The Bottom Line – Coming Clean about Toilet Anxiety

public toilets can trigger toilet anxiety

Yes, toilet anxiety or toilet phobia is a real thing. And it can be a serious issue for some people. Both physically and mentally. But it isn’t something that gets talked about very often.

  • So how do you respond when nature calls and you are away from home?
  • Will you hold it in until you are in familiar surroundings?
  • Or if you are happy to use a public toilet do you have rules or habits you stick to?
  • And do you expect these of others too?
  • Is your idea of the right toilet behaviour affecting your health?

OK. This is awkward. But It’s time to come clean about bathroom behaviours. What you may consider a quirk or basic etiquette can mask a life-impacting problem. And it can turn into something that has serious repercussions on your health.

Confession Time

Over the years toilet anxiety has been a bit of a challenge for me. And even as I write this I am struggling with the idea of baring myself in this way. This is very private. And it makes me feel vulnerable. I want to make jokes to hide my discomfort. Yet, this issue is too serious to bury or attempt to hide behind clumsy humour.

So I’m ‘fessing up. I’m glad to say it’s not been a life-limiting issue for me. But it has definitely been there. More so in the past when I was younger. Seeking to impress others. To fit in. And it is likely it has had an impact on my digestive health.

Consider the following typical scenario.

Nature would call and I’d finally listen.

So now I’m sitting in a cubicle.

Someone else is in the room and I’m waiting for them to leave. I ready to let nature take its course. But I’m worried that I will make noises. Or even worse, a smell. I’ve held off going for hours but finally had to resort to using a public toilet.

I wince in discomfort as I can hear them rifling through a makeup bag. There’s a click and then a twist as they open their lipstick. A few seconds pass. Then the click of closure. There it is. They are zipping their makeup bag. I unwind a little. Have they left yet? Shoes clack on the floor. The door swishes closed. Thank God for that. I relax and proceed.

Another self-imposed rule I would have was it was OK if I never got to see the other person. So, I’ve now finished what I need to do but I hear the external door open. I’m not coming out until they lock themselves in a cubicle or leave. I hear the lock slide into place in another cubicle. The coast is clear.

Time for a quick exit. Wash my hands. Fast. And then get out before they see me.

Toilet Anxiety – It’s a Real Thing

I am very aware of my friends and family attitudes to toilet behaviours. There are those that insist on finding the nearest toilet as soon as we arrive somewhere. Others that will only go for a wee when we’re out and about.

Toilet phobia relates to all fears around using the toilet. Will there be a toilet where you are going? And will they be clean enough? What if people can hear you?

The symptoms of toilet anxiety are about using the toilet and difficulty going. Shy bladder, known as paruresis, is a medical term for problems urinating. Also known as bashful bladder it is thought to be a caused by feeling anxious and judged by others. This is in the DSM-5, a manual used by clinicians to diagnose mental health conditions. Paruresis is classified as a subtype of social anxiety disorder.

Shy bowel (parcopresis) is the medical term for problems defecating. Yet, this does not get the same level of recognition at present.

The problem is usually worse when having to use public toilets. Especially when there are lots of people around. And it can be in the home too. Have you had guests over and waited until they left before you went?

Yep, I’ve done that too.

And what about when someone stands outside the bathroom? Everything clams up. Only intense concentration and focussing will allow nature to take its course. Or not. So you wait what seems the appropriate amount of time. Then flush, wash and leave.

Coping Mechanisms for Toilet Anxiety

Do you have toilet phobia? You may be suffering with toilet anxiety if you adopt any of the following strategies:

  • you drink less so you won’t have to go as often
  • or you look for toilets giving more privacy or good ventilation
  • as a man, you choose a cubicle instead of a urinal
  • you avoid certain social situations, events and other occasions
  • you consider your work situation with care, including travel and the working environment

So, what does this mean for you? There is the obvious short-term discomfort. But long-term? You may be creating some serious future health problems.

The Damaging Impact of Toilet Phobia

Put aside the short-term physical or mental discomfort. Plus the missed social or work opportunities. Not forgetting the limits you inflict on your lifestyle.

But what is more cause for concern is the potential long-term impact on your health.

Drinking Less

Taking in less fluid can lead to dehydration. Which has its own range of complications. Even mild dehydration can affect memory, attention, concentration and reaction time. Then there is the added risk of low blood pressure, weakness, and dizziness.

And if you reduce your fluid intake you increase the risk of urinary tract infections.

Holding It In

Not going for a wee is one thing. But hold in your poo. The consequences are pretty gross and quite worrying.

If you already struggle with anxiety you don’t need this extra thing to deal with in your head.

Holding it in on a regular basis can lead to an escalating bunch of issues, some even life-threatening.

The first problem is constipation. The stool remains in your colon and your body reabsorbs the water. This may seem a minor issue. Yet, it has a bunch of unpleasant side effects. Including bad breath, discomfort and the likelihood of haemorrhoids.

More serious consequences are fecal impaction and even bowel perforation.

But if that doesn’t worry you enough there is another aspect of refusing to go. If you ignore the urge your body can develop rectal hypersensitivity. Your body learns to ignore the urge and demands more faecal matter before telling the brain that it’s time to go. Grim.

Recognise and Overcome Your Toilet Phobia

First of all, listen to your body and respect the need to go when you do. It is natural and nothing to feel ashamed of. Occasionally holding it is OK too. So don’t panic if you’re out of reach of a toilet for a short while.

Consider that if you are anxious and uptight when you try to go you’re fighting a losing battle!

Remember that toilet anxiety, shy bladder and shy bowel are real conditions. Like you, many other people struggle with these issues. And left unchecked, they can have significant effects on your health and life.

If you continue to have problems consider Cognitive Behavioural Therapy (CBT). Relaxation exercises or hypnosis may help too.

Finally, if you cannot deal with this on your own seek help. Talk to your doctor and mental health professionals for guidance. It’s time to let it go of the loo taboo!

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