Paruresis is a social anxiety disorder characterized by difficulty urinating which is rooted in a psychological, rather than physical, cause. This psychological condition may also be referred to as bashful bladder syndrome or shy bladder syndrome. The severity of paruresis can vary. Some people have very mild cases which cause occasional inconvenience while others must make lifestyle changes to cope with the issue, and in rare cases people may not be able to urinate without a catheter.
Like other social anxiety disorders, paruresis is believed to be rooted in a trauma. However, that trauma may not always be directly related to urination. Certainly things like being bullied in a restroom, mocked while trying to produce a urine sample, or teased for incontinence can contribute. However, people with a history of any sort of abuse may develop paruresis and other anxiety disorders.
People with paruresis usually have difficulty urinating in a setting where they think that they are being observed or where people are in close proximity. A public restroom is a classic example. However, people can also experience difficulties when they try to pee in unfamiliar environments, or even when they use the restrooms in their own homes and people are around. People may also develop other anxieties, such as nervousness about hearing the sound of urination or fears of restrooms which develop as a result of having difficulty urinating.
If someone experiences difficulty urinating, it is advisable to go to a urologist to rule out physical causes. The urologist can review the patient's history and run some tests to determine whether or not a problem like a bladder infection or prostate enlargement is responsible. If there are no physical causes, a mental health professional can be consulted for advice.
Paruresis treatment can take a number of forms. Therapy is usually strongly recommended so that patients can work through the trauma which may be at the root of the problem, and therapy can also be used to provide people with coping techniques. If a patient is experiencing physical problems such as bladder infections as a result of paruresis, a doctor can provide medication and counseling. As with any social anxiety disorder treatment, sometimes patients need to work with several counselors to find one who is a good fit. It is difficult for treatment to progress if the patient does not like the therapist or feels uncomfortable, and people should not be ashamed to find a different therapist.