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Frequent Urination Anxiety Symptom

Marilyn Folk BScN medical reviewer
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: May 10, 2019


frequent urination anxiety symptoms

Frequent urination, urgency to urinate, a sudden urge to go to the washroom symptom description:

There are many descriptions for this symptom. Common descriptions include:

The frequent urination anxiety symptom can come and go rarely, occur frequently, or persist indefinitely. For example, one day you visit the washroom numerous times, and the next day your urination frequency is normal.

Frequent urination can precede, accompany, or follow an escalation of other anxiety symptoms, or occur by itself.

Frequent urination can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur ‘out of the blue’ and for no apparent reason.

The frequent urination anxiety symptom can range in intensity from slight, to moderate, to severe. It can also come in waves, where it’s strong one moment and eases off the next.

This symptom can change from day to day, and/or from moment to moment.

All of the above combinations and variations are common.

It’s also common to urinate more frequently during sleep hours or when resting. Others also might experience leaking, wetting, or dribbling before or after each washroom visit.

Can anxiety cause frequent urination?

Yes! But before we explain why.

Medical Advisory

We recommend all new, changing, persistent, and returning anxiety symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms, including this anxiety symptom. If your doctor concludes your symptoms are solely anxiety-related, you can be confident there isn't a medical cause. Generally, doctors can easily determine the difference between anxiety symptoms and those caused by a medical condition.

Doctors aren't infallible, however. If you are uncertain about your doctor’s diagnosis, you can seek a second or more opinions. But if all opinions agree, you can be assured anxiety is the cause of this symptom.

How the bladder functions normally

The urinary system is comprised of organs, muscles, tubes, and nerves that work together to create, carry, store, and evacuate urine. This system includes the two kidneys, two ureters, bladder, two sphincter muscles, and the urethra.[1][2]

frequent urination urinary system

The body gets its nutrients from the foods we eat. After the body has taken what it needs, waste products remain in the blood and bowel. Regarding urination, the waste products in the blood called urea, produced from foods containing protein, are taken to the kidneys for filtration. The kidneys remove urea, and combined with water and other waste products, pass it through the urinary system to the bladder which results in the formation of urine.

The bladder is a small, balloon-like hollow muscular organ that receives urine. So that the urine doesn’t just pour out of the body, the bladder is closed by sphincter muscles that encircle the opening of the bladder and close tightly until we are ready to relax them to urinate.

When the bladder fills, nerve cells in the bladder message the brain, which creates a sense of urgency to urinate. The urge to urinate becomes stronger as the bladder fills up. When we are ready to urinate, the brain signals the bladder muscles to tighten, which forces the urine out, and the sphincter muscles to relax, which allows the urine to come out. Both actions cause the bladder to empty.

When the body is healthy and not overly stressed, this process works normally. Problems can occur, however, when the body becomes chronically stressed, such as from overly apprehensive behavior.

There are many reasons why anxiety and stress can cause urinary problems, including frequent urination. Here are some of the most common:

1. The effects of the stress response

Apprehensive behavior (worry, nervousness, fretting, fear) 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 that enhance the body’s ability to deal with a threat—to either fight with or flee from it—which 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 (some people become so frightened that they become seemingly paralyzed with fear similar to a “deer caught in headlights”).[3][4]

The stress response affects the body in many ways. Specific to frequent urination, the response:

NOTE: the emergency response causes some people to pee themselves when afraid whereas it prevents others from urinating when anxious, stressed, or afraid. The reasons for this difference are unknown at this time.

All of these emergency actions can interfere with normal urinary function and cause frequent urination symptoms.

This sudden urge to void is common and often experienced by stage performers and public speakers just before they are about to perform or present.

See our “Stress Response” section for the many ways anxiety and stress affect the body and nervous system.

2. Stress-response hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently and/or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering, which can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants (also often referred to as "hyperarousal").[6][7][8][9] A body that becomes hyperstimulated can exhibit all of the changes of an active stress response, including the urge to urinate even though a stress response hasn’t been activated.

Moreover, hyperstimulation stresses the body. Chronic stress can cause persistent symptoms, including a persistent urge to frequently urinate. As long as the body is hyperstimulated, it can present symptoms, including those affecting urinary function.

3. Hyperstimulation can cause the body to act erratically

Stress hormones have a dramatic impact on the body, and especially the nervous system (which includes the brain).

