Sleeping Problems and Frequent Urination

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Reader’s Question

My problem is that I am going to the toilet very often. Right now I am out of options and ideas: I’ve had every possible examination and I am physically absolutely healthy — there’s nothing wrong with my bladder or my kidneys.

I have to urinate every hour or two hours. It becomes unbearable at night, as I haven’t slept in three years already. I can’t work, and it seems I have no life besides toilet. Doctors in my country have nothing to say except that I just have to accept it and try to live with it. Some of them mentioned that the reason could be psychological. My question is how likely is that? How common is such condition? What treatments could be applied? How am I supposed to live with this kind of disease?

How am I supposed to handle it, because sometimes when I keep waking up at night or stopping at every gas station during a trip. I feel so miserable that I would give up on anything just to become healthy again.

I don’t know if any additional information would help. I can mention that it started right after I moved out of my country and began a new life abroad with my partner. My whole life turned out to be full of painful and pointless examinations and a surgery on top of all my fears. It’s been a year that I haven’t seen any doctor and tried to live on my own, but I’m just not capable. I miss a lot of jobs because I feel so exhausted, and I have no will power to leave my bed in the morning.

The whole situation became even more complicated after a surgery, as I am terrified of any physical pain or interaction into my body. I felt as in hell during all those months of examinations (I think they took over a year, I don’t remember now), and when a year ago it had all stopped I hoped I would finally get back to normal. That’s when I got nightmares and began screaming during sleep in addition to constant urination. I feel terrible and suppose that I not only have to cope with this “peeing thing”, but also with the rest of my psychological problems.

Was it too much for me? Will this experience keep following me even if there’s a way to treat problems with urination? How can I get rid of nightmares and screaming and eventually forget all that pointless pain I’ve been through? If there’s a psychological reason for my urination, and how likely is it that it could repeat again in future? Maybe doctors gave me the wrong idea and there’s no psychological reason for it. In this case I’d still be very grateful if I get some answers to the rest of my questions.

Psychologist’s Reply

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It is very likely that this is psychosomatic, meaning a physical symptom of psychological distress. How can I say so with any level of certainty? By observing the following:

  • you’ve ruled-out physical causation,
  • if it were psychosomatic, then it would likely be caused by high stress and anxiety, and
  • all you talk about in your query is stress and anxiety.

How common is it to be scared to the point of losing bladder control? Very common. It has historic references in every culture. For example, you’ve heard of the military brigade commander who dressed for battle in a red shirt and brown pants? He said if he was shot, he didn’t want his men to see him bleed, and if he messed his pants, he didn’t want them to see that either.

My father was an eye doctor in his day. He told me once about a patient who came to see him with a twitch in his eye. He said “Doc, you gotta help me. This twitch is driving me crazy.” My dad answered, “I could help you but I’m not going to. If I stop your eye from twitching, then your nerves will go somewhere else, maybe somewhere worse. I don’t want to fix your twitch only to give you an ulcer!” Now, I don’t say these things to make light of your problem, but to normalize it for you. Fear affects our bodies, and fear has affected yours. And while I do not make light of it, injecting some humor into your fears may be good therapy for yourself. It may take a while to see the humor in this, but we can help you get to that point.

Your doctors are right to point you in this direction but not accompany you here. You deserve to work with a specialist, a psychologist, who can help you work through the issues that cause the anxiety. It’s very likely that by addressing the fears you describe, the bladder problems will abate all by themselves. To help make you available to talking therapy, you may consider asking your doctor for a short-term prescription of an anxiolytic or antidepressant. There are pros and cons to each medication, so talk to him about it and see what is best for you. It could be useful in this way: talking therapy works by delving into the anxiety-producing material and sorting it out. That is, in itself, an anxiety-provoking process. If you are afraid that it would be overwhelming, then meds might take the edge off of it for you. Then, you could explore the issues with fewer reservations and get to the heart of the matter faster. Meds are not necessary, but they could offer this kind of help and short term relief.

Once you do find some relief and a reduction of symptoms, you may also consider changing therapy with an individual psychologist to group therapy. For you, being around others who are struggling, helping each other work through problems, and developing camaraderie in the process might be a welcome support. These are all things you can discuss with your psychologist, which I hope you will do soon.

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