Incontinence And Mental Health
So, back to the chicken and egg question. Both anxiety and depression have been found in many patients with incontinence. But was the incontinence caused by the mental health problems or did the mental health problems cause the incontinence?
It turns out its a two way street when it comes to anxiety and urinary incontinence. Anxiety and incontinence interact and exacerbate each other. And, anxiety is a risk factor for developing incontinence.
The same appears to be true with other mental health issues, like depression, which is also a risk factor for developing incontinence. Several studies have linked depression to urinary incontinence in women especially. And, people with pelvic floor disorders are three times more likely to experience depression than the general population.
Anxiety even rears its head when you start talking about overactive bladder. According to one study, 48% of patients with overactive bladder exhibit anxiety symptoms. Plus, according to the same study, about 24% of OAB patients have moderate to severe anxiety.
While anxiety and incontinence dont have to go together, its easy to see how incontinence can cause anxiety — maybe even more anxiety than you started with.
The Stress That Kickstarts Adrenal Fatigue Can Be:
- Physical: You experience infections or suffer allergies and food sensitivities. Excessive sports like marathon running and over-exercising can cause or worsen adrenal fatigue.
- Emotional: Caused by issues like work pressures, financial or relationship problems. Past unresolved trauma and abuse. Feeling unworthy, not good enough, pushing yourself to over-achieve all the time.
- Chemical: Your liver is overloaded by toxins coming from xenoestrogens, antibiotics, prescription drugs or you have lived or worked near places that are highly toxic. Chemo and radiation can also contribute.
- Spiritual: You feel a lack of purpose or direction in life.
- Dietary: A period spent overloading on caffeine, carbs and high-sugar foods can stimulate repeated cortisol release, setting up the adrenal fatigue pattern. Chronic gut issues like constipation, diarrhea, bloating, IBS, leaky gut and unaddressed food sensitivities can also cause adrenal fatigue.
Whatever the trigger, if the resulting hormonal imbalances are not corrected and the stress continues, your adrenal glands may end up completely and utterly taxed and worn out. Then the very hormones meant to give you energy and keep you alive if youre under threat, can start to compromise your health. And eventually, they become depleted.
Mental Health And Male Urinary Incontinence
Both depression and anxiety have been found in many men who suffer from incontinence. But, did the mental health issues cause incontinence or was the incontinence caused by mental health issues?
Its actually both!
Urinary incontinence and stress interact and aggravate each other. So, if someone constantly feels anxious, stressed out, they are at a high risk for developing incontinence.
One study shows that depression can also cause incontinence.
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I Cant Shed Any Pounds No Matter How Little Or How Well I Eat
Blame it on: High and low cortisol
- Hate getting dressed in the morning because you have to find new ways to disguise the extra kilos that keeping appearing on your belly?
- Feel distressed by unpredictable fluid retention that makes you look puffy in the face, tummy and legs?
- Struggle to shed any kilos or even just maintain your current dress size even though you eat right for your body and exercise regularly?
- Complain that even if you ate nothing but air you still wouldnt lose any weight?
Then its highly likely you have adrenal fatigue. Its well accepted that stress and weight gain go hand in hand.
The culprit? Cortisol. The impacts of high cortisol can easily be seen in people who suffer Cushings disease, a condition that causes chronic excess cortisol. Cushings sufferers experience round puffy faces, high blood pressure and weight gain, particularly around the belly and chest.
But similar side effects can occur if you are exposed to sustained stress. Suddenly you pack on more pounds even though youre not eating more food. And exercise doesnt shift it either.
Try Pelvic Floor Exercises
The muscles in the bottom of the abdomen that support the pelvis, bladder, and urethra are known as the pelvic floor muscles. These muscles can become stretched or weakened as a result of surgery, pregnancy, or childbirth, reducing their ability to control the pelvic organs effectively.
Pelvic floor exercises can help restrengthen these muscles and improve the symptoms of urinary incontinence and OAB. A physical therapist can work with an individual to come up with an exercise plan that works for them.
In a review of 31 clinical trials, researchers found an association between participation in pelvic floor muscle therapy and significant improvements in not only the symptoms of urinary incontinence but also in quality of life. The measures of quality of life included a score of anxiety and depression symptoms.
People of all sexes can benefit from pelvic floor exercises. A found that following prostatectomy, which is the removal of part or all of the prostate gland, participation in pelvic floor exercises led to significant improvements in urinary incontinence, anxiety, and depression.
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What Can You Do To Manage Urinary Frequency
First of all, it is extremely important to ensure there isnt a medical problem causing it, and your doctor will discuss any other symptoms with you and look at your medical history. Examples of conditions that can cause urinary frequency include diabetes, MS, Parkinsons, dementia, stroke, bladder tumours and bladder stones.
If your urinary frequency is determined to be secondary to your experience of anxiety, it can help to visit a licensed counsellor to look at both the underlying cause of your anxiety as well as getting cognitive behaviour tips for the management of secondary symptoms.
