Managing PTSD & Incontinence

Post-traumatic stress disorder (PTSD) is generally associated with nervousness, anxiety, and nightmares. It is also common for episodes of PTSD to cause sweating or trouble breathing, but what most people don’t realize is that PTSD can cause urinary accidents.

This post will explain why incontinence is a side effect of trauma and PTSD and what you can do to manage your symptoms.

Trauma & PTSD

Trauma is an emotional response to a life-changing event that can create shock, denial, flashbacks, dysregulated emotions, strained relationships, and physical symptoms.

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It’s reported that 70% of people in 24 countries have experienced a traumatic event, and around 30% have experienced as many as four traumatic events in their lifetimes.

Many things can cause trauma:

  • War and torture.
  • Childhood abuse or assault.
  • Losing a loved one.
  • Dealing with serious health problems.
  • Sexual abuse or assault.
  • Violent encounters.
  • Emotional abuse.
  • Serious accidents or injuries.
Causes of Trauma chartCauses of Trauma chart

After living through trauma, people may sometimes experience post-traumatic stress disorder (PTSD). About 1 in 3 people who live through trauma develop PTSD, but it isn’t currently known why only certain people develop PTSD. Those who do are typically young to middle adulthood, with a mean age of 23.

PTSD is a mental health condition triggered by a traumatic event that the individual was either involved in or witnessed. Often, the individual has difficulty recovering after the terrifying experience and can feel stressed or frightened even when they’re not in immediate danger.

PTSD is widely known among veterans who were on active duty. One study showed that around 12% of U.S. veterans were diagnosed with PTSD. This number includes men and women veterans. A women’s health study also found that among female veterans, 19% reported having urge or mixed incontinence.

It is also common for people to experience PTSD after sexual assault or abuse; One study showed that 75% of sexual assault survivors were diagnosed with PTSD a month after the assaults.

The Journal of Urology also found that among women diagnosed with PTSD:

  • 45% reported incontinence.
  • 23% reported stress urinary incontinence.
  • 23% reported urge incontinence.
  • 35% reported nocturia (bedwetting).

The severity and type of PTSD may vary due to various contributing factors. A person may have:

  • Short-term (acute) PTSD: Lasting for around six months.
  • Ongoing (chronic) PTSD: Lasting for more than a year.

It isn’t totally clear to healthcare professionals why PTSD occurs, but it’s suggested that it happens due to:

  • Your body attempting to keep you alive. Some research suggests that PTSD develops in order to keep you alive if the traumatic or life-threatening situation were to occur again. With the flight-or-fight response activated in your body, you can react more quickly and are more likely to survive.
  • Changes in your hippocampus. Your hippocampus is a part of the brain responsible for memory and emotion. It’s been found that in people with PTSD, their hippocampus is smaller in size. This is believed to be due to anxiety or fear.

The risk factors for developing PTSD include being predisposed to anxiety and depression.

PTSD symptoms generally include:

  • Re-experiencing symptoms through flashbacks or nightmares.
  • Avoiding event reminders (such as riding in a car after a car accident).
  • Experiencing angry outbursts or insomnia.
  • Feeling on edge and guilty.
  • Having issues recalling events surrounding the incident.
  • Being in a perpetual state of flight-or-fight.

Nocturnal enuresis, nighttime bedwetting, and urinary incontinence are also symptoms, especially in children, even if they’ve already been potty trained.

How PTSD Contributes to Incontinence

Reliving trauma and the anxiety that it puts on your body can activate the sympathetic nervous system, known as the fight-or-flight response.

During fight-or-flight, your body creates more of the stress hormone, adrenaline, and your body’s nerves are triggered, making you less prone to feeling pain and quicker to react to threatening stimuli.

When this adrenaline fills your body, your heart rate increases, causing more blood to flow through your body. Due to more blood flowing through your body, the kidneys filter more blood, resulting in an increase in urine production, which causes the bladder to fill faster.

Therefore, the bladder muscles tense up and contract, increasing the amount of pressure on the bladder, signaling the release of urine which causes bladder dysfunction and incontinence.

How PTSD causes incontinence in the bodyHow PTSD causes incontinence in the body

Incontinence is defined as a loss of bladder control and affects many people but is not normal. While there are different types of incontinence, such as stress urinary incontinence and overactive bladder, but PTSD is usually related to urge incontinence.

Urge incontinence occurs when you feel the sudden, unexpected urge to urinate. Usually, it may be impossible to make it to the bathroom in time when this urge comes about, leading to urine leakage. The urge to urinate may also happen at night, leading to bedwetting.

Managing PTSD & Incontinence

Episodes of urinary incontinence are quite common in individuals with PTSD, so it’s essential to have the right tools to manage these episodes. There are a variety of PTSD treatments available, but you also want to ensure that your incontinence symptoms are also treated.

It is also important to remember that incontinence can be a source of anxiety and embarrassment, and this anxiety can exacerbate symptoms further.

The following tips can help you manage PTSD and symptoms of incontinence.

