Around 1% of adults don’t grow out of the bedwetting problem they had as children. While this sounds like a small number, for each and every person who suffers from bedwetting as an adult, it can have devastating effects on your life.
If you’re an adult who still regularly or just occasionally wets the bed, and you’ve tried since childhood to cure the problem without success, you are no doubt still trying to get to the very root of the problem. For many people, this includes taking a look at their overall lifestyle and considering whether stress might in fact be a cause for bedwetting. Undoubtedly, wetting the bed makes you stressed, so it can also be said that stress is an effect of bedwetting. This makes it even harder to determine whether it could also be the cause!
But can stress also cause bedwetting in adults?
It goes without saying that if you are an adult who experiences bedwetting, you’re very likely going to feel stressed as a result. It would be easy, then, to assume that the stress is contributing to the bedwetting problem as it can feel like you are in a downward spiral: the more the bedwetting happens, the more stress you feel. This cycle of cause and effect could stop you from finding out what is the true reason for why the bedwetting originally began.
You might be surprised to learn however, that stress is not considered a primary cause of bedwetting. That doesn’t mean that it can’t be a trigger though. If you are constantly feeling stressed and anxious about bedwetting, you are less likely to be able to focus on the training and lifestyle modifications you might need to make in order to combat this problem once and for all.
Overactive bladder syndrome (OAB) is a condition that causes an abnormal and constant urge to urinate, even after you’ve just been to the toilet. Note that OAB is not the same as bedwetting, which often originates as a result of kidney malfunction. Always see your doctor to rule to kidney related issues.
Symptoms of OAB can sometimes be similar to that of a urinary tract infection (UTI) – however when a doctor conducts a UTI test, no infection is found.
More serious overactive bladder sufferers will find the condition affecting their normal life, as you might be unable to go anywhere for fear of not having a bathroom nearby when you experience an urgent need to urinate. This can affect work and social life, your sleep, and lead to anxiety and depression.
So what causes overactive bladder syndrome? Can stress be an underlying cause?
Having an overactive bladder certainly leads to stress – and this can lead to the condition becoming worse as anxiety increases. This causes a cycle that is difficult to break. But does stress cause the initial onset of an overactive bladder?
OAB happens when the bladder muscle that usually automatically controls your urine output and control, starts to become “overactive”. In short, this muscle stops working as it should and is instead contracting involuntarily, which creates the feeling that you have an urgent need to urinate even if there is almost no urine in the bladder. In severe cases of OAB, urinary incontinence can occur when a person loses control of the bladder completely.
If you’re experiencing OAB symptoms, the first thing to do is visit your doctor. They will likely conduct a UTI test to rule out any infection, and may suggest further testing such as an ultrasound which is able to test if your bladder is emptying itself properly when you urinate. Two ultrasounds are usually undertaken: one with a full bladder, and one just after you’ve urinated, allowing your doctor to see the pre and post-void bladder state.
Studies have shown that there is a definite link between psychological stress and overactive bladder. One interesting study, Correlation between psychological stress levels and the severity of overactive bladder symptoms by four experts found that there was a “positive correlation between perceived stress levels and urinary incontinence symptoms”. In other words, people who had higher stress level experienced worse overactive bladder symptoms which had a more negative impact on their quality of life.
When you experience stress, the body activates its instinctive stress response. The body wants to ensure that the most vital parts are operating – your heart – while other areas such as the bladder are not a priority for a body that’s in “fight or flight” mode. Ongoing stress raises stress hormones and can cause all manner of physical symptoms – frequent urination or loss of bladder control being one of them. Clearly, what we need to do is reduce stress where possible and help return the body to a more normal relaxed state. Easier said than done as people who suffer from regular stress and anxiety know. Anxiety Center has some excellent tips for reducing stress as it directly relates to urinary symptoms.
There are several reasons why OAB might develop in someone, and it’s vital that you see your doctor to determine any underlying causes. On a more personal level I can speak for myself in saying that I believe my own sudden overactive bladder was initiated by severe stress and anxiety due to life pressures. This certainly does not mean that everyone with OAB experiences it because of stress, but as the study above indicates, stress can almost certainly make symptoms worse. If you have a bladder infection, bladder stones or other health problem causing or contributing to OAB, these need to be addressed urgently. They also need to be ruled out by your doctor before you can consider that your OAB may have developed solely due to general stress or anxiety.
