No doubt about it -- there's nothing quite like using your own bathroom. It's familiar, clean (enough), and all your favourite reading material is right there on hand. Ahhh.
Now imagine a public washroom: cramped, grimy, silent. One other person walks in and suddenly you can't pee to save your life. Sound familiar? You may have shy bladder syndrome.
A bashful bladder
Shy bladder, or paruresis, is also known as bashful bladder, pee shyness, stage fright or shy kidneys. A shy bladder is not the result of an infection or inflammation, but a psychological condition classified under anxiety disorders. Responding to perceived dangers (i.e., listening ears, uncomfortable proximity to other people, dirty facilities, feeling exposed, feeling rushed, etc.), the body's sphincter muscle squeezes shut and prevents the flow of urine -- regardless of how full the bladder is.
At one time or another, about 17 million North Americans will experience some form of shy bladder syndrome, according to psychologist Dr. Avrum Miller, who treats shy bladder syndrome at the Anxiety and Stress Relief Clinic in Vancouver, B.C.
Shy bladder symptoms
Symptoms of a shy bladder can range from simply needing to create external noise (like running water) before being able to pee in a public environment, to a complete inability to urinate anywhere that is not your own home. People with an extreme form of shy bladder syndrome will avoid everyday social activities such as dining out, visiting a friend's house or attending a sporting event. "One to two million lives are severely hampered [in North America]," says Dr. Miller.
How does shy bladder begin? Dr. Miller explains most cases are connected to social approval. "People [with shy bladders] become exquisitely conscious of those around them," he says. "It often begins around puberty when peers may have teased, harassed or hurried you in the washroom, and suddenly you associate the washroom with anxiety." He adds that rarer cases of shy bladders are connected to physical, emotional or sexual abuse, and in some instances may stem from traumatic toilet-training experiences.
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