Mind Over Bladder: Mental Tricks for Managing OAB
If you have overactive bladder (OAB), you know that it’s a very real physical issue. But although the problem is physical, some time-tested methods for managing it are psychological.
The mental strategies below may help control the urge to go. These techniques may also ease stress and anxiety about the possibility of having an accident.
Mental strategies are easy to learn, simple to use, and free of harmful side effects. Such strategies are often combined with other OAB treatments, such as pelvic muscle exercises and medication. Ask your doctor how these approaches fit into your personal treatment plan for OAB.
Retrain your brain.
The sphincters are a ring of muscles that hold the bladder closed. During urination, the bladder squeezes and the sphincters relax, letting urine escape the bladder. Normally, the brain sends signals that control when this happens. In people with OAB, the process no longer works as smoothly as it once did. With practice, however, many people are able to retrain the brain to control the bladder again.
The National Association for Continence outlines a typical, six-week retraining program on its website. Ask your doctor if this type of program is right for you. It involves urinating on a schedule, gradually lengthening the time between bathroom visits. If you have the urge to go between scheduled times, mental distraction or relaxation (the next two strategies) often can help you ignore the urge until it goes away.
Distract your mind.
When the urge to go strikes at an inopportune moment, try thinking about something else until the urge passes. Focus on a complex mental task that demands all your attention. For example:
Count backward from 99 by threes
Recite all the words to a song or poem you learned as a child
Recall the first and last names of everyone in a large office
Practice giving directions to your home from various locations
Relax your body.
Focusing on relaxing thoughts is another way to take your mind off the urge to go to the bathroom. Plus, relaxation eases anxiety and stress, which may result from unexpected bathroom breaks or worries about getting to the toilet. You can use this quick and easy relaxation technique anywhere, anytime:
Take several deep breaths to calm your mind. Then picture yourself on a relaxing vacation. Use all your senses to paint a vivid scene in your mind. If you picture a beach scene, for example, you might imagine the sight of palm trees, the sound of the surf, the feel of a swaying hammock, and the taste of salt in the air.
Live in the moment.
Mindfulness works differently from distraction. Instead of ignoring an urge, you make a conscious choice to notice whatever you’re experiencing from moment to moment. You take note of sensations, thoughts and feelings, but then you move on to the next moment. This helps you see the urge to urinate as just another body sensation, which you can notice without becoming preoccupied with it.
In one small study, women who had sudden, strong urges to urinate along with urine leaks were randomly assigned to eight weeks of either mindfulness or yoga classes. Women in the mindfulness group had fewer accidents than those in the yoga group. For many, the benefits were still apparent a year later.
Like any skill, mindfulness can be honed through regular practice. Try this exercise:
Take a mindful stroll. As you walk, notice the sensation of your muscles working, your feet pressing against the ground, and your breath moving in and out. Also take note of the sights, sounds and smells around you. If other thoughts come to mind, notice them without judging them. Then let go of those thoughts as you move on to whatever the next moment brings.
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- Baker, J, et al. Comparison of mindfulness-based stress reduction versus yoga on urinary urge incontinence. Female Pelvic Medicine and Reconstructive Surgery. 2014;20(3):141-6.
- Lee, HE, et al. Short-term effects of a systematized bladder training program for idiopathic overactive bladder: A prospective study. International Neurology Journal. 2013;17(1):11-7.
- Mattiasson, A, et al. Efficacy of simplified bladder training in patients with overactive bladder receiving a solifenacin flexible-dose regimen: Results from a randomized study. BJU International. 2010:105(8):1126-35.
- Sinclair, AJ, Ramsay, IN. The psychosocial impact of urinary incontinence in women. The Obstetrician and Gynaecologist. 2011;13:143-8.
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- Overactive bladder, National Association for Continence, April 30, 2014. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/urge-incontinence/
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