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Anxiety-related urge incontinence and psychological dependence on protection

I'm wondering if anyone else has had their incontinence diagnosed as being related to mental health-related factors (specifically for me: stress and anxiety).

I'm a 29 year old man and I've been dealing with incontinence issues for the last 9 years or so. Around when I was 20, I started to have urgent needs to go to the bathroom, and a feeling like I could never fully empty my bladder or bowels. Shortly after trips to the bathroom, I'd feel like I had to go again nearly immediately.

Being in early undergrad, this was very upsetting. Friends started to notice I went to the bathroom a lot, and made comments. Car rides and commutes became very stressful. But I thankfully never had any actual leakage (even though I'd often feel like I had already started to leak when fighting a strong urge). What was weird was that I rarely had any urges at home, or anywhere I had close access to a bathroom.

Around the same time, I was developing symptoms of generalized anxiety disorder. When my anxiety was as its worst, I started having leakage. I no longer felt safe going outside, and limited myself to few social activities. Eventually, I realized I needed to go a doctor about it; I still didn't really accept that I really was having issues not making it to the bathroom on time.

I saw my family doctor, who was really unkind and made me feel humiliated. He was dumbfounded that I had these issues, as if I was at fault for them. I went through physical exams with him, X-rays, and a urine test, and nothing appeared wrong. He told me to try kegel exercises and OAB medication. I tried to do Kegel exercises and use the medication, but found they didn't do much after trying them for 6 months (upping and changing my dose didn't work either). I never went back to him again.

I eventually started wearing depends real fits, because I had a 2 hour commute by Subway for an internship and needed to be able to feel comfortable making the ride; I was worried about leaking before getting to work. When I was at work, I'd sneak into the file room and change out of my real fit into my boxer briefs.

Surprisingly, I found my incontinence issues dramatically stopped happening on the train. The strong urges became far less common, I no longer was feeling like I had to go as often, and leakage became rare. I tried to go without the real fits again, but found the urges came back right away.

I decided to just start wearing them whenever I was out, as it made my anxieties around leakage so much less debilitating. It felt like I was able to be myself again, and I was relieved to feel some freedom from all the urges.

Now, I think I've just gotten so used to the security of them, that I am unable to get my confidence to a level I can go out without at least some form of pad. Over the course of the years dealing with this, I've gone between levels of protection needed to feel that sense of security. When my anxiety's at its worst, I've worn higher capacity medical adult diapers as the lower capacity options became less assuring when I really felt strong urges.

I've recently been to a urologist, and he determined that I had weaker bladder control than normal, and similarly got me to try new OAB medication and physical therapies (actually telling me that my kegels were the wrong thing to help with this). I've tried these new therapies for months, but I'm still not comfortable going out with wearing some form of padding.

He's also recommended I go to a therapist about this, and I've been trying to. My psychologist thinks it might be some form of OCD symptom related to my anxiety. Has anyone else dealt with incontinence in this form?

Re: Anxiety-related urge incontinence and psychological dependence on protection

Hi! I have been dealing with related urge incontinence due to stress and anxiety. I have had a diagnosis of urge incontinence years ago. I am currently in my early thirties but have been dealing with it in my twenties and early teens.

It is usually managed well with pads and bladder medication. But when it comes to my anxiety and increased stress in my life, my incontinence gets worse. My urges are constant no matter how many times I go to the bathroom, which then increases my anxiety.
It is one of the main reasons I have anxiety.

I take medication for incontinence and for anxiety. I have noticed that when my anxiety is managed well and somewhat in control, my bladder urges decrease. My anxiety recently increased and with that so did urges and leakage. I am working with doctors to change anxiety meds and build confidence back but it very much effects me socially.

I don't usually write or discuss these issues with others but saw that you are having a similar issue of anxiety increasing your incontinence and urges. I do believe there is a correlation between the two. I hope that you are able to get to a place with your anxiety that can greatly reduce incontinence for you.