The nervous system is responsible for sending and receiving sensory information to and from the brain. A main component of the nervous system is specialized cells called neurons (nerve cells), which communicate with each other using an electrochemical process (the combination of electricity and chemistry).

frequent urination neuron anatomy

This system of communication and reaction works normally when the body and nervous system are healthy. Problems can occur, however, when the body and nervous system become hyperstimulated (chronically stressed).[7][8][9]

For example, because of their electrochemical properties, neurons are particularly sensitive to hyperstimulation. When they become overly stimulated, they can act erratically and more involuntarily than normal, which can cause them to “misreport,” “over-report,” and send “false” nerve impulse information to and from the brain.[8][9] These abnormalities can cause a wide range of sensory and physical anomalies, such as causing an urge to urinate when the bladder isn’t full.

This erratic and more involuntary nervous system behavior can affect any area of the body, including the bladder and the muscles associated with it. The frequent urge to urinate; frequent urination; and ‘leaking,’ ‘spotting,’ incontinence, and ‘accidents’ are all examples of hyperstimulation’s adverse effects on the urinary system.

4. Hyperstimulation (chronic stress) can cause Over Active Bladder (OAB)

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.[10]

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.”[11]

While the exact science isn’t settled about the reasons why emotional problems can contribute to OAB, two theories suggest:

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:

This list isn’t exhaustive.

It’s common for those who are overly stressed and anxious to have nights where they are up every hour or so going to the washroom. The more stressed and stimulated the body becomes, the more of a problem frequent urination can become.

5. Inflammation

Chronic stress, such as that caused by overly apprehensive behavior, can cause issues with inflammation. Inflammation can affect many parts of the body, including the urinary tract (and prostate for men).

A urinary tract (and prostate) that become inflamed can cause all sorts of urinary function symptoms, such as the urge to frequently urinate.

Cystitis, an inflammation of the bladder, is often caused by a urinary tract infection (UTI) but can be aggravated by chronic stress and the inflammation issues chronic stress can create in the body, including in the bladder.

Interstitial Cystitis, a chronic bladder health issue that can cause chronic pain and pressure in the bladder, has also been associated with anxiety disorder.[13]

Moreover, overly anxious people tend to hold their urine longer than they should. This is because they are generally so busy and involved with what they are doing that they don’t want to take the time to urinate. Holding in urine can cause issues with UTIs. Then, the chronic stress their behaviors cause can aggravate and prolong UTI recovery.

6. Medications

Medications can also cause frequent urination problems, such as diuretics, muscle relaxants, psychotropic drugs (sedatives), narcotics, antihistamines, and alpha-adrenergic antagonists.[14]

Frequent urination anxiety symptom treatment

When frequent urination is a side effect of medication, talking with your doctor and pharmacist could prove helpful.

When frequent urination is caused by inflammation or infection, talking with your doctor could also prove helpful.

Ending an active stress response

When frequent urination is caused by inflammation, which in turn is caused or aggravated by not urinating regularly, urinating according to a schedule can prove helpful. Periodically clearing the bladder can help reduce and prevent UTIs and the inflammation associated with them.

When frequent urination is caused by anxiety and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside. Keep in mind it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

Eliminating chronic stress (hyperstimulation)

When frequent urination is caused by chronic stress, it may take a lot longer for the body to calm down and recover, and to the point where this symptom is eliminated.

Nevertheless, when the body has fully recovered from the adverse effects of chronic stress, frequent urination completely subsides. Therefore, this symptom needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about this feeling. Sure, it can be unsettling and even bothersome. But again, when your body has recovered from the stress response and/or chronic stress, this symptom disappears.

Short-term remedies for frequent urination

While eliminating hyperstimulation should be the overall goal of eliminating chronic, frequent urination, some short-term strategies could ease symptoms. For instance:

Therapy

The number one reason why anxiety disorder and its symptoms persist is because of unidentified and unaddressed underlying factors that cause issues with anxiety. This is why dealing with your anxiety issues is the most important overall.

Since the majority of stress comes from behavior (the ways we think and act), addressing the core reasons for anxiety disorder can reduce and eliminate the unhealthy stress that often leads to hyperstimulation and symptoms, including this one.

Keep in mind that eliminating anxiety symptoms doesn’t necessarily mean you’ve overcome issues with anxiety. Anxiety symptoms are symptoms of stress. Eliminating anxiety symptoms means you’ve eliminated the unhealthy stress that is causing your symptoms. But if the underlying factors that cause issues with anxiety aren’t addressed, it’s just a matter of time until the body is overly stressed and symptomatic again.