1. See a Therapist

It can be an excellent option to meet with a therapist to have your symptoms evaluated. Talk therapy can help identify triggers that may be causing the incontinence to occur, along with cognitive behavioral therapy treatments to improve PTSD symptoms.

2. Wear Incontinence Products

If you are managing incontinence alongside PTSD after living through trauma, incontinence products may be able to alleviate some of the anxiety, shame, and stress away from your everyday life.

How to manage ptsd and incontinence infographicHow to manage ptsd and incontinence infographic

Adult briefs (diapers) and bladder control pads may be especially helpful in the case of urge incontinence by helping keep you dry when leakage occurs. You may also be eligible to get free incontinence products through your insurance and Aeroflow Urology. Check to see if you qualify in under two minutes.

3. Find Support

Make sure you communicate with a loved one who is managing PTSD, and if you are managing PTSD yourself, speak with loved ones you trust, a therapist, support groups, or veteran groups. Local support groups are another way for individuals with PTSD to talk through their PTSD symptoms.

The Department of Veterans Affairs is another support group that may be helpful to veterans managing PTSD and incontinence.

4. Learn Relaxation Techniques

Relaxation techniques, such as deep breathing and meditation, are incredibly beneficial if you struggle with an incontinence episode or PTSD.

It can be difficult to calm yourself during stressful moments; However, it’s recommended that you practice relaxation techniques before an episode occurs to help deactivate the sympathetic nervous system, restoring the body to a rest or digest state. This can also be a great technique for calming PTSD episodes, especially in children.

Woman meditatingWoman meditating

5. Visit Your Healthcare Provider

While your PTSD may cause your incontinence, incontinence can also be a symptom of a bladder condition or a urinary tract infection (UTI). A visit to the individual’s healthcare provider can be beneficial in treating or managing incontinence.

Your healthcare provider may also be able to help you find a therapist or other local or online support groups.

6. Do Pelvic Floor Exercises

If you’re managing incontinence, pelvic floor therapy or pelvic floor exercises will help you gain strength in your pelvic floor muscles, which can improve incontinence symptoms.

You can do these exercises in the comfort of your own home or with a group or therapist. Exercise can also help decrease the symptoms of PTSD by lessening anxiety and stress and increasing the hormones that make you happy.

How Aeroflow Urology Can Help You

Whether you or your loved one needs bladder control pads, underpads (chux), or protective underwear, Aeroflow Urology can assist with receiving incontinence products through your insurance.

This can help relieve some of the incontinence's financial stress, make accidents easier to manage, and bring back a better quality of life.

Once you find the right incontinence products for your needs, returning to your routine can be more achievable. This can also alleviate stress and give confidence to the individual in knowing that they are protected and covered if an accident occurs. 

To see if you or a loved one can qualify for free incontinence products, simply fill out our form.

Once approved, one of our Continence Care Specialists will reach out to you to answer questions, fill out the necessary paperwork, and send you free product samples.

After you’ve chosen your supplies, they’ll be sent directly to your home in discreet packaging every month. 

References:

NHS. (2021, February 17). Post-traumatic Stress Disorder. Nhs.uk. https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/

‌Trauma and Its Aftermath | SPH. (n.d.). Www.bu.edu. Retrieved May 4, 2022, from https://www.bu.edu/sph/news/articles/2018/trauma-and-its-aftermath/#:~:text=Traumatic%20events%20are%20a%20near

‌How Exercise Can Help Your PTSD Mentally and Physically. (n.d.). Verywell Mind. https://www.verywellmind.com/exercise-for-ptsd-2797465

‌Nodell, B. (2021, July 20). 75% of sexual assault survivors have PTSD one month later. Newsroom.uw.edu. https://newsroom.uw.edu/news/75-sexual-assault-survivors-have-ptsd-one-month-later

Hill and Ponton. (n.d.). PTSD and Veterans: Breaking Down the Statistics. Hill & Ponton, P.A. https://www.hillandponton.com/veterans-statistics/ptsd/

‌‌Lee, L. (n.d.). PTSD and Aging. https://www.ptsd.va.gov/publications/rq_docs/V30N4.pdf

‌PTSD Linked to Urinary Incontinence in Female Veterans. (2012, June 1). MPR. https://www.empr.com/home/news/drug-news/ptsd-linked-to-urinary-incontinence-in-female-veterans/

‌Boyd*, B., Gibson, C., Eeden, S. V. den, McCaw, B., Subak, L., Thom, D., & Huang, A. (2019). PD31-07 INTERPERSONAL TRAUMA: AN UNDER-RECOGNIZED RISK FACTOR FOR SYMPTOMATIC URINARY TRACT DYSFUNCTION IN MIDLIFE AND OLDER WOMEN. Journal of Urology, 201(Supplement 4). https://doi.org/10.1097/01.ju.0000556184.47145.af


Dr. Aleece Fosnight

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.

Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.

Disclaimer

Information provided on the Aeroflow Urology blog is not intended as a substitute to medical advice or care. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.

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