Anxiety Depressed Mood Frequent Urge To Urinate And Frequent Urination
- Medical Author: Melissa Conrad Stöppler, MD
Reviewed on 10/15/2020
Frequent urination can occur with a urinary tract infection or with poorly controlled diabetes mellitus, for example. and can be related to physical illness or may arise from mental health conditions. Emotional conditions can sometimes lead to physical symptoms as well. Keep track of these and any unusual symptoms you are having, and speak with your doctor if you are concerned.
While the list below can be considered as a guide to educate yourself about these conditions, this is not a substitute for a diagnosis from a health care provider. There are many other medical conditions that also can be associated with your symptoms and signs. Here are a number of those from MedicineNet:
How Is Anxiety Related To Bladder Symptoms
To understand how anxiety and bladder symptoms are related, it helps to understand how emotions work on the body. If, for example, you were suddenly faced with a stressor, such as being chased by a dog, your emotions would generate a stress response in your body the fight or flight response. Among other things, you may notice your pulse pounding rapidly in your ears, that your mouth feels dry, you may feel a bit shaky and not hear much going on around you, and you may feel sweaty.
This is all the result of a cascade of hormones that the body releases to respond to an acutely stressful situation, preparing you to fight a danger or run away. These hormones also act on the bladder, causing the muscles to relax and the bladder to empty. This is why, in films or novels, you find that when a person gets scared they wet their pants.
When you suffer from anxiety, your fight or flight response tends to be activated when there is no clear danger present. On a neurobiological level, the need to urinate is controlled by three different nerve pathways. The first, the autonomic nervous system, manages involuntary control. Its two branches supply the internal sphincter and detrusor muscle respectively with nerves.
Keeping a diary of when you go to the bathroom, how much urine you pass when you get there, what medications you are on, what youve had to drink during the day, and any other pertinent surrounding situational factors can help your doctor zero in on the cause of your symptoms.
Diuretics: Why Coffee Tea And Soda Make You Pee More
If you have high blood pressure, you may be familiar with , a type of medication that helps get your body get rid of excess sodium and water. But there are plenty of foods and drinks that behave as diuretics as welland if youre not aware of them, they could cause you to unwittingly shed water through frequent urination. For instance, men who drink two cups of coffee a day are at a 72 percent higher risk for a leaky bladder and frequent urge to pee than those who skipped the joe, according to a study in The Journal of Urology.
Its not the coffee itself, but the caffeine in the beans, a known stimulant, that has a diuretic effect. speeds up your internal processes while blocking the absorption of salt into the bloodstream, resulting in an increase in urine production. For that reason, types of tea and cola may also up your count for bathroom visits. So how many trips a day is OK? Voiding up to eight times a day is considered normal, says Ekene Enemchukwu, M.D., a pelvic reconstructive surgeon and assistant professor of urology at Stanford University Medical Center in Palo Alto, California.
When it comes to caffeine, coffee is the biggest offender, with about 96 mg per eight-ounce cup . Cant live without your daily jolt? Consider a smaller mug or try half-caf-half-decaf. Black tea has about 47 mg of caffeine per eight ounces, while green tea is about half that at 28 mg . Cola is just 22 mg per eight ounces, but keep in mind most cans are at least 12 ounces .
You Suffered A Stroke
Having a stroke can sometimes damage nerves in the bladder and lead to excess urination. Since the muscles used to urinate may be affected, which can cause bladder control issues, a urinary catheter may be needed to resolve the frequent urge, says Dr. Nandi. Strokes can also affect cognition which can also cause excessive urination as well as incontinence.
Yet, theres an issue with catheters. Unfortunately, they can cause urinary tract infections. And, if the muscle stays affected, the UTIs can become chronic and cause more issues with quality of life, later on, he cautions. So, youll want to speak to a doctor to figure out your most opportune game plan. Next, learn 11 things you never knew about peeing.
How Anxiety Causes You To Urinate More Is Explained By A Urologist
Its no secret that theres something about anxiety that causes more trips to the toilet to take a leak.