Rebounds of symptoms and a return to a struggle with anxiety are caused for this very reason: the core issues that cause problematic anxiety haven’t been successfully addressed.

To eliminate issues with anxiety and symptoms once and for all, we need to eliminate the cause of problematic anxiety – the underlying factors that cause issues with anxiety. When you eliminate the cause of the problem, you eliminate the problem and the problem's symptoms.

If you have been struggling with anxiety and symptoms, including frequent urination, we recommend connecting with an experienced anxiety disorder therapist to help you overcome your anxiety issues. Research has shown that working with an experienced therapist is an effective treatment for anxiety disorder.[15][16]

All of our recommended anxiety disorder therapists have personally experienced anxiety disorder and have overcome it. Their personal experience with anxiety disorder combined with their Masters Degree and above professional training makes them a good choice when desiring to overcome anxiety disorder and its symptoms.

Moreover, getting therapy via teletherapy, distanced therapy, or e-therapy (telephone or online therapy) is as effective, if not more so, than in-person therapy.[17][18]

All of our recommended therapists are experienced at working with clients via distanced therapy and new technologies. We’ve found distanced therapy to be especially effective when working with anxious clients.

Research has also shown that self-help information can also be beneficial.[19][20] For a more detailed explanation about anxiety symptoms including this one, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

Much more could be said about this anxiety symptom. For a more detailed explanation about anxiety symptoms including this one, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.


The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.

Additional Resources:


REFERENCES:

1. "Stanford Children's Health.” Stanford Children's Health - Lucile Packard Children's Hospital Stanford, 2019, www.stanfordchildrens.org/en/topic/default?id=anatomy-of-the-urinary-system-85-P01468.

2. “Anatomy and Function of the Urinary System.” Anatomy of the Urinary System - Health Encyclopedia - University of Rochester Medical Center, 2019, www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P01468.

3. Ressler, Kerry J. "Amygdala Activity, Fear, and Anxiety: Modulation by Stress." Biological Psychiatry, 15 June 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882379/

4. Harvard Health Publishing. “Understanding the Stress Response.” Harvard Health, May 2018, www.health.harvard.edu/staying-healthy/understanding-the-stress-response.

5. Rabassa, Cristina, and Suzanne C. Dickson. “Impact of Stress on Metabolism and Energy Balance.” NeuroImage, Academic Press, 7 Feb. 2016, www.sciencedirect.com/science/article/pii/S2352154616300183.

6. Kinlein, Scott A., et al. “Dysregulated Hypothalamic–Pituitary–Adrenal Axis Function Contributes to Altered Endocrine and Neurobehavioral Responses to Acute Stress.” Frontiers In Psychiatry, 13 Mar. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358064/

7. Chang, L. et al. “Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in irritable bowel syndrome.” Center for Neurobiology of Stress, 22 Jan. 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745840/

8. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4373764/.

9. McEwen, Bruce S. “Neurobiological and Systemic Effects of Chronic Stress.” Chronic Stress (Thousand Oaks). U.S. National Library of Medicine, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5573220/

10. “What Is Overactive Bladder (OAB)?” What Is Overactive Bladder (OAB)? - Urology Care Foundation, 2019, www.urologyhealth.org/urologic-conditions/overactive-bladder-(oab).

11. Lai, Henry, et al. “The relationship between anxiety and overactive bladder/urinary incontinence symptoms in the clinical population.” Urology, Dec. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116264/

12. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/.

13. KH, Chung, et al. "Bladder pain syndrome/interstitial cystitis is associated with anxiety disorder." Neurourology and Urodynamics, Jan 2014, https://www.ncbi.nlm.nih.gov/pubmed/24038135

14. Harvard Health Publishing. “Medications That Can Cause Urinary Incontinence.” Harvard Health, Dec. 2014, www.health.harvard.edu/bladder-and-bowel/medications-that-can-cause-urinary-incontinence.

15. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/.

16. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017, jamanetwork.com/journals/jama/article-abstract/2654783.

17. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.

18. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017, www.psychologytoday.com/us/blog/the-pregnant-pause/201712/advantages-e-therapy-over-conventional-therapy.

19. C., Lewis, et al. "Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review." British Journal of Psychiatry, Jan. 2012, https://www.ncbi.nlm.nih.gov/pubmed/22215865

20. Kumar, Shefali, et al. "Mobile and traditional cognitive behavioral therapy programs for generalized anxiety disorder: A cost-effectiveness analysis." Journal PLOS, 4 Jan. 2018, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190554


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