shy bladder social phobia anxiety disorder

Paruresis, commonly known as bashful or shy bladder syndrome, is a social phobia that involves a form of urinary retention (when you’re unable “to go”). It’s avoidance results in a fear of using public lavatories. It’s a fear or phobia preventing sufferers from urinating when in the real, or imaginary, presence of others. This type of urinary retention is not a physical condition and isn’t caused by a blockage of any part of the body. It’s actually a psychological condition – a result of “mind over matter” if you like.

Individuals suffering from paruresis have a phobia of relieving themselves in the presence of other people. More precisely, paruresis is the fear of being unable to take a leak without some or total privacy, depending on the symptoms severity. The condition can interfere with one`s quality of life. To a very great degree in some cases! People suffering from paruresis face difficulties that range from social situations to travelling on long plane trips to work problems. It’s also a very specific problem when there’s a requirement to submit a urine sample (drug testing for example) to order.

Shy Bladder – Social Phobia Or Physical Condition?


To anyone not familiar with the condition it can appear trivial and almost amusing. But, as any sufferer will confirm, the actual effect is far from funny.

Shy bladder syndrome is officially classified as a social phobia and a form social anxiety disorder. The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) actually mentions paruresis by name. This manual is published by the published by the American Psychiatric Association or APA for short.

You may be surprised when we tell you that is also one of the most common disorders – ranking second only to a fear of public speaking! As a matter of fact it’s estimated to affect around 7% of the worlds population. It’s also estimated that 12% of American adults have had this problem at one point in their lives.

It’s characterized by a dread of social situations for fear to having to use the restroom or toilet . It can really affect ability to function normally in at least some parts their daily lives. These fears may be triggered by actual or perceived scrutiny from others. Anyone familiar with bashful bladder syndrome will immediately relate these symptoms with paruresis.

The urinary system has nothing to do with the inability to urinate. It’s purely the anxiety you associate with the act of urinating over-stimulates the nervous system and ‘clamps down’ on the inner sphincter muscle. This stops the passage of the urine from the bladder to the urethra and you are unable to pee.

So, shy bladder syndrome is an irrational fear that stops you from giving in to the body’s natural needs.

What Causes Paruresis Shy Bladder?


It’s different in every case and it’s often very difficult to pinpoint the specific cause of shy bladder syndrome. This disorder can afflict a young child in preschool, a minor in late or early adolescence, or even an individual in mid or late adulthood.

Many people are not able to identify any particular trigger that first caused it. Others believe that their condition was brought about by a specific incident that occurred during or before adolescence. Incidents such as sexual abuse, embarrassment by a parent, harassment in public lavatories or teasing by siblings or classmates.

Even though most minors experience such incidents (for example being teased by their age-mates while trying to use a urinal or public toilet), not everyone ends up developing shy bladder syndrome. It very much depends on the individual.

Just How Common Is This Social Phobia?


There’s no definitive figures. There’s no accurate way to work out the number of people suffering from paruresis either. Surveys over the last few decades suggest that the numbers could be anywhere between just 1% to more than 25% of American citizens. There`s isn’t any clear data about this condition on a worldwide basis either. Estimates according to the International Paruresis Association , suggest that around 7% of Americas population are affected. That’s 21 million people in the US alone! We can therefore assume that it’s pretty common!

So, what we do know for sure is that it’s clearly a serious problem that affects people all over the world. We reckon that the IPA estimates are not far off at around 7%.

Associated Symptoms Of Shy Bladder Syndrome


Here`s an explanation of how this social phobia affects an individual`s life. After an initial bad experience, the person anticipates difficulty relieving themselves whenever entering a public toilet. Forceful attempts to control this process fail. Anxiety therefore increases. The increased anxiety then reduces the chances of the individual taking a leak in a public facility even more. And so the problem develops.

Paruretics must then adjust to the medical condition by urinating as often as possible when they are at home. Limiting the intake of water and other fluids when out. Even turning down social invitations so that they can avoid a potential embarrassing situation.

As with many social phobics, people suffering from paruresis practice avoidance behavior. The result briefly reduces the fear that is associated with the inability to pee. However, it reinforces the pattern. Some may not feel particularly worried while in public lavatories. For others the issue can be much worse. Anxiety symptoms, including shaking, heart palpitations, dizziness, sweating and faintness are not unheard of.

It’s a condition that’s rarely talked about. And, since this subject is rarely discussed publicly, most paruretics feel that they`re the only people suffering from it. They also feel embarrassed of their condition and become good at concealing it from their spouses, closest friends and even their doctors. The sense of humiliation, shame, depression and isolation resulting from this situation can be incapacitating. It plays on the mind and can affect standards of life considerably. That’s why it needs addressing.

Is The Shy Bladder Social Phobia Treatable?


Treatment options are similar to any other form of social anxiety. They pretty much all involve some form of therapy. You should always start with a visit to a urologist though. This will make certain that there is nothing physical causing the problem.

We have put together a section on Shy Bladder Cures where we look at most of the main treatments options including cognitive behavior therapy, graduated exposure treatment, breath hold, hypnosis for shy bladder and self help programs.

Good luck – you can do it!