Emotions and Incontinence

By Katherine Bontrager

While on first glance incontinence may seem like solely a physical issue, bladder leaks can affect emotions, bringing up a wealth of feelings that often can be difficult to manage. But by learning to overcome the emotional effects of incontinence, you can ensure that it won't keep you from living your life.

Men Versus Women

Incontinence-related emotions vary widely depending on the circumstances and the individual, says Nancy Muller, executive director of the National Association for Continence (NAFC).

"Men are often bewildered, devastated, angry and frustrated," Muller says. In contrast, women often express embarrassment, a reluctance to talk about their symptoms and even guilt, she says. "They harbor myths about causal factors, such as the mistaken belief that their incontinence is just a natural part of aging or just a part of being a woman, and therefore something to accept and live with," she says.

Conquering Fear and Embarrassment

Betsy Lampe has been incontinent since undergoing a hysterectomy in the early 1990s, and she knows all about the emotions that often go hand in hand with bladder weakness. "I do many speaking engagements about writing and publishing, and I always insist on having a podium," Lampe says. "Not because I like to have a microphone or because I need something to lean on, but because I want something in front of me in case I have a leak."

The emotional whirlwind of incontinence starts with a fear of being discovered and a fear of being wet in public, says Cheryle Gartley, founder and president of The Simon Foundation for Continence, a not-for-profit organization that seeks to increase the public awareness about incontinence. So people choose to remain at home so they can be close to a bathroom, she says. "This behavior leads to isolation, which leads to a downhill cycle of depression, robbing people of their coping mechanisms," says Gartley. The necessary first step is to consciously recognize what is happening, Gartley says. "We talk to thousands of people every year and many times they don’t realize how it’s affected their lives," she says. "Specific words come up like 'used to.' ‘I used to play tennis; I used to be active in my church.’"

To manage such feelings, Dr. Susan Bartell, a licensed psychologist specializing in family issues, suggests that each day you make a plan to do something from your "normal" life and then follow through with it. "It doesn't have to be complex or difficult, but as you resume these normal activities you will begin to see that self-imposed isolation is not necessary," she says.

In fact, staying active, both socially and physically, is the best prescription for beating the blues. Social connections help combat negative feelings, and physical activity can promote the release of endorphins, proteins in the brain that act as the body's natural pain reliever. When endorphins are released, a person may experience a feeling of euphoria, which can improve your mood and the way you feel about yourself.

Lampe ensures incontinence doesn’t rule her life and still manages to work and play with great enthusiasm. "I still do what I want to do, I just plan ahead for incontinence," she says. "I jet ski for fun ... and sometimes lift heavy boxes of books at work ... I don’t let incontinence, or the threat of it, turn me into a sedentary old lady."

Overcoming Depression

If you don't conquer the negativity that often comes with a diagnosis of incontinence, it can quickly lead to depression, an experience with which Missy Lavender is intimately familiar.

Lavender became incontinent following the forceps-assisted birth of her first child, awakening the morning after giving birth in complete disbelief. There was no mention of this in childbirth classes or the books and magazines she had so carefully studied. "I was horrified and went on the Web and spent all this time doing research," says Lavender, who lives in Chicago. "And nothing I found looked like me. I was very upset and very depressed."

It wasn’t until she found an urogynecologist who helped her understand how to manage and treat the condition that Lavender began to feel less isolated. "The years following, until I had a full pelvic reconstruction in December 2001, were miserable, to put it mildly, for me and my husband as I struggled to feel good about myself," she says. "It’s a hard thing even now. Years after pelvic surgery I’m still working on feeling sexy, feeling like a woman."

Over the years, Lavender has talked with dozens of women and doctors about incontinence and now encourages women experiencing the same difficulties through her organization: the Women’s Health Foundation. The foundation offers a program that helps women learn how to exercise, while educating them about bladder and pelvic health.

Besides educating yourself about the medical aspects of the condition, it's also important to realize that there are countless others who are sharing the same experiences, says Dr. Bartell.

People also may be unwilling to share their feelings with other people, even a spouse. "It is important to share your feelings with a partner and also ask for support," Dr. Bartell says. "Keeping this a secret will only cause more of an emotional burden. If necessary, it can be very helpful to speak with a counselor who can help you understand your feelings and offer support in coping with the changes you are experiencing in your life."

Your doctor is also a great person with whom to discuss incontinence and express your feelings. Your physician can help encourage you by talking about treatment options, as well as offering ways to manage the condition.

"Once you take it from the subconscious to the conscious, you can start to decide what to do," Gartley says. "As you start to decide how to live your life, you will become a problem solver and that diffuses the emotional impact of incontinence."