Bashful bladder syndrome (BBS), or paruresis, is a psychological disorder that makes it very difficult for people to pass urine especially if they feel they may be interrupted, don’t have adequate privacy, or if they must urinate for things like urine samples. It is not that uncommon, though degree to which it may affect people varies. It’s also been shown to be more common in men than in women, potentially due to the relative lack of privacy in men’s public restrooms.
The bashful bladder syndrome is considered a social phobia, somewhat akin to shyness, and the term shy bladder may be used instead. Bashful bladder is no joking matter for people it affects significantly, because it can mean that those with the condition can seldom go out for longer than a few hours, take trips because of the necessity of using public restrooms, and the like. It can also cross over into creating medical problems, since failure to urinate regularly can cause urinary tract infections.
What causes bashful bladder is not always known, though some people in treatment may point to specific traumatic events as children that created the condition. When the cause is unknown, it’s important to determine that failure to urinate when needed is not the result of things like an enlarged prostate gland. People with the condition should see a doctor to rule out specific medical as opposed to psychological causes.
Most often, people with bashful bladder know they have it because trying to urinate, especially in public restrooms, generally results in being unable to. BBS may cause a person shame, extreme discomfort that urination doesn’t occur and can cost a tremendous amount of time while a person waits for an empty public bathroom or needs to return to a “home” toilet to urinate.
Often, when a person with BBS is at home, urinating may not be difficult provided no one is waiting to use the bathroom or the person does not fear intrusion by others. There are a few triggers that seem to set the condition off. These include having to urinate in a public environment, sensing that other people are close to the bathroom or might hear, and the available structures that may lend privacy. This last trigger may be why the condition occurs more with men, since group public bathrooms for men feature few stalls, and some stalls do not even have doors on them.
The main treatment for bashful bladder syndrome is therapy, and occasionally medication. Social anxiety is now being treated with a variety of medications like Paxil® in combination with therapies like cognitive behavioral therapy. There are also support groups for people with the condition, including the International Paruresis Association (IPA). It may be very helpful to know that a person is not alone in fighting this condition, and the IPA has numerous links to important information about the condition.
