Shy bladder syndrome, also called a bashful bladder, or by its medical term paruresis, is a type of anxiety disorder. People who have a shy bladder are afraid of urinating in public bathrooms, in the homes of others or in the presence of others. If not treated, this form of urine retention can interfere with everyday life.
The fear of urinating in a public restroom must be treated from both the mental and physical sides of the problem. Treatment for paruresis involves both medical procedures and behavioral modification.
Graduated Exposure Therapy
Graduated exposure therapy is also called cognitive-behavioral therapy, or CBT. It is a treatment that combines the expertise of a behavioral specialist who has experience with this type of phobia and a patient who actually tries to urinate in anxiety-provoking situations.
The International Paruresis Foundation (IPF) explains that a mental health professional will help you talk through why you feel the way you do about using public bathrooms in an attempt to eliminate irrational thinking that leads to your physical problem. Your homework is to try to successfully urinate in a bathroom that is not your own--a friend's house or the restroom of a restaurant.
Catheterization
Holding your urine for long periods of time is not healthy and can cause severe discomfort. Immediate treatment options employed to void your bladder include catheterization, according to the American Urological Association (AUA). If you have no other urinary dysfunction---such as an infection---you can learn how to use a catheter yourself when it becomes necessary.
Medications
The AUA and IPF both promote the use of medications in some people who experience a shy bladder. Anti-depressant medication in the selective serotonin reuptake inhibitor, or SSRI, class might curb the anxiety that is contributing to your problem. Sedatives may also be prescribed, to help your body to relax enough to empty your bladder.
Herbs
The IPF reports that some people with paruresis may benefit from herbal remedies that are used to treat prostate enlargement and generalized anxiety disorders. Saw palmetto improves urine flow in patients with prostatitis and may be effective for a shy bladder. Kava kava and St. John's Wort are mood-enhancing supplements, which might alleviate some of your anxiety and help you relax enough to urinate. Consult your doctor before using herbal supplements, especially if you are also taking conventional medications for your shy bladder.
