A Brief Guide To Shy Bladder Syndrome

Shy bladder syndrome, also known as paruresis or urophobia, is basically the difficulty to urinate when in a public area.  It's a very common psychological disorder and occurs among the majority of individuals in today's society.  In mild cases shy bladder syndrome can be associated with a type of performance anxiety; however, in more severe cases the syndrome is symptomatic of social phobia and can affect the person's daily functioning.

Shy bladder syndrome generally begins in childhood around the teenage years.  The anxiety linked to being criticized and judged by their peers can lead to social anxiety and inability to urinate.  While this paruresis or urophobia can be overcome, there are those who will continue having difficulties 'going' in adulthood.

Signs and symptoms

There are three different types of shy bladder syndrome: mild, moderate and severe.  The symptoms of someone who has severe shy bladder syndrome include:

- a need for complete privacy when urinating
- an inability to urinate outside of their own home (in public restrooms or at another person's house)
- an inability to urinate when guests are present at his/her home
- an inability to urinate if someone is waiting outside the bathroom
- feeling anxious when thinking about going to the toilet
- negative self-talk when trying to urinate in public, e.g. "I will never pee, I'm useless."
- fear of others smelling urine
- fear of others hearing urine hitting the toilet water
- restricting drinking to avoid going to urinate
- avoiding traveling and social events for fear of having to urinate

Treatment

As is aforementioned, the shy bladder syndrome is a psychological one which is based in anxiety. This being the case there are various medical and therapeutic options one could utilize to overcome this condition.

1. Pharmaceuticals

As an individual with shy bladder syndrome is able to urinate in the privacy of their own home, doctors may prescribe short-term anti-depressants to overcome the anxiety of urinating in public areas.  However, it is recommended the individual combine this medication with psychological therapy to treat the phobia once medication has been reduced and eliminated.

In severe cases, it may be suggested that one learn how to self-catheterize.  The catheter will be inserted up the urethra and bladder to drain urine, even in public areas.

2. Psychological treatment

There are various psychotherapeutic options available to an individual suffering from shy bladder syndrome.  These include relaxation techniques, cognitive behavioral therapy, counseling and gradual exposure therapy.