But whats really going on here? I was inspired to write this article, with a urologist as an expert source, due to my own experience with this situation.
Some years ago I was up every 90 minutes or less overnight to empty my bladder.
And every minute that I lie awake, I was consumed with enormous anxiety, because while I lie there in the darkness, I kept anticipating that at any moment, Id begin hearing that awful thumping sound of my parents German shepherd having a seizure as a result of an incurable brain tumor.
I was staying with them to take care of this dog, which I loved. The anxiety was torture.
Anxiety or nervousness can cause frequent urination, says Kenneth Peters, MD, chief of urology for Beaumont Hospital, Royal Oak, MI.
The exact reason is not known, however. We see this in people of all ages.
The brain is involved in processing signals from the bladder. This is how we know when we need to urinate.
Normally, we can suppress this sensation until it is convenient to void. However, it is not uncommon when people are nervous or upset, that both the bladder and bowel become more active.
What Is Anxiety Exactly
is an umbrella term for a range of uncomfortable feelings like fear, worry, and stress. It has both a colloquial and clinical meaning. Sometimes people describe garden-variety episodes of stress as anxiety, but theyre able to cope with and move on from this anxiousness without the stress being overwhelming. Other times, though, anxiety is overwhelming, which is when we get into diagnosable-mental-health-condition territory.
There are various anxiety disorders that can really disrupt a persons life. One is generalized anxiety disorder, which happens when you experience immense, disproportionate fear about any number of circumstances and events, according to the Mayo Clinic. Another is social disorder, which happens when social interactions trigger your feelings of worry. Yet another anxiety disorder youve likely heard of is panic disorder, when a person has repeated panic attacks involving uncontrollable terror. These bouts of fear are so forceful that people with panic disorder often worry about having panic attacks in the future and avoid anything they think might set one off.
Although the triggers for various anxiety disorders can differ, one major thing they have in common is the potential to cause physical symptoms of anxiety.
The Effects Of The Stress Response
Apprehensive behavior activates the stress response, which causes the body to secrete stress hormones into the bloodstream where they travel to targeted spots to bring about specific physiological, psychological, and emotional changes.
These changes enhance the bodys ability to deal with a threatto either fight with or flee from itwhich is the reason this response is often referred to as the fight or flight response, the emergency response, or the fight, flight, or freeze response .
The stress response affects the body in many ways. Specific to frequent urination, the response:
- Immediately voids the bowels and bladder of waste and the body of water through perspiration and urination. The body does this so that we dont have to stop in the middle of fighting or fleeing to go to the washroom. So as part of the emergency readiness process, the body causes a strong urge to void the bowels and bladder immediately after an emergency alarm has been triggered.
- Relaxes the bladder and tightens sphincter muscles so that we dont have to stop to urinate when fighting or fleeing.
- Increases heart rate, which can cause the kidneys to filter urea more quickly. As the bodys stress increases, so can the amount of urine produced, which can increase the urge, urgency, and frequency to urinate.
- Increases metabolism, which also increases water filtration and urine production.
All of these emergency actions can interfere with normal urinary function and cause frequent urination symptoms.
Causes Of Urge Incontinence
The urgent and frequent need to pass urine can be caused by a problem with the detrusor muscles in the walls of your bladder.
The detrusor muscles relax to allow the bladder to fill with urine, then contract when you go to the toilet to let the urine out.
Sometimes the detrusor muscles contract too often, creating an urgent need to go to the toilet. This is known as having an overactive bladder.
The reason your detrusor muscles contract too often may not be clear, but possible causes include:
- drinking too much alcohol or caffeine
- not drinking enough fluids this can cause strong, concentrated urine to collect in your bladder, which can irritate the bladder and cause symptoms of overactivity
Overflow incontinence may also be caused by your detrusor muscles not fully contracting, which means your bladder does not completely empty when you urinate. As a result, the bladder becomes stretched.
