Studies of the relationship between incontinence (both urinary and fecal) and anxiety suggest that while anxiety disorders are unlikely to cause incontinence, they also show that incontinence is consistently a cause of anxiety. Incontinence, which in most cases is a natural and treatable occurrence as the body ages, is portrayed in the media as a joke or shameful in a way that can make actual sufferers feel as though they will be mocked or dehumanized if they seek help. This has the effect of prolonging their suffering and increasing their incontinence-related anxieties.
This article will provide an overview of several studies of the relationship between incontinence and anxiety, and discuss ways in which incontinence-related anxiety can be decreased.
Incontinence = Anxiety?
While true incontinence with anxiety is rare, those that do suffer from it often experience profound anxiety and embarrassment which fuels their incontinence further. Take my free 7-minute anxiety test to learn more.
Studies on Incontinence and Anxiety
While some studies appear inconclusive as to the relationship between incontinence and anxiety, others illustrate a probable link. Before you begin, make sure you take my anxiety test.
In a study of women over 40 in which participants were mailed a questionnaire including questions on general health, urinary symptoms and the Hospital Anxiety and Depression Scale (HADS), researchers found a link between the number of people experiencing urinary incontinence and those who exhibited symptoms suggestive of anxiety disorders.
In another study of women with urinary incontinence, 31% of participants had experienced urinary incontinence in specific situations including anxiety, sexual intercourse, or sleep. Also, many of the women avoided social activities in general, while some avoided only non-intimate social activities and others avoided only intimate social activities, such as sexual intercourse.
While those studies would indicate that incontinence in those with anxiety is possible, in a general study of both men and women participants over 50, researchers found that randomly selected individuals who met standardized criteria for anxiety disorders were no likelier to have urinary incontinence than people without anxiety disorders. Perhaps this indicates that anxiety is likely not the cause of urinary incontinence but that they co-occur.
Another general study of both men and women 65 and over in the UK with a focus on faecal incontinence revealed evidence that once again pointed to an increased likelihood of incontinence in women, and a significant association between incontinence and depression for both men and women.
In summary, these studies suggest that incontinence can be correlated with anxiety in some if not all cases, that it is more prevalent among women than among men, and that it can prevent a healthy person from engaging in activities that they otherwise would. However, they do not seem to confirm a cause/effect. It's possible that those with incontinence are more likely to experience anxiety, not vice versa.
Possible Causes of Incontinence
Now, there is one thing that is known about anxiety: Severe anxiety turns off a part of the brain that controls urination and defecation. That's why during periods of extreme anxiety, it's not uncommon to feel the need to go to the bathroom. It's fairly rare to go without controlling it (except in the cases of extreme fear, like facing a life or death situation), but it is known that anxiety can turn off this part of the brain.
One theory suggests that perhaps as people age and their ability to avoid urination and defecation are already decreasing simply due to age-related issues, incontinence then becomes more likely. Still, these are all guesses. It is not well known when or why incontinence occurs, or whether anxiety is the cause, the effect, or both.
Decreasing Incontinence-Related Anxiety
If incontinence is causing you anxiety because you are fixating on the idea that it is a sign of bodily weakness or loss of personal control, it may be a good idea to take up some uplifting and focus-based activities that will give you a more positive outlook and help you to feel more in control. These activities may include:
- Meditation Meditation provides you with an opportunity to clear your mind of worry. It also involves physical discipline such as sitting very still and controlling your breathing rate and sometimes even heart rate, which can give you a sense of being able to effectively control aspects of your body that many people can't.
- Gentle Exercise Gentle exercise is something you can do either in a group or at home which will help to keep your body as fit as possible. It will also release endorphins in your brain, which are chemicals that promote positive thinking.
- Writing/Drawing Finding a creative outlet such as writing creatively or drawing, sketching or painting is a good way to release stress by translating it into art. The more you make art or write, the better you get, and seeing your improvement can give you a sense of empowerment and pride.
- Learning Something New Something new to learn might be useful phrases in a language or languages of your choosing, how to identify particular birds or plants, or how to cook a dish you've never tried before. Adding a new skill to your repertoire will make you more confident in your ability to make your life what you choose to.
An important part of decreasing incontinence-related anxiety is talking to your doctor. The sooner you can address your problem, the less anxiety it will cause. Because long-term anxiety has a high likelihood of developing into an anxiety disorder, it is particularly important that you take care of both your physical and mental health by discussing options with your healthcare professional.
A common misconception is that incontinence carries with it a social stigma of senility and will invariably result in isolation and loneliness. In fact, incontinence is a condition that often simply requires evaluation and personalized preventative measures to keep it from inconveniencing you in your everyday life, and should not be allowed to keep you from living the life you want.
If you're someone that is suffering from extreme anxiety and believe that it's affecting your bodily functions, make sure you take my free 7-minute anxiety test now. This test is a useful tool for evaluating your anxiety and figuring out how to stop it.
Perry, Sarah, Catherine W. McGrother, Keith Turner. An investigation of the relationship between anxiety and depression and urge incontinence in women: Development of a psychological model. Leicestershire MRC Incontinence Study Group. British Journal of Health Psychology. Sept. 2006. 11 (3): 463-482.
Lam GW, Foldspang A, Elving LB, Mommsen S. Social context, social abstention, and problem recognition correlated with adult female urinary incontinence. Institute of Epidemiology and Social Medicine, University of Aarhus. Dec 1992. 39 (6): 565-70.
Bogner, Hilary R., Joseph J. Gallo, Karen L. Swartz, Daneil E. Ford. ANXIETY DISORDERS AND DISABILITY SECONDARY TO URINARY INCONTINENCE AMONG ADULTS OVER AGE 50. The International Journal of Psychiatry in Medicine, 2002. 32 (2): 141-154.
Edwards, Nia I., Dee Jones. The prevalence of faecal incontinence in older people living at home. Age and Ageing, 2001. 30 (6): 503-507.