The Link Between Anxiety and Incontinence

Anxiety can cause a lot of unpleasant emotions, including fear, worry, or shame, making it difficult to tackle everyday tasks. When you're also dealing with incontinence, that anxiety can cause great distress. Over 25 million American adults experience some form of incontinence, whether it's chronic or temporary, and about 19% of adults live with an anxiety diagnosis each year. Learn more about these conditions and how they can affect each other. 

Understanding Incontinence

Urinary incontinence is the loss of control over your bladder, whether it's leakage from sneezing or having the urge to urinate so strongly and suddenly, you don't have time to make it to the toilet. Although it affects many people, incontinence can still be disruptive to daily life.

Types of Incontinence

There are several types of incontinence that can impact people differently.

• Stress incontinence occurs when pressure is exerted on the bladder from coughing, sneezing, or laughing, resulting in unintentional leakage. 
• Urge incontinence is the sudden, intense urge to urinate followed by a bladder spasm that causes leakage. The leak can either be a few small drops or a large gush. You may feel the urge to urinate often, even throughout the night. 
• Reflex incontinence involves urinating involuntarily due to bladder muscle spasms. It can result in passing a large amount of urine without warning.
• Mixed incontinence refers to a combination of urge and stress incontinence. This can involve experiencing a sudden, intense urge to urinate combined with a weakened pelvic floor that causes leakage when you cough or sneeze.
• Overflow incontinence is when you experience constant or frequent leaking because your bladder doesn't completely empty. 
• Transient incontinence typically refers to a temporary symptom of a medical condition. For example, post-birth complications or urinary tract infections can cause transient incontinence. 

Causes of Incontinence

There are many factors that can cause urinary incontinence, such as damage to the pelvic floor or nerves. Several other medical conditions can also cause or worsen incontinence, including:

• Neurological disorders
• Bladder irritation or infections
• Prostate problems, such as an enlarged prostate or cancer
• Menopause

Age can contribute to incontinence as well. Although this condition can occur at any age, it's most commonly seen in women over 50. In one study, nearly half of older women reported experiencing some type of incontinence. Women who are pregnant or have given birth are also at an increased risk of incontinence.

There are a few factors that can contribute to pregnancy incontinence. For example, women undergo many physical changes during pregnancy. As the baby grows, your bladder may become compressed because of its position below the uterus, causing more frequent urination. Hormonal changes, such as an increase in the hormone progesterone, may loosen ligaments and joints to make more space for the baby, resulting in decreased bladder control. 

Even after the pregnancy is over, it can take weeks for the uterus to shrink and stop putting pressure on the bladder, which is why some women continue experiencing incontinence post-pregnancy. 

Symptoms of Incontinence

Symptoms can vary depending on the type of incontinence, but common signs include:

• Leaking urine during everyday activities, such as sneezing, coughing, laughing, or exercising
• Feeling a sudden, uncontrollable urge to urinate
• Urinating frequently
• Waking up throughout the night to urinate
• Urinating in your sleep
• Leaking urine without warning
• Being unable to reach the toilet in time

Understanding Anxiety

People with anxiety frequently experience intense, excessive, and persistent worry or fear about everyday situations. These strong emotions are hard to control and can interfere with your ability to accomplish daily tasks.

Types of Anxiety Disorders

There are a few anxiety disorders people are commonly diagnosed with. 

• Generalized anxiety disorder is characterized by persistent or excessive worry or anxiety about routine situations. These emotions are usually disproportionate to the actual circumstances and difficult to control. 
• Social anxiety disorder, or social phobia, involves high levels of anxiety, fear, or avoidance of social situations. It usually stems from feeling self-conscious or concerned about being viewed negatively or judged by others. 
  
  
• Panic disorder includes repeated episodes of intense anxiety, fear, or terror that generally peak within minutes. These episodes, or panic attacks, can result in avoiding situations where they've occurred or feeling extreme worry about them happening again. 

Causes of Anxiety Disorders

The exact cause of anxiety is unknown, but there are a few factors that may contribute to an anxiety disorder. Genetics are thought to play a role in anxiety. For instance, research shows that generalized anxiety disorder has an inheritability risk of about 32%. 

Disruptions in brain activity responsible for controlling emotions may also account for anxiety disorders. The brain's limbic system, which includes the hippocampus, amygdala, hypothalamus, and thalamus, comprises the brain's emotional processing center and controls many cognitive and behavioral functions, such as the stress response system. People with heightened activity in these areas may experience anxiety.

Negative or stressful life events can also increase the risk of anxiety. These events can often be traumatic or cause major life changes that are difficult to adjust to. Examples include:

• Childhood abuse or neglect
• Severe illness or injury
• Job loss
• A breakup or divorce
• Domestic violence
• Sexual assault
• Losing a close friend or family member
• A change in living conditions

Symptoms of Anxiety

Exact symptoms can vary depending on the anxiety disorder. However, there are a few common signs and symptoms, including:

• Feeling restless, nervous, or tense
• Having an increased heart rate
• Feeling a sense of impending doom, panic, or danger
• Sweating
• Trembling
• Breathing rapidly
• Trouble thinking or concentrating
• Feeling tired or weak
• Having difficulty controlling worry
• Feeling the urge to avoid situations that trigger anxiety
• Having trouble sleeping
• Experiencing gastrointestinal problems

Can Anxiety Cause Incontinence?

Anxiety and incontinence can go hand in hand. Anxiety can affect the body in many ways, including making you feel as if you need to urinate more often. If you already experience incontinence, you may feel anxious while out in public or in a new environment where you don't know where the nearest bathroom is. A study conducted by the National Library of Medicine on the link between anxiety and overactive bladder (OAB) found that 48% of respondents diagnosed with OAB also experience symptoms of anxiety. 

