ADVICE: Why do I have to pee when I'm nervous?

Needing a bathroom break when you have the jitters is common. Here are some ways to calm the urge.

Maja Begovic March 5, 2021
nervous peeing

Dear Asking For a Friend,

I am in the midst of looking for a job and fortunately, I have had a number of virtual interviews. Generally, I think I present well and appear confident and smart. But here’s the thing — I get really nervous. And it’s more than just sweaty palms. As soon as the interview starts, I have to pee. I have tried not drinking anything beforehand, and also emptying my bladder (repeatedly), but it never fails — instead of focusing on what I am saying, I am thinking about how much I have to run to the washroom. It’s really frustrating and not good for my confidence.

Signed, Gotta Go

Dear Gotta Go,

When we feel nervous, it sets off a chain reaction in the body — our stress response activates in preparation for a real or perceived threat — our blood pressure increases, and our breathing becomes shallow. Below the belt, moments of nervousness can also impact our bladder.

According to Dr. Humberto Vigil, a urologist at The Ottawa Hospital, one of the main centers in our brain — the pontine micturition center — that controls our normal voiding is located in close proximity to another major brain center called the limbic system, which plays a major role in supporting our emotions and behaviours.

“Scenarios or situations that are anxiety-provoking or stressful will activate the limbic system, and potentially the pontine micturition center as well,” he says. “Stimulation of the pontine micturition center is essentially like turning the ‘on’ switch for voiding, and will lead to increased bladder sensitivity and overactivity.”

In addition to biological reasons, muscle tension might also be to blame. When we feel anxious, we hold tension in our body, including the muscles around the bladder, which may trigger urinary urgency. Anxiety can also make us hypersensitive, exasperating feelings of a full bladder, and there is some evidence to suggest that when we’re anxious, our bodies may process liquids more quickly than usual.

To manage your symptoms, Vigil suggests avoiding common bladder irritants, such as caffeine, carbonated beverages, alcohol, spicy foods and smoking. You could also try contracting pelvic floor muscles rapidly five times to help subside urgency, followed by shifting your attention away from your bladder. Finally, avoiding triggers of bladder overactivity around anxiety-provoking situations specifically can also be beneficial.

You could also try distracting yourself in the moment with simple tricks often used to control an overactive bladder, such as counting backward from 99, reciting the lyrics of your favourite song or thinking of the first and last names of the people you work with. You can also practice relaxation techniques daily to help you feel more calm in high-stress situations.

A 2008 study by Dr. Ardesheer Talati, an assistant professor of clinical neurobiology at Columbia University, found that people with anxiety disorders were eight times more likely to experience “bladder pain and an urgency to urinate,” and that these symptoms may occur intermittently or persistently.

Vigil suggests that those with significant issues with generalized anxiety or social phobias, would benefit from management directed at their anxiety either through mindful exercises, meditation, cognitive behavioral therapy or medication.

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