Hands up if you avoid public toilets, preferring to hold on until you can go at home? Well, you're not alone. It has a name -- it's called toilet anxiety.
"Toilet anxiety, or toilet phobia, is a term used to describe a number of issues related to using the toilet. It is a type of anxiety in which the sufferer may experience concerns and fears related to being able to urinate or defecate, using a public toilet, being too far from a toilet, having an accident in public, other people being able to hear or see you use the toilet, the cleanliness of public toilets, or being confined in a small space," Dr Simon Knowles, senior lecturer at the Swinburne University of Technology Told The Huffington Post Australia.
Toilet anxiety is so prevalent -- affecting up to 32 percent of Australians -- that Dr Knowles has completed a study on the topic.
"Like other anxiety conditions, the age of onset for toilet anxiety tends to start in adolescence although can occur later in life. Current prevalence is unknown however research suggests rates between 6.5 up to 32 percent of the population may be affected to some degree."
Toilet anxiety not only relates to the use of public toilets, but home ones, too.
"For some individuals, anxiety associated with using their own toilet at home may occur if they perceive others in the house may hear them or require the toilet soon after them. Another common source of anxiety is associated with the use of toilets in a work environment. In some workplaces, toilets are very close to the offices, therefore resulting in the fear that work colleagues may hear them while using the toilet. Anxiety may also be due to worries that work colleagues would use the toilets as the same, or close to the same time they do," Dr Knowles said.
Individuals experiencing shy bladder or bowel are likely to report anxiety which can feel overwhelming.
"Another form of toilet-related anxiety we are currently researching is the anxiety associated with not being able to make it to a toilet in time. Many clients I have worked with have significant anxiety relating to a fear of not making it to the toilet in time. Consequently, they often go to extreme lengths to avoid this situation, this can include only going out to locations where there are many freely available restrooms and at times then they are less likely to be used and/or taking drugs to reduce the need to use public toilets."
While the problem may not seem that serious at first thought, it can result in other complications down the track.
"Individuals experiencing shy bladder or bowel are likely to report anxiety which can feel overwhelming and as a consequence have a significant impact upon their quality of life. This can include avoidance of activities that many of us take for granted, such as going of shopping, eating in restaurants, social activities, and in extreme cases engaging in work."
"In relation to physical complications, individual can experience a range of symptoms including abdominal pain and distress. Unfortunately, individuals can experience considerable shame and avoid seeking treatment. Self-management strategies, such as taking over the counter medications, to reduce the need to use a toilet in public, or avoid potential accidents in public can create cycles of increasing distress, both physical and psychological," Dr Knowles said.
The good news is that there are solutions.
"The first and most essential step is to seek advice. It is important that if an individual has any health concerns, psychological and/or physiological, they discuss them with their local GP. The GP will be able to help identify the treatment options or referrals to specialist services that would be most appropriate -- this might include a referral to a urologist, gastroenterologist or psychologist."
"While there is limited research exploring the efficacy of psychological interventions for shy bladder or bowel, we do know that there is very strong evidence for the effectiveness of psychological treatments in relation to anxiety and functional-based gastrointestinal conditions, such as Irritable Bowel Syndrome," Dr Knowles said.
The ongoing research programs at Swinburne led by Dr Knowles aim to develop free online psychological interventions to help people with gastrointestinal conditions.
"Currently at toiletanxiety.org we have information about what toilet anxiety is and also several free handouts on strategies that may be used to help challenge the shy bladder or bowel. With luck and financial support we hope to develop and evaluate a free online intervention for shy bladder and bowel over the next couple of years," Dr Knowles.