How I Learnt To Control My Overactive Bladder
This is my personal experience only and is not intended to diagnose, treat or provide specific advice. See your doctor for specific recommendations for your personal condition.
Implementing some of the recommendations in the Anxiety Center link above relating to reducing stress certainly helped reduce and eventually almost completely eliminate my OAB, and allow me to get it under control to the point where it has no impact on my daily life.
This included regular moderate exercise in the form of very simple walking just 20-30 minutes per day – even if I had to get up a little earlier to fit it in. At first, because my overactive bladder was so bad, walking was difficult as I would have a severe urge to urinate.
I controlled this by:
1. drinking very little water up to 2 hours before bed the previous night, and:
2. if possible, not visiting the bathroom before going on a morning walk. I found that urinating brought on an even greater urgent urge to urinate straight after. If instead I didn’t urinate until after my walk, I was able to complete the walk with only a mild urge rather than severe urgency.
The next part of my strategy was simple deep breathing exercises. This took up approximately 5 minutes per day, scattered throughout my busy days. If I stopped and felt myself with tightened stomach muscles and tense shoulders, I knew it was time to stop and breathe.
A simple 30-60 second quiet deep breathing break does wonders for reducing stressful feelings in the moment; even if you didn’t realize you were feeling stressed! The bladder is a muscle – relaxing the muscles, including the bladder, can only be a good thing especially where the bladder muscle is involuntarily contracting to cause your overactive bladder. It must be relaxed to function properly.
Thirdly, I eliminated caffeine from my diet during the worst period of OAB. This provided a noticeable benefit with regard to less frequent urination urges. I also reduced the amount of water I consumed later in the day where possible, and avoided drinking anything 1-2 hours before bedtime.
As I learnt to control and fix my OAB, using the other techniques I’ve outlined here, I was able to gradually reintroduce caffeine and non-restrictive water drinking back into my life as normal.
The fourth and I believe most significant method I used to control and virtually completely eliminate my symptoms of OAB is one I had not read about anywhere but simply tried it myself out of sheer desperation. It involves working directly with the bladder itself and taking a risk that was not comfortable or something that I would want to try outside of a controlled environment (e.g. the bathroom). What I did was simple:
Our instinct when we have that urgent overwhelming urge to urinate is to try and hold it in. Because the bladder muscle isn’t working as it should, holding it in is not as simple or effective as it is for someone with a normally functioning bladder.
This is where leakage occurs – no matter how hard you feel you’re holding, urine can still eliminate because the bladder muscle is doing what it wants without your control.
I decided to find out what would happen if I gave up trying to hold it in. Let me point out that by this stage by OAB symptoms were so bad that I was unable to sleep at night due to needing to get up multiple times to urinate (where one or two drops would come out, if that), nor could I go on long walks, travel in the car or do anything that required being away from a bathroom for more than an hour. I needed to retrain my bladder.
I decided to put aside instincts and halt my attempted holding in of urine when the urge was at its most strongest: straight after having visited the toilet and attempting to empty the bladder.
I did this in the shower where any accidents would have minimal to no effect or embarrassment.
With a severe urge to urinate, I did the opposite of trying to hold it in: I completely relaxed my bladder as you do when going to the toilet (note that my bladder should have almost fully empty as I had just been to the toilet moments earlier – however many with OAB will find this is when the urge comes on strongest). I expected a dribble at least – a drop or two. But what happened was: absolutely nothing.
No urine came out and the urge to urinate subsided virtually completely. What had I done? I’m not a urologist or doctor of any type, but I believe relaxing the bladder rather than fighting it worked in a similar way to how we treat a leg cramp: you don’t try and tighten a cramping muscle, instead you try and relax it as much as possible.
This action of relaxing my bladder when I know it should be close to empty (due to recent elimination) has brought my OAB under control to the point of it being a non-issue in my life. I progressed to the point where I could not only do this in the shower, but also in bed when I experienced that awful urge even though I’d just been to the toilet – again, this resulted in the urge disappearing. I was telling my bladder, “no, you’re not full and I do not need to urinate right now: relax”.
Clearly it’s a risky action to attempt anywhere but outside the shower, and just because it’s worked for me it doesn’t mean it will work for you.
I simply share my experience here to provide ideas to people with OAB who are willing to try any non-invasive technique to try and reduce or minimize symptoms.
For me, relaxation was the key to controlling and eliminating my overactive bladder: Relaxing my mind with deep breathing, relaxing my body with moderate regular exercise, and relaxing my bladder by not fighting with it.