Mental health and incontinence

Mental health and are both hard to talk about, but they shouldn’t be. What many people don’t realise is that the two can be interlinked. In fact, 30% of women with incontinence will also suffer from depression1, which is three times more likely than the general population2. Another study found that 28% of Overactive Bladder patients also experience depression, with half of these suffering from moderate to severe depression3. We also talked to England Rugby star Lewis Moody about urine leakage and how we can End Bladder Shame.

Having a problem with your bladder can massively affect your self-confidence and have an impact on many areas of your life including your mental health. It’s important to remember that you’re not alone, and there are things out there to help.

We spoke with Dr John S. Young, Associate Professor in Urology, to learn more about the connection between mental health and incontinence.

How can incontinence affect mental health?

Many studies clearly demonstrate that has a significant negative impact on mental health, to an extent comparable to the effect of neurodegenerative diseases and cancers. Dr. John talks about the effect of incontinence: “clinical studies and patients alike describe the multitude of ways that incontinence impacts on all aspects of life.” These include:

• emotional - fear of incontinence in public as well as feeling and becoming socially withdrawn

• relationships - fear of intimacy

• stopping exercise - for fear of incontinence

• employment - feeling stigmatised, reduced self-confidence and self-worth leading to periods of absence from the workplace

• quality and length of sleep

What symptoms of mental illness should I look out for?

is still a taboo subject for many, but if you know someone is suffering or you are suffering yourself, then it’s a case of looking out for signs of mental illness which will usually present themselves as depression.

According to Dr. John, these signs may include:

• withdrawal - not going out any more and cancelling plans (sometimes at the last minute)

• changes in mood - including both irritability or frustration and seeming sad, miserable or emotionally numb

• expressing dark thoughts

• changes in eating habits (such as eating more or eating less)

• increased consumption of alcohol

How can mental health issues increase incontinence

The relationship between mental health and is a complex one. How one person experiences a condition can be completely different to another person depending on the nature of the mental illness, how severe it is and whether medication is used to manage it. Certain medications used to treat mental health issues can both increase and decrease the risk of incontinence. There is evidence that a group of medicines used to treat bipolar disorder and schizophrenia have been shown to increase the likelihood of developing incontinence4.

There can be cases where mental health concerns can directly cause or increase incontinence, as Dr. John explains: “Mental illness can be associated with lifestyle factors that affect the bladder; such as the consumption of substances (caffeine, alcohol) that affect bladder function, and fluctuating fluid intake (excessive one day and insufficient intake the next day).”

“A person suffering with pathological anxiety may develop obsessive habits that lead to more frequent voiding, a heightened awareness of bladder fullness and a type of incontinence associated with this, called urge incontinence. By contrast, incontinence can occur because a person becomes less aware of bladder fullness; that is, detached from the sensations that tell us when we need to empty our bladder.”

What should you do if someone you care about is experiencing mental health issues due to their incontinence?

If your friend or family member seems to be suffering from and mental health issues, the first thing to do is talk to them and let them know you are there to offer support. If you’re having trouble about starting the conversation, read our article on how to talk about incontinence. You may want to encourage them to talk to a clinician about how they’re feeling.

Dr John says “it’s important to seek help and there are many options - from behavioural therapy to medication. A GP is well-placed to advise and refer a patient suffering from mental health issues associated with incontinence to specialist services.”

Some people may also find it helpful to be part of support groups that meet in person, or communities that support each other online. “It can help to know that many others are or have experienced the same symptoms, often with the same impact. Sharing stories of what’s helped can be of great support.”

If you are struggling with incontinence and think it may be affecting your mental health, don’t be afraid to reach out. To improve your incontinence, you may want to try pelvic floor exercises or use TENA products to help you feel more confident and put your mind at ease.