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A woman sits, resting her chin on her hand, looking worried. Her anxiety can exacerbate her incontinence.

How anxiety can affect incontinence

Walking into an interview for a new job, getting ready for a party you’ve spent weeks anticipating, having the boss over for dinner—these are all scenarios where anyone might be feeling a bit nerved up. And if you happen to have incontinence, you already know that those extra jitters can mean you’re more likely to experience bladder leaks. You just might not know why or how.

Do you experience more leaks when you get nervous, or are you getting nervous because you’re worried about dealing with more leaks?

A woman gives a presentation in front of a white board. Incontinence can make nerve-wracking situations even scarier.

The stress-leak connection can be a two-way street. One National Institute of Health study noted that almost half of those living with urinary incontinence report symptoms of anxiety. And close to 25 percent of that group report levels of anxiety that are moderate to severe. Meanwhile, a European study of more than 16,000 women found that those dealing with symptoms of anxiety or depression demonstrated as much as two times the likelihood of developing urinary incontinence.

Talk about a classic vicious cycle!

The bladder leak/stress connection

Medical research has yet to determine the exact reason why anxiety contributes to an increase in urinary incontinence and vice versa, but there are two prevailing theories:

A mom tries to manage her baby while her toddler makes a mess. Stressful situations can worsen bladder leaks.

Stress stimulates the fight-or-flight response
If you’re a woman with an overactive bladder, involuntary reflexes can increase leaks. Being in a job interview, attending a formal event or having to make a presentation or perform in front of a large audience—settings where anyone is bound to feel a bit more nervous—can heighten your fight-or-flight response. This can increase the sensitivity of the nervous system and interfere with voluntary muscle control involving the bladder.

Stress increases muscle tension
Everything from the grinding frustrations of daily life to moments of major personal panic—like an unexpected visit from the in-laws or letter from the IRS—can cause stress to surge, which in turn can affect muscles. The abdominal muscles may tighten in this process, leading to a greater need to pee. This stress also often means we have more trouble sleeping, and difficulty sleeping means an increase in the need to get up and pee in the middle of the night—the frustrating phenomenon known as nocturia.

Reducing stress can mean peeing less

Regardless of whether stress causes more bladder leaks, or more bladder leaks increase stress, the anxiety caused by incontinence can make living with it even more challenging. Equipped with an understanding of the connection, proactively taking steps to better manage stress makes sense. You can find great guidance on getting started with a self-care strategy here.

Life is always going to serve up its share of challenges, but simple steps like exercise, meditation or breathwork and being part of a more caring, empathetic community will definitely go a long way toward helping keep stress in check.

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