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How and When Anxiety Causes Loss of Bladder Control

Micah Abraham, BSc
How and When Anxiety Causes Loss of Bladder Control

Anxiety is enough of a struggle for men and women every day. When anxiety symptoms cause you to feel shame, embarrassment, or fear, that battle is amplified considerably. There are a lot of anxiety symptoms that create significant distress, and unfortunately, anxiety is the type of condition that makes it difficult to ignore or forget that distress.

Loss of bladder control is easily one of the best examples of a distress condition that can be caused by anxiety and fear. The good news is that it's fairly rare. The bad news is that when it does occur it may be something you fear for the rest of your life if you don't get help.

Uncontrollable Urination: A Rare Anxiety Symptom

Many people struggle with feeling as though they need to urinate when they have anxiety. Luckily, even when this occurs, it is still controllable. It's a standard part of anxiety and anxiety attacks. 

But when anxiety reaches its absolute peak, some people experience a loss of bladder control, also known as "incontinence." It's one of the most distressing and embarrassing anxiety symptoms, and if it ever happens to you, it becomes something you fear for possibly the rest of your life.

How This Occurs

What happens is that anxiety causes your fight or flight system to be activated. That activation causes most of your anxiety symptoms, such as rapid heartbeat, nervousness, muscle tension, and more. All of these are activated by your limbic system.

This system is very efficient, so the rest of your body runs reasonably smoothly despite struggling with these symptoms. Sometimes you may feel like you need to use the bathroom, but otherwise, you are still in control. Unfortunately, when that anxiety becomes too extreme, your limbic system essentially decides it is unable to support all of your body.

It rushes energy to the heart, muscles, lungs, and everything that you would need if you were faced with something fearful (as would occur if you faced a predator in the wild). Because it places so much energy in those areas, it runs out of energy to control the rest of your body and shuts down the areas that it doesn't think it needs to support. For some, that includes the area that controls the bladder.

When This Occurs

The good news is that it is tough to reach the point of pure terror. The bad news is that there are people that struggle with it. Despite the way anxiety can make you feel like you need to urinate often with anxiety, it's not very common in general anxiety disorder, panic disorder, or obsessive-compulsive disorder.

Where it tends to play the most prominent role is with phobias. For those with intense phobias, encountering the object that they fear can lead to a moment of pure panic. It's when that occurs that the person becomes most likely to experience a loss of bladder control, as their limbic system reacts so strongly that it simply cannot manage your bladder anymore.

However, though it's common with phobias, it can also affect people with panic disorder and PTSD in sporadic cases. These conditions can cause very intense moments of fear. With panic disorder, for example, the very peak of a panic attack can be so fearful for people that they feel they're about to die, and their ability to control their bladder responds with it. Those with PTSD may experience a similar issue if something occurs that triggers a fear-inducing flashback.

So while it's most common in phobias, it can occur at any point with any anxiety where the fear is so pronounced that any part of your body not involved in fighting or fleeing shuts down immediately.

How to Recover From a Loss of Bladder Control

This type of response tends to only occur in those that are faced with extreme fear. It's unfortunately not something you can control if you still experience that level of fear. You cannot tell your limbic system to control your bladder because it's reacting to what it perceives as a dangerous threat, and if you ever were in danger you would want your limbic system to act the same way.

There are two important factors for overcoming the loss of bladder control:

Your anxiety is going to make it very hard for you to not care about something like a loss of bladder control. You are going to need to do whatever it takes to remind yourself that no one is judging you - no one cares that you lost control of your bladder from fear, and no one would care if it happened again in the future. Fear of losing control of your bladder contributes to further fears and anxiety. You have to make sure that you do whatever it takes to prevent it from affecting you further.

You'll also need to learn to control your anxiety so that it is not severe enough to cause that level of fear. Those with phobias should strongly consider desensitization therapy. It's an effective and widely used to way to reduce overall phobias.

Article Resources
  1. Davis, Michael. The role of the amygdala in fear and anxiety. Annual review of neuroscience 15.1 (1992): 353-375.
  2. Van der Ploeg, Henk M. Treatment of frequency of urination by stories competing with anxiety. Journal of Behavior Therapy and Experimental Psychiatry 6.2 (1975): 165-166.
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