Other simple lifestyle changes can reduce your need to visit the bathroom so frequently, such as removing bladder irritants like caffeine and alcohol, reducing your weight if you are overweight, and stopping smoking.
Finally, since humans are able to learn new behaviours and responses, it is possible to train your bladder to not respond to your emotional nervous systems signals. Bladder training, for example, is a reliable technique that has been shown to improve symptoms,6,7 and involves bringing back your desire to pee into voluntary control. It is done in a stepwise fashion over time.
If you are finding you need to pee all the time, and believe it could be related to anxiety, then it is important to visit your GP, as there are plenty of solutions that can help. Incontinence is a very common condition, and there is no need to just put up with it.
Symptoms Of Urinary Retention
The symptoms of urinary retention are not always obvious but may include
- Hesitancy really having to strain to pass urine
- Strong feelings of urgency and frequency and when passing urine only a small amount comes out
- A urinary stream that is very weak and intermittent
Whilst your bladder is not emptying properly there is a risk that the residual urine in the bladder will become infected. This could cause further complications and problems if it isnt removed regularly. It is important to seek help if you experience any of the above symptoms.
It is a good idea to keep a record of your bladder activity in a bladder diary for a few days before your appointment with your doctor or nurse.
Your Doctor or Healthcare Professional may recommend the following tests:
The Impact Of Stress On The Gi Tract
If you havent heard the phrase I was so scared, I almost peed myself, maybe you have heard I was so scared, I almost pooped myself. Your ability to hold in urine and feces is controlled by the same muscles so it makes sense that theyd behave the same way under stress. Its true that stress and anxiety can cause diarrhea so we know that our bowels are impacted by stress.
Looking at studies of IBS patients, too, the connection between bowel health and mental health is clear. About 60% of IBS patients have generalized anxiety disorder. Another 20% have depression. Thats a pretty significant overlap.
Can It Be Treated
Yes, treatments can help. The most common one is a form of cognitive behavior therapy known as graduated exposure. Youâll be slowly re-introduced to the fearful situation. That helps lower your brainâs anxiety response.
You might see a major improvement after just 8-12 sessions with a trained behavioral therapist or even a friend or family member. The International Paruresis Association offers tips that can help.
You have other options too, and trying more than one boosts your odds of getting better. Among them are hypnotherapy and self-catheterization, after a urologist or other medical professional teaches you what to do.
Talk to your doctor before you try any type of treatment just to be sure nothingâs wrong with your urinary system.
Medscape: âParuresis or Shy Bladder Syndrome: An Unknown Urologic Malady?â
International Paruresis Association: âAbout Avoidant Paruresis,â âParuresis Fact Sheet,â âA Few Notes on Paruresis,â âFrequently Asked Questions.â
Vythilingum, B. Depression and Anxiety, 2002.
Urology Care Foundation: âParuresis.â
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Exercise Smarter But Not Harder
- Walk briskly: Studies show that walking has many, many health benefits.
And the scenic stimulation of blue sky and nature, means that you come back from your walk usually feel uplifted, not depleted.
- Move at a moderate pace: I recommend exercise like weight training, use of kettle bells and dancing.
- Do more gentle forms of exercise: It may seem counter-intuitive to slow your exercise pace to get more benefit but it really is important. Think about animals they dont go on marathon runs or head to the gym every day.
- Calm your brain with yoga: Yoga is like a moving meditation that connects your mind, breathe and body and induces a relaxation response which helps lower your cortisol levels. At the same time it boosts your alpha brain activity, which promotes greater calm.
Try A Variety Of Relaxation Approaches
- Keep your focus here and now: Try to live through your senses, not just your head. The more mindful you are, the more this will help to reduce your cortisol levels.
- Take a break in nature: This can not only reduce your stress hormones, but also boosts natural killer cells that increase your immunity.
- Enjoy regular touch: Through hugs, making love or enjoying a massage. Enjoyable physical contact triggers the release of oxytocin, which has calming impacts.
- Persist with meditation if its not working for you: Try visualization or listening to soothing music with your eyes closed. Chanting for just 12 minutes a day can also reduce stress levels and lower inflammation in people who are stressed.
- Slouch: Instead strike a power pose. Try the victory pose and the wonder woman pose . Research from Harvard University shows that these kinds of poses, drop your cortisol and raise your testosterone, so you feel more in control and more able to handle risks and tricky situations. Amy Cuddy, who is an expert in this area, gives a fantastic Ted talk about the impact of body language on hormones and emotional states.
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Hyperstimulation Can Cause Over Active Bladder
While not a disease, Over Active Bladder is the name of a group of symptoms that affect urinary function, such as the sudden urge to urinate that seems difficult to control, incontinence, and frequent urination. OAB affects approximately 30 40 percent of North Americans.