Your detrusor muscles may not fully contract if:
- there’s damage to your nerves for example, as a result of surgery to part of your bowel or a spinal cord injury
- you’re taking certain medicines
Types Of Urination Problems
Urination problems come in many different forms, and unfortunately, this variation is one of the reasons they can be hard to link to anxiety.
There is no denying that urination problems are linked to some very scary diseases, which is why seeing a doctor is so important. Many people with anxiety and urination problems convince themselves they have:
- Prostate Cancer
- Diabetes
- Multiple Sclerosis
And many other significant health issues. Unfortunately, these worries can fuel anxiety further, leading to further urination problems and issues understanding other anxiety symptoms. When other health issues are ruled out, anxiety is very often the cause of urination issues.
There are several different types of urination problems as they relate to anxiety. These are analyzed below:
Chapter 5 Symptoms Of Drinking Too Much Or Too Little
Drinking too much water can result in hyponatremia, a condition that causes the sodium in the body to become too diluted. Sodium is an electrolyte, which regulates the amount of water that is in and around the bodys cells. Diluted sodium causes the swelling of cells. The swelling can result in mild to life-threatening health problems.
Drinking not enough water causes dehydration and results in hypernatremia. In contrast to hyponatremia , hypernatremia means that the levels of sodium ions in the blood are too high. Medically, natremia means the presence of sodium ions in the blood. So, hypo -natremia is diluted sodium ions versus hyper-natremia, which is too many.
In contrast to the symptoms of hyponatremia , the symptoms of dehydration and hypernatremia include feeling tired, dizzy, experiencing digestive problems, sore eyes, bad breath, aching joints, headache, and high cholesterol levels. A loss of more than 10 % of total body water causes severe thirst as well as physical and mental deterioration.
The Impact Of Stress On The Gi Tract
If you havent heard the phrase I was so scared, I almost peed myself, maybe you have heard I was so scared, I almost pooped myself. Your ability to hold in urine and feces is controlled by the same muscles so it makes sense that theyd behave the same way under stress. Its true that stress and anxiety can cause diarrhea so we know that our bowels are impacted by stress.
Looking at studies of IBS patients, too, the connection between bowel health and mental health is clear. About 60% of IBS patients have generalized anxiety disorder. Another 20% have depression. Thats a pretty significant overlap.
Oab/incontinence Symptoms In Oab Patients With Both Anxiety And Depression
Since there was a strong correlation between anxiety and depressive symptoms , we studied the influence of depression on the results. We compared the OAB/incontinence symptoms and quality of life measures among OAB subjects who had both anxiety and depression versus those who had anxiety but no depression . OAB subjects with both anxiety and depression reported higher ICIQ-UI and IIQ-7 scores than those who had anxiety but no depression . However no difference was noted in ICIQ-OAB, UDI-6 or OAB-q.
How We Use Are With Our Students
Anticipating: Our students write down a list of all anxiety-provoking situations that they have ever encountered. The list is not shared with any other classmates but helps us educators to provide us an insight on what a childs amygdala perceives as threat versus a real threat. By anticipating what an amygdala might interpret as distress, we were successful in making the student feel safe in school. Please note: It is crucial to understand that the amygdala processes emotions and memory. As our case studies show, a childs amygdala might change reality. Sadly, parents can lose their child over the amygdalas altered memories.
Reducing:If the stress-provoking situation is school related, we adjust the students individualized curriculum accordingly. If having to take a test results in a childs frequent urination , we educators adjust the way we evaluate a students academic performance. If a child shows signs of urinary problems before a field trip or being in a larger social setting , we adjust the students social group. By initially reducing unavoidable situations that an amygdala might interpret as distress, the child still gets exposed to stress but re-learns emotionally step by step that these situations are not life-threatening situations. enables a child to relearn.
Pelvic Floor Exercises Can Strengthen Your Bladder
If youve been dealing with issues of frequent urination for a while, you might think its just how you are, or maybe its something that happens as you get older. But there are plenty of things you can do, from taking medication to making changes to your diet, that can improve your situation.
