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.