" blindness, "shell shock," and foreign accent syndrome. Anywhere from 65 to 90% of cases of conversion disorders occur in women, usually between the ages of 20 and 40, but even pseudocyesis can occur in men.

Read More: 12 Myths About Pregnancy Exposed

What's Being "Converted" in a Conversion Disorder?

Psychiatrists usually explain conversion disorders in terms of primary and secondary gain. The primary purpose of a conversion disorder is to play out an emotional conflict that the patient has suppressed. Someone who is ashamed of his or her origins may develop a foreign accent. Someone who feels "out of control" may develop psychogenic non-epileptic seizures.  Someone who can't bear an everyday sight may develop hysterical blindness, and someone who desperately wants a baby may develop pseudocyesis.

Although the symptoms of conversion disorders are very real, the person who has the disorder may display what Sigmund Freud described as la belle indifference. The person who has the disorder does not care that they have the condition, at least in Freud's analysis of the condition. In modern medical practice, however, only about 22% of people who have a "real" medical problem and 29% who suffer a conversion disorder are truly indifferent to their symptoms. Not caring about symptoms does not mean that a condition is "all in the head."

Not a Delusion

A conversion disorder is not a delusion. People who are delusional have firm but false ideas that cannot be corrected by reasoning. People who have conversion disorders really do experience their symptoms. Like a delusion, however, a conversion disorder may center around a wish that cannot be fulfilled in the real world, or at least that the patient feels and thinks cannot be fulfilled in the real world.

The Inner Drama Of Pseudocyesis

What's going on in a woman--or a man--who experiences false pregnancy, that is, pseudocyesis? The inner drama of pseudocyesis will differ from person to person, but the following themes appear over and over again:

• Symptoms are not factitious or artificially produced. The person who appears to be pregnant is not "faking it."

• In the majority of cases in which the patient does not display la belle indifference, there is real impairment of social, vocational, or physical activities. Pseudocyesis results in real physical disability.

• There has been a loss of love, a loss of a loved one, or a loss of fertility. Even post-menopausal and infertile women and men can experience false pregnancy.

• There is a need to express intense love for another human being that is not fulfilled in other relationships.

• The person who experiences the false pregnancy is not psychotic. There are no delusions, but even in the certain knowledge that one is not pregnant (after negative pregnancy tests or ultrasound, or recognition that one is male) the symptoms persist. Antipsychotic drugs do not help. The patient is not schizophrenic.

• The person who experiences the false pregnancy has been sexually abused and/or abandoned as a child or as an adult.

• Anxiety and depression are comorbid conditions, also occurring in most people who suffer pseudocyesis (especially men).

• The patient denies an emotional problem and resists psychiatric treatment.

Women and men who are told they are experiencing pseudocyesis often choose not to return to treatment after being told they have a psychiatric, stress-related disorder. The reality is that pseudocyesis is a condition very similar to high blood pressure or peptic ulcers. It is caused by stress, and finding ways to handle stress will relieve the condition.

Surprisingly, the older tricyclic antidepressants (such as amytriptylline, which is sometimes marketed under the trade name Elavil), which many psychiatrists who graduated from medical school after 1995 have never prescribed for their patients, seem to have more value than the more modern antidepressants in limiting the symptoms of the disease. People of high intelligence are more likely to overcome pseudocyesis on their own, as are people who can identify the stresses in their live and deal with them.