Symptoms And Treatment Options
Paruresis is a type of phobia and it is also known by the names bashful or shy bladder syndrome. A person suffering from this phobia will find it very difficult or even impossible to pass urine when other people are present. In other words, it is a fear that prevents a person from urinating in the absence of privacy (some or complete) depending on the severity of the condition. It is common for some people to experience difficulty in urinating when there are persons present in close proximity. However, paruresis is an extreme fear and it goes beyond just embarrassment and shyness.
This phobia can affect the quality of life of a person in many areas. Paruresis affects both men and women and is a common social phobia that many people experience. Typically, the phobia is experienced for the first time at school.
There is some evidence to the effect that paruresis may be hereditary. Some paruretics find it difficult to point to a specific incident that triggered the condition in them. However, some others attribute it to a traumatic experience that they went through before or during adolescence. The traumatic experience may range from embarrassment caused by a parent, harassment in public toilets, teasing by siblings or classmates to sexual abuse.
Symptoms of Paruresis
A person suffering from paruresis will generally be shy and sensitive and fearful of other people judging or criticizing him/her. The severity of the phobia can range from mild or moderate to severe. Some of the common signs and symptoms are as follows:
- They look for total privacy when they want to go to the toilet.
- They fear that other people may hear the sound of urine hitting the water in the toilet.
- They fear that other people may get the smell of urine.
- They engage in negative self-talk when they have to use a public toilet.
- They find it difficult to urinate in public toilets or bathrooms at other people’s homes.
- They experience difficulty in passing urine at home when there are guests or visitors.
- They may not be able to use the toilet at home if a person is waiting outside.
- They feel anxious about going to the toilet.
- They restrict their drinks to bring down the need to urinate.
- They avoid social events and travel as much as possible.
Paruresis Treatment Options
Often, people suffering from paruresis visit an urologist first to know if they have any physical problems. The urologist examines the patient to make sure that he/she does not have any physical ailment. The specialist gives reassurance that he/she is not the only one to have this problem and discusses behavioral approaches, including scheduling urination and using a private toilet instead of a urinal, in order to alleviate the patient’s problem. The urologist may teach the patient self-catheterization, if he/she prefers to do that, and refer him/her to an anxiety disorder specialist for cognitive as well as graduated exposure therapy.
Self-catheterization provides immediate relief to the patient and improves his/her quality of life to some extent. The minimal risk involved in self-catheterization practiced by patients who are otherwise healthy and intellectually able far outweighs the harm that this phobia can cause to the life of the patient.
Behavioral and exposure therapy have been found to be of great help to people suffering from paruresis. Case reports published over the past four decades indicate that this therapy helps to eliminate the problem partially in some and completely in the case of some other patients.
Some of the other methods of treatment that have been tried for alleviating the symptoms of paruresis include hypnotherapy, medications, sphincter botulinum toxin injection, paradoxical intention, and surgery.
A limited sample study showed that people suffering from paruresis may derive benefits if subjected to adjunct drug therapy. In the case of some patients, selective serotonin reuptake inhibitors (SSRIs) help reduce the anxiety levels so that graduated exposure therapy becomes more effective.
Summarizing, proper as well as effective treatment can relieve the symptoms of paruresis in most people. However, the disorder may come back occasionally. If proper education is given to the patient, he/she will be able to manage the situation without getting alarmed about recurrence. Cognitive behavioral therapy is seen to be effective in 80 percent to 90 percent of paruresis cases.
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Fear Of Urinating In Public – Treatment
Treatment Of Paruresis:
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