Facing trouble using public toilets, blame it on shy bladder syndrome

Bhubaneswar: Psychiatrists are nowadays getting complaints of people of all age groups suffering from shy bladder syndrome (paruresis), due to which they feel nervous and anxious to use public toilets and lavatories at hotels, restaurants, malls.
According to doctors, shy bladder syndrome is a social anxiety disorder due to which people are unable to or have severe difficulty in urinating outside. Though they may have to urgently go to the toilet, they have a lot of trouble peeing in a bathroom that isn’t their own. In some cases, it could lead to severe somatic or psychiatric complications. But there is treatment available, they said.
Dr Pallabi Sahu, consultant psychiatrist, SCB Medical College and Hospital, Cuttack, said most of these cases are referred by urologists. “When people suffer from this syndrome, they usually go to an urologist because they are unaware. When an urologist find no convincing diagnosis of their complaints, he refers the case to a psychiatrist, who detects the psychiatric aspects,” she explained. Its prevalence is not exactly known in India because of stigma associated with visiting a psychiatrist.
“The syndrome is basically triggered by post-traumatic stress disorder (PTSD). When a person has experienced trauma that has caused social anxiety of some sort, it could lead to shy bladder syndrome,” said Dr Chitrabh Raghav Sinha, who runs a campaign to break social stigma related to mental illness in Delhi.
“There is nothing to panic or associate the syndrome with taboo. Such syndrome is not very uncommon and most of the people can overcome it through counselling and relaxation exercises,” he said.
Dr Lagnajit Dash, another psychiatrist, said cognitive behaviour therapy can help by viewing the patient’s anxiety from a different perspective. “Therapists help people suffering from this syndrome to pee without inhibitions in bathrooms used by others. This is done in graded manner,” he said.
“Besides cognitive therapy, doctors also prescribe alpha-blocker medicines to help open the patient’s bladder sphincter to urinate,” said senior psychiatrist Samrat Kar. “There are anti-anxiety drugs that we give to some patients to relieve nervous disorder. Sometimes, both psychotherapy and medicines are prescribed,” he said.