A good place to start? Putting your pelvic floor muscles on a program. Thats rightthe muscles responsible for holding in your pee can sometimes get a little lazy, and the right exercises can get things back on track. You cannot strengthen the bladder itself, but you can exercise and strengthen your pelvic floor muscles with kegel exercises, says Dr. Enemchukwu. This can help improve bladder control. Specifically, a type of pelvic floor physical therapy known as bladder training can be helpful, she says: This teaches you how to ignore your bladder when it gives you false signals by using distraction and quick flicks, a type kegel exercise.
Ultimately, dealing with the constant urge to pee is annoying, but unlikely to be threatening. Moreover, its something your doctor hears a lot, so you can feel confident in the treatment advice you get. Issues with urinary frequency can affect up to half the population, says Dr. Akhavan. So it is an extremely commonand treatableissue.
Up next, What is the Anti-Inflammatory Diet and What Foods Can You Eat On It?
You Have Interstitial Cystitis
A few signs and symptoms include: pelvic pain that is alleviated by urination, a persistent need to urinate, and frequent urination, says Dr. Landry.
According to Dr. Nandi, Most people will urinate up to seven times a day, but those suffering with interstitial cystitis may urinate as much as 35 to 40 times a day, and many times the actual act of urination will only produce a few drops of urine and the distracting sense of urgency may not always subside after going. This symptom will occur all day and usually throughout the night, which can cause problems with sleep patterns. Plus, pain might be present, and itll intensify as the bladder fills up, he explains.
Unfortunately, the exact cause of interstitial cystitis is not known, but many factors probably play a role. For example, there might be a defect in the protective lining of the bladder; as a result, a leak in the epithelium might allow toxic substances in urine to irritate the bladder wall. Additionally, there might be a genetic cause or an infectious etiology, Dr. Landry explains.
Regarding treatment, not every patient will respond, she cautions. But your doctor might recommend the following: oral medications, nerve stimulation techniques, bladder distension , medications instilled into the bladder, surgery, or acupuncture, which might also provide some relief, she says.
Make A Social Appointment
Youll need some time after youre diagnosed with OAB to figure out the best treatments. Meanwhile, you may continue to struggle with symptoms. Dont let that stop you from enjoying social interactions.
You can always plan ahead to accommodate any potential urge to go. Meet a friend at a museum or theater where the bathrooms are easily available. Limit your time together to reduce anxiety. Gradually, as you start treatment and experience success, youll be able to expand your outings.
Anxiety Urination Versus Urination Anxiety
Is there a difference between anxiety urination and urination anxiety? While Google does not appear to detect a difference, we certainly do in our work with students.
Anxiety urination is when anxiety causes frequent urination or other urinary problems. Urination anxiety is when frequent urination causes anxiety.
The distinction between the two is crucial. Urination anxiety can be due to a medical problem . Urination anxiety should be reported to a doctor.
Your Sleep Is All Screwed Up
A person with anxiety might have a tough time falling asleep and/or staying asleep, or might have restless and unsatisfying sleep, according to the . Elevated levels of hormones like cortisol and adrenaline make it hard to get a good nights sleep, since your buzzing body may not be able to relax enough to rest. The racing thoughts that can come with anxiety are no recipe for great sleep, either.
Its not just that anxiety contributes to sleep problems. Sleep issues such as insomnia can make you more prone to anxiety too, the Mayo Clinic explains. What a great cycle.
The Unseen Troubles Of Oab
If you suffer from overactive bladder, you may worry about having an accident while in public. You may feel like you can no longer travel, exercise, or enjoy the activities you once did. You also may feel less attractive and worry about how your condition will affect your sex life.
All of these worries can contribute to overall feelings of stress and anxiety. Fortunately, you can take steps to manage your symptoms and your emotions so you can get back to being yourself.
Even if youre embarrassed about your symptoms, its important to see your doctor. A number of treatments are available to help you regain control. Certain lifestyle modifications can limit the strong urge to go, such as:
- dietary changes
- bladder training
- pelvic exercises
Medications may also be helpful. They work by blocking certain nerve impulses to help relax the bladder muscle, making it easier to resist urges. Your doctor can help you determine the best treatment for you.