Research has found that emotional problems, such as anxiety disorder, can cause and aggravate over active bladder. For instance:
OAB patients reported higher anxiety symptoms compared to controls. OAB patients with anxiety reported more severe OAB/incontinence symptoms, worse quality of life, and more psychosocial difficulties compared to OAB patients without anxiety. There are positive correlations between the severity of anxiety symptoms and OAB/incontinence symptoms.
While the exact science isnt settled about the reasons why emotional problems can contribute to OAB, two theories suggest:
- The heightened autonomic nervous system activity can override normal nervous system communication between the bladder and brain causing the brain to generate a sense of urgency to urinate when the bladder isnt full, as we mentioned previously.
Any of the above reasons can cause a wide range of bladder and urination problems, including frequent urination.
Frequent urination during sleep hours is also common. Contributing factors include:
- Hyperstimulation can cause an increase in resting metabolism even when sleeping. An increase in resting metabolism will cause the body to produce more urine than normal.
Blockage Or Narrowing In The Urethra Or Bladder Neck
For you to be able to urinate normally, all parts of your urinary tract need to work together in the correct order. Urine normally flows from your kidneys, through the ureters to your bladder, and out the urethra. If a blockage or narrowing occurs somewhere along the urinary tract, you may have difficulty urinating, and if the blockage is severe, you may not be able to urinate at all.
Medical problems that may narrow the urethra and block urine flow include
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Your Body On Stress Symptoms Of Adrenal Fatigue
Youre about to go for a job interview. Your body treats this as a perceived threat and triggers a powerful danger signal. This activates your HPA , a feedback loop between your brain and other organs such as the kidneys. Your hypothalamus is like the command center and its job is to send urgent Watch Out messages to your pituitary and Adrenal glands. Within femtoseconds, your fight or flight response kicks in. This preps you to defend yourself or flee. So you experience a rapid cascade of other stress responses:
Frequent Urination Urgency To Urinate A Sudden Urge To Go To The Washroom Symptom Description:
There are many descriptions for this symptom. Common descriptions include:
- You feel you have to urinate more frequently than usual.
- You feel you need to urinate even though you just urinated.
- It seems your bladder needs emptying even though you just emptied it.
- You feel you need to urinate more than two times per hour.
- You feel you need to urinate even though you havent been consuming more liquids than usual.
- You feel you need to urinate, but when you do, you produce little or no results.
- You frequently feel a need to go to the washroom.
- You feel you need to urinate many times per hour.
- You feel you need to urinate through the night at least once per hour.
- Getting up every hour or so to urinate during the night prevents you from getting good sleep.
- Every time you wake up you have a strong urge to go to the washroom.
The frequent urination anxiety symptom can occur rarely, frequently, or persistently. For example, one day you visit the washroom numerous times and the next day your urination frequency is normal.
Frequent urination can precede, accompany, or follow an escalation of other anxiety symptoms, or occur by itself.
Frequent urination can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur “out of the blue” and for no apparent reason.
The frequent urination anxiety symptom can range in intensity from slight, to moderate, to severe. It can also come in waves where its strong one moment and eases off the next.
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Follow An Adrenal Fatigue Diet
- Live on caffeine: That cup of Joe may perk you up but have you stopped to think how? The reason a caffeine hit wakes you up is because it rapidly sends your adrenal hormones skyrocketing. This causes adrenaline to rise by around 32% and noradrenaline to spike by around 14%.
If you are caffeine sensitive, that adrenal rush may be accompanied by shaking, heart palpitations, difficulty sleeping and a general sense of anxiety. So if possible, cut caffeine out. Or at the very least, cut caffeine intake right back. Instead, try my matcha latte it has less caffeine so it is a much gentler stimulant.
- Drop your carbs too low: Research shows that ketogenic-style diets that cut right back on carbs and increase protein, can increase cortisol levels by 18% while also reducing the thyroids T3 hormones.
You dont need extreme measures to ensure you are balancing hormones with food so make sure you eat some healthy carbs such as buckwheat, quinoa and sweet potato.
Address Root Causes Of Your Stress
- Seek counseling: if you need to help heal from unresolved trauma or need support for depression.
- Reduce lifes daily stressors: These can add up to big adrenal impacts if they continue day after day. That might mean you get up just 15 minutes earlier so you dont have to rush and have time for breakfast. Or it might mean that you try pull back your mortgage payments so you have more money to get through the week.
A while ago, a woman from our Hormones Balance community contacted me for help with stabilizing her hormones. When she wasnt improving we tried to identify hidden stresses that may be standing in the way of her hormonal balance. She identified that she was suffering stress every morning when she had to walk through an area where she didnt feel safe on her way to work. Once she took a different route, even though it took her a little longer, her stress levels significantly reduced and her hormonal health substantially improved. Its a potent reminder of just how much we are hardwired for survival and as a result, how big even seemingly small stressors can be.
- Address relationship problems and potential abuse: Make time for more intimacy and improved communication with your partner. If youre not in a good place together, read some self-help books together or attend couples counseling. I did a call about abusive relationships , watch it here.
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