What is toilet anxiety and how can we manage it?

When a medical condition makes you need the toilet suddenly, ongoing worry about where the nearest one is, is understandable. Here we explore toilet anxiety, and, crucially, how to cope with it

Imagine you’re somewhere you’ve never been before, and you suddenly realise you need to use the bathroom. You start looking around and asking people where the nearest toilet is, but there doesn’t seem to be one nearby.

Many of us will instantly recognise the fear that can rise in situations like this. The worries of ‘What if I can’t find anywhere to go?’ or ‘What if I don’t make it to the bathroom?’ For most of us, however, this experience is rare. For those with inflammatory bowel disease (IBD) or overactive bladder (OAB), this experience is more common, and can understandably lead to anxiety.

I’ll be honest, my motivation for writing about this is personal. Several members of my family live with these conditions, and my mum in particular (who has ulcerative colitis) has been struggling with anxiety around accessing toilets. At its worst, toilet anxiety can stop people living their lives, making travel difficult, and spontaneous activities fraught with worry.

April Trawicki, support services manager at Crohn’s & Colitis UK, explains how IBD might impact someone’s mental health.

“The symptoms of Crohn’s and colitis, such as fatigue, pain and an urgent need for the toilet, can be challenging to cope with. They can make someone worried about leaving home and seriously affect their work and social life. This can lead to feelings of isolation, and can increase the risk of depression or anxiety.”

April goes on to note that as they are fluctuating conditions, it can be difficult to plan ahead as every day can be different and unpredictable. “They are also hidden conditions, meaning others don’t always understand the impact of having Crohn’s or colitis,” she adds.

Alongside the hidden nature of these illnesses, there is the stigma society attaches to bodily functions. Talking about our toilet habits isn’t the easiest thing, but this is something the IBD charity encourages, offering a Talking Toolkit for those living with Crohn’s and Colitis to tell loved ones about their experience (visit ittakesguts.org.uk to access).

Other practical tools April recommends include joining Crohn’s & colitis UK to receive a ‘Can’t Wait Card’ and a RADAR key.

“Both can be used to help access toilets when out and about,” April explains. “We know that planning toilet access on journeys before people set off can help people feel more confident away from home. There are many toilet map apps available online, which can help with journey planning.

“Some people also carry an emergency kit, such as a change of clothes, alcohol-free wet wipes, and a neutraliser aerosol to disguise odour is useful.”

After seeing multiple doctors and nutritional experts, my mum is now finding some relief physically – but the psychological impact can be harder to manage. In terms of treatment, cognitive behavioral therapy (CBT) is often recommended for anxiety. CBT looks to help people understand the link between thoughts, feelings, and behaviours, working to find helpful thought processes around the situation that causes anxiety.

For many, this can be extremely useful. For others, however, this approach doesn’t always help. We’re all different, and therefore it can be useful to explore other options. An approach my mum has started looking into, for example, is hypnotherapy.

Using hypnosis to work with the subconscious, hypnotherapists support clients in ‘rewiring’ neural pathways so they respond to anxiety differently. Hypnotherapist Shonagh Terry’s first client with this problem had an overactive bladder and, after 25 years, was desperate for help.

Shonagh explains that she took some time to talk to the client about the subconscious, and how it is in charge “even though the conscious mind is the one they are aware of”, and how hypnotherapy can influence the emotional reaction to our thoughts.

During the session, Shonagh used self-esteem and confidence as the basis of her suggestions. “Two days later she phoned and said, ‘I don’t know what you have done, but I haven’t had a single leak since I saw you.’ I was as delighted as she was. She came back in a week, and had had one incident.

“Over time, she did have moments when she lapsed slightly, but when we examined the situations, anxiety from a life experience had a major part to play in it. She stopped all medication. Her GP and consultant were delighted for her.

“The treatment plan I used with her I have used as a basis for all my bowel and bladder conditions. I am always amazed at the success rate they have, and I ensure I constantly praise, accentuate the positive, and emphasize that they can take back control.”

When you pick apart most cases of anxiety, it seems that a lack of control is at their heart. So I can understand how being empowered to take back control, especially with conditions like these, would have a powerful effect.

A technique that can help with this, Shonagh says, is identifying where you lack balance in terms of influence and concern.

“Look at your life and make a list of what’s bothering you, including habitual behaviours. It should be no longer than eight items,” Shonagh says. “Tackle the biggest thing first. Imagine two circles, one called influence and one called concern. They should be roughly equal in size. If your influence is small and the concern is large, you’re out of balance/control.

“Reduce or increase the circles until they are more in balance. That may mean identifying the positives in your life, rejecting negative thoughts or associating with negative/critical people, and/or finding a consultant, expert, or therapist who you feel in-tune with to help you through your maze.”

So, what tools can you use to support yourself?

1. Practical preparation (ie having a ‘Can’t Wait Card’, a RADAR key, and an emergency kit for peace of mind).

2. Community support (ie connecting with others who ‘get it’, and explaining your condition to friends, family,
and co-workers).

3. Psychological support (ie looking into CBT or hypnotherapy to help you manage anxiety and build confidence).

Underlying all of this is taking care of your physical health, working with doctors, and making recommended lifestyle shifts. Together, these approaches can help you regain a sense of control, and live life to the fullest, because you absolutely deserve to.


To find out more, visit Hypnotheraphy Directory.

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