Our bladders are one of those great design features of the human body, enabling us to store urine then release it when it’s convenient. When the system works well it’s really helpful, bladders being somewhat elastic in capacity. But an over-active bladder can really disrupt your life, constantly prompting you to seek out a toilet, and urgently. Particularly annoying if you then find it wasn’t really full after all, or if, once you get there, your bladder seems to have changed its mind and refuses to empty.
I’ve noticed that some people seem to be more susceptible to bladder problems, particularly if they are inherently anxious. Could there be a connection? Off I went for a swim in the ocean of peer reviewed studies to see whether science would confirm what I suspected – that the greater your anxiety, the more vulnerable you are to bladder problems.
I didn’t have to get more than ankle deep in the sea of literature before answers began to appear. In one particularly useful study (citation at the end of this article) rats were subjected to stress, their pattern of urination noted, then their bladder tissue examined for changes. The scientists found that even ten days of stress caused bladder changes. Specifically, they found that with extra stress more ‘mast’ cells appeared in the wall of the bladder.
Mast cells are a particular immune cell charged with monitoring their local area for problem substances (like those we’re allergic to). When they encounter an allergen they ‘activate’, releasing powerful chemicals including histamine to attract more immune cells to the area. They then inactivate the offending substance, orchestrate allergic reactions, expel the offender and generally create an unholy mess until other immune cells arrive to clean up. If you’ve experienced the sneezing and runny nose of hay fever in response to pollen then you’ve experienced mast cell activation.
More mast cells in your bladder wall means your bladder is over-primed to respond, and over-respond it certainly can, leading to an over-active bladder. More anxiety in the long term means more mast cells. So it seems there really is a connection between anxiety and bladder problems.
The solution to an over-active bladder, though, is to focus recovery efforts at the other end of your body; what’s happening inside your skull. Like so many health problems, managing your stress response and seeking out ways to become more resilient to stress is actually the most powerful therapy.
Smith, A. L., Leung, J., Kun, S., Zhang, R., Karagiannides, I., Raz, S., ... & Mayer, E. A. (2011). The effects of acute and chronic psychological stress on bladder function in a rodent model. Urology, 78(4), 967-e1.
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