How Anxiety Can Worsen Incontinence

When anxiety reaches its peak, your fight-or-flight mode kicks in, causing your limbic system to take over. This can activate several anxiety symptoms, such as muscle tension, rapid heartbeat, and nervousness. When this happens, your limbic system may struggle to control bodily functions it doesn't deem essential, including your bladder. This can trigger temporary incontinence. 

How Incontinence Can Trigger Anxiety

People who experience incontinence may struggle with anxious thoughts about losing control of their bladder while in public. They may worry about feeling embarrassed or ashamed and facing judgment or criticism from others. Although there are no official criteria for anxiety incontinence, you may experience similar symptoms to other anxiety disorders that are exacerbated while in public spaces. These symptoms can include:

• Overwhelming fear of urinary incontinence in public
• Avoiding public restrooms or transportation
• Planning social and occupational activities around bathroom availability
• Forcing yourself to use the bathroom before leaving the house
• Spending excessive time in the bathroom ensuring your bladder is empty
• Avoiding social activities, such as holiday parties or sporting events, where a bathroom may not be easily accessible

Impact on Mental Health

Because anxiety incontinence is associated with feelings of shame and embarrassment, it can negatively impact your mental health and all aspects of life, including work, social activities, and relationships. It can also influence your ability to travel to new places, meet up with friends, or accept a new job offer if you're uncertain of bathroom accessibility.

Role of the Gut-Brain Axis

These anxious or nervous feelings may be linked to the gut-brain axis. The gastrointestinal tract is sensitive to emotions, including anxiety, anger, happiness, and sadness. Your gut and brain interact very closely and send signals to each other when there's an issue. This means if you're experiencing distress in your gut, it can either be the cause or byproduct of mental health issues, such as anxiety or stress. 

Contributing Factors

There are several factors that may cause or contribute to anxiety and incontinence. 

Trauma and Past Experiences

Traumatic experiences associated with incontinence, including losing control of your bladder in a public setting, can cause feelings of anxiety. Interpersonal trauma, such as domestic violence, can also contribute to incontinence. One study that explored the connection between interpersonal trauma and urinary symptoms in older women found that post-traumatic stress disorder (PTSD) symptoms have a strong correlation with different types of incontinence. PTSD can cause severe anxiety, which may contribute to incontinence. 

Lifestyle Factors

Certain lifestyle factors can also put you at risk of anxiety and incontinence. Lack of physical activity can result in weaker muscles from not moving around enough, and weakened pelvic floor muscles can worsen incontinence. Additionally, obesity can lead to incontinence due to increased pressure on the bladder and pelvic floor muscles. Lack of exercise and eating poorly can also negatively affect your mental health, which may increase your anxiety.

Medications and Substance Abuse

Certain medications can exacerbate or cause incontinence. Some of the most common culprits are antidepressants, sleep aids, diuretics, and high blood pressure prescriptions. Because alcohol is a diuretic, it produces more urine, which can increase the risk of leakage. In general, drugs can cause incontinence due to how they disrupt the connection between the bladder and urethra. 

It's not uncommon for those struggling with anxiety to use substances to alleviate their symptoms. Many drugs, including alcohol, can cause heightened feelings of anxiety, which can worsen your mental health and incontinence issues. 

Coping With Anxiety Incontinence

If you're wondering how to stop adult incontinence anxiety, there are several strategies you can use to cope with both conditions and take control of your life. 

Behavioral Strategies

Bladder training can teach your muscles to hold urine longer, even when you feel a strong urge to go. Try holding your urine for a few minutes past the initial urge, and this may help prevent or reduce leakage. Pelvic floor exercises, such as Kegels, can also make it easier to hold urine. These can be done by lying down and focusing on tightening your pelvic floor muscles to strengthen them. With your doctor's consent, try repeating this action a few times each day and incorporate it into your daily routine. 

Medical Treatments

Medical treatments, including medications or injections, may help alleviate incontinence symptoms. Botox injections can paralyze the bladder muscles and reduce the urge to urinate. Inserted surgical devices, such as a urine drainage bag or an indwelling catheter, can also be used to reduce incontinence. 

Mental Health Interventions

Therapy and medication can help reduce symptoms of anxiety contributing to incontinence. By talking to a therapist, you can learn new coping strategies for managing stress and anxiety. Although some anxiety medications cause incontinence, a doctor can closely monitor you and adjust the dosage if needed to reduce side effects. 

Diet and Exercise

Exercising regularly and maintaining a healthy diet are productive ways of alleviating stress and anxiety. Incorporating healthy lifestyle changes into your daily routine can also reduce incontinence by getting you up and moving, which decreases the amount of pressure on your bladder. 

Managing Stress and Anxiety

Stress and anxiety can cause you to tighten muscles throughout your body, such as your core and pelvic floor muscles. Deep breathing exercises can help relax your entire body and unclench your muscles. As you reduce these physical stress response symptoms, you can also alleviate anxiety and incontinence. Yoga and meditation are other relaxation techniques you can use to reduce stress. 

Absorbent Products

If incontinence persists even with treatment, Nexwear incontinence products can help prevent leakage and help keep your skin dry. Absorbent products come in many styles from thin to ultra padded to accommodate a wide range of incontinence. 

The Bottom Line

If you're dealing with anxiety incontinence, there are several measures you can take to alleviate your mental health symptoms and improve your condition. By eating healthier, exercising, and learning better stress and anxiety management techniques, you can take control of your life and your body. 

Using absorbent products is one of the quickest ways to manage incontinence while working on your anxiety. Nexwear offers several products that can help you maintain a fulfilling lifestyle without worrying about leakage or sacrificing style. Shop our products today, so you can become more confident and live worry-free.