How Stress And Anxiety Affect Your Bladder
Have you ever felt yourself going to the toilet more frequently than usual when you are stressed? Or does your bladder play up when you are anxious?
As soon as you become anxious or stressed, your body releases adrenaline and cortisol, two stress hormones which can cause a “fight-or-flight” response.
The need to urinate when feeling panicked may be an evolutionary effect its easier to flee or fight with an empty bladder. The exact mechanisms behind this explanation are not fully understood, but when you are stressed out or feeling anxious, the nervous system operates at a higher intensity, meaning that it takes less to activate the reflex, according to Dr Alan Wein, a professor of urology at Penn Medicine at the University of Pennsylvania.
Another explanation could also be that your muscles tense up more, including your bladder muscles.
Research shows that there is a strong correlation between stress and anxiety and your bladder. A clinical study published in investigated urinary symptoms among patients with overactive bladder syndrome who also suffered from anxiety. Those with anxiety had more frequent urination patterns than those who didnt.
A vicious cycle
Unfortunately, in those who suffer from an overactive bladder or urinary incontinence, the condition itself may spur anxiety or stress, as you are constantly worried that you may not make it to the toilet in time. This anxiety makes your bladder more reactive a vicious cycle.
Manage anxiety
Image credit: iStock
Incontinence And Mental Health
So, back to the chicken and egg question. Both anxiety and depression have been found in many patients with incontinence. But was the incontinence caused by the mental health problems or did the mental health problems cause the incontinence?
It turns out its a two way street when it comes to anxiety and urinary incontinence. Anxiety and incontinence interact and exacerbate each other. And, anxiety is a risk factor for developing incontinence.
The same appears to be true with other mental health issues, like depression, which is also a risk factor for developing incontinence. Several studies have linked depression to urinary incontinence in women especially. And, people with pelvic floor disorders are three times more likely to experience depression than the general population.
Anxiety even rears its head when you start talking about overactive bladder. According to one study, 48% of patients with overactive bladder exhibit anxiety symptoms. Plus, according to the same study, about 24% of OAB patients have moderate to severe anxiety.
While anxiety and incontinence dont have to go together, its easy to see how incontinence can cause anxiety — maybe even more anxiety than you started with.
Hyperstimulation Can Cause Over Active Bladder
While not a disease, Over Active Bladder is the name of a group of symptoms that affect urinary function, such as the sudden urge to urinate that seems difficult to control, incontinence, and frequent urination. OAB affects approximately 30 40 percent of North Americans.
Research has found that emotional problems, such as anxiety disorder, can cause and aggravate over active bladder. For instance:
OAB patients reported higher anxiety symptoms compared to controls. OAB patients with anxiety reported more severe OAB/incontinence symptoms, worse quality of life, and more psychosocial difficulties compared to OAB patients without anxiety. There are positive correlations between the severity of anxiety symptoms and OAB/incontinence symptoms.
While the exact science isnt settled about the reasons why emotional problems can contribute to OAB, two theories suggest:
- The heightened autonomic nervous system activity can override normal nervous system communication between the bladder and brain causing the brain to generate a sense of urgency to urinate when the bladder isnt full, as we mentioned previously.
Any of the above reasons can cause a wide range of bladder and urination problems, including frequent urination.
Frequent urination during sleep hours is also common. Contributing factors include:
- Hyperstimulation can cause an increase in resting metabolism even when sleeping. An increase in resting metabolism will cause the body to produce more urine than normal.
Symptoms: How Often Is Frequent
Frequent urination is defined as urinating more often than what you consider normal. Urination may occur in small or large amounts. The Cleveland Clinic defines frequent urination as urinating more than 4 to 8 times per day for healthy people who are not pregnant.
Additional symptoms of a potential medical problem may include:
Talk to your doctor if the cause of frequent urination cant be explained by increased fluid intake, especially caffeine or alcohol.