“All of us at anxietycentre.com have experienced debilitating anxiety. But we’ve also overcome it and returned to normal and lasting health. Because we know the hardship anxiety unwellness can cause, we are committed to helping others, with over 30 years of service.” - Jim Folk, President, anxietycentre.com

Frequent Urination Anxiety Symptom

Jim Folk author
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: September 13, 2019


frequent urination anxiety symptoms

Frequent urination is a common anxiety disorder symptom. It occurs because of how chronic anxiety affects the body. Many anxiety disorder sufferers experience frequent urination, or episodes of frequent urination, due to chronic anxiety.

Do you struggle with anxiety? Have you been diagnosed with anxiety disorder. If you haven't been diagnosed with anxiety disorder, you can use our Free Online Anxiety Disorder Test Quiz or our regular free online instant results Anxiety Test to get an idea of your level of anxiety, and if it is in the range of what is normally considered to be an anxiety disorder.

The following information pertains to the anxiety symptom “Frequent Urination.”

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:

  • You feel you have to urinate more frequently than usual.
  • You feel you need to urinate even though you just urinated.
  • It seems your bladder needs emptying even though you just emptied it.
  • You feel you need to urinate more than two times per hour.
  • You feel you need to urinate even though you haven’t been consuming more liquids than usual.
  • You feel you need to urinate, but when you do, you produce little or no results.
  • You frequently feel a need to go to the washroom.
  • You feel you need to urinate many times per hour.
  • You feel you need to urinate through the night at least once per hour.
  • Getting up every hour or so to urinate during the night prevents you from getting good sleep.
  • Every time you wake up you have a strong urge to go to the washroom.

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:

  • Immediately voids the bowels and bladder of waste and the body of water through perspiration and urination. The body does this so that we don’t 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 don’t have to stop to urinate when fighting or fleeing.
  • Increases heart rate, which can cause the kidneys to filter urea more quickly. As the body’s stress increases, so can the amount of urine produced, which can increase the urge, urgency, and frequency to urinate.[5]
  • Increases metabolism, which also increases water filtration and urine production.
  • Increases autonomic nervous system (the nervous system under involuntary unconscious control) activity, which can cause the brain to sense an urgent need to urinate as well as cause sphincter muscles to release for some people.

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:

  • Chronic stress can adversely affect the body’s muscles and muscle groups, including those that control the bladder and urinary tract.[12] The stress response causes muscles to tighten. Hyperstimulation can cause muscles and muscle groups to tighten, spasm, and act erratically and more involuntarily than normal. This abnormal muscle behavior can affect any muscle or group of muscles in the body, including those in the bladder and urinary tract, which includes the sphincter. It’s suggested that abnormal muscle behavior is the reason why some stressed and anxious people have ‘accidents’ or feel they’ve lost control of their bowels or bladder when overly stressed, such as when anxious or afraid.
  • 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 isn’t 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.
  • Hyperstimulation can cause an increase in resting heart rate, which can also cause an increase in urine production.
  • Hyperstimulation can cause an increase in resting perspiration, which also can cause an increase in urine production.
  • Hyperstimulation can cause an increase in nervous system activity, which can also cause a heightened urge to urinate even if the bladder isn’t full.

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:

  • Reduce stress so that your body’s metabolism and heart rate are lower, which can reduce urine production.
  • Reduce your intake of fluids so that your body doesn’t produce as much urine. Be sure, however, you don’t reduce your fluids too much that your body becomes under-hydrated.
  • Regular light to moderate exercise can help reduce stress and keep muscles toned and fit, including those associated with the urinary system. Remember, however, rigorous exercise stresses the body so it’s best to avoid strenuous exercise until your body has recovered from hyperstimulation.
  • Moderately increase salt intake so that your body retains some fluids. However, be sure to keep your salt intake within a healthy limit.
  • Regular deep relaxation can help slow the body’s metabolism as well as reduce hyperstimulation, which can also help reduce urine production.
  • Get regular good sleep (between 6.5 to 8 hours per night). Regular good sleep can reduce stress hormone production during the day, which can reduce urine production.
  • Slow down your pace. Living a fast-paced lifestyle can increase stress hormone production, which will increase urine production. Deliberately slowing down your pace can reduce stress hormone production, reduce urine production, and calm the body overall.
  • Avoid stimulants. Stimulants stress the body, increase stress hormone production, and aggravate hyperstimulation, which in turn increases urine production. Avoiding stimulants can keep stress hormone levels in check and keep the body calmer overall.
  • Avoid diuretics. Diuretics increase the excretion of water from the body, which will increase urine production. Many medications have a diuretic effect, but so do some foods, particularly coffee and green and black teas. You can speak with your doctor, pharmacist, and a natural nutritionist for more information.

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:


Return to Anxiety Disorders Signs and Symptoms section.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including the anxiety symptom frequent urination.


REFERENCES:

1. "Stanford Children's Health.” Stanford Children's Health - Lucile Packard Children's Hospital Stanford, 2019.

2. “Anatomy and Function of the Urinary System.” Anatomy of the Urinary System - Health Encyclopedia - University of Rochester Medical Center, 2019.

3. Ressler, Kerry J. "Amygdala Activity, Fear, and Anxiety: Modulation by Stress." Biological Psychiatry, 15 June 2011.

4. Harvard Health Publishing. “Understanding the Stress Response.” Harvard Health, May 2018.

5. Rabassa, Cristina, and Suzanne C. Dickson. “Impact of Stress on Metabolism and Energy Balance.” NeuroImage, Academic Press, 7 Feb. 2016.

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.

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.

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.

9. McEwen, Bruce S. “Neurobiological and Systemic Effects of Chronic Stress.Chronic Stress (Thousand Oaks). U.S. National Library of Medicine, 2017.

10. “What Is Overactive Bladder (OAB)?” What Is Overactive Bladder (OAB)? - Urology Care Foundation, 2019.

11. Lai, Henry, et al. “The relationship between anxiety and overactive bladder/urinary incontinence symptoms in the clinical population.” Urology, Dec. 2016.

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.

13. KH, Chung, et al. "Bladder pain syndrome/interstitial cystitis is associated with anxiety disorder." Neurourology and Urodynamics, Jan 2014.

14. Harvard Health Publishing. “Medications That Can Cause Urinary Incontinence.” Harvard Health, Dec. 2014.

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.

16. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

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.

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.

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.