When “it’s all in your head”

cm90210

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TLDR: My doc thinks my urinary problems over the past 10 months are caused by psychological issues - is this normal? Has this happened to you? Should I give up seeking for an alternate explanation? Have you ever heard of this? Am I being “gas lit”?

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I’ve shared on many prior threads that I’ve had a variety of bouts of bedwetting over the past 10 years or so - and most recently have been dealing with daytime urgency. I have seen a couple different urologists over the past 5 months and have tried a couple different medications (one was at a major medical school medical center). My prostate is fine, cystoscopy was normal, all blood work is normal, not consistently retaining urine after I pee, no ongoing infections, etc. None of my docs can really explain any kind of physical or medical cause for my recent urgency (some days I’m having to go to the bathroom every 45 or 60 minutes). In the 10 years prior, no one has been able to give me any reason or cause for the bedwetting either.

I’m taking Mybetriq right now for the past several months and I find a decided positive difference between when I’m on the med and when I go off (I’ve dropped it a few times because I wasn’t sure). But even it doesn’t resolve everything on every day. Some days and times I feel totally normal. But other days, especially when I’m stressed or in certain situations, my bladder really acts up even while on the medication. I also find that i have issues when I’m doing certain activities or having certain movements (running seems to be a trigger; going from sitting to standing; thinking about the bathroom at all or walking to it when I have an urge; etc... I relate with some of the recent conversation on here about Triggers). I’ve been considering asking for adding a second med along with the mybetriq (doc suggested oxybutinin in small doses can be good combined); or perhaps trying Botox which my Urologist is also recommending.

Of course, I’ve been a lifelong DL - and while there is some difference between needing and wanting incontinence products - figuring out where the lines are, trying to determine what is normal or abnormal, and understanding how my DLness might have impact on my new issues has been very confusing and challenging. Do I secretly want to NEED diapers? I honestly dont know. Some days, probably yes. Other times its very very inconvenient and embarrassing and stressful — and its in those moments when I definitely NEED them that I’m reminded that something is indeed wrong, whatever the cause.

In my most recent round of appointments with my GP, he is suggesting I go see a psychiatrist to get on some medication especially for anxiety - because he thinks that that is probably the underlying cause given that we have done all the tests and assessments and have found nothing except that I’m healthy. This is what my wife believes as well (and she also thinks that my DLness is contributing to it unconsciously as well). Note that she is supportive of me in every way, including supportive and to some degree participatory in ABDL activities. I’m not against getting on some mood medications although I’m generally pretty functional...I have been very very stressed lately and have had problems managing my emotions. I also have a history of a number of traumas and abuse situations including some ongoing PTSD. I have been medicated before in the past, and just didn’t tolerate the different options I tried before. I have never been to a psychiatrist.

The long and the short of it is - is it reasonable to guess and assume that these physical problems I’ve been having are really rooted in my mind/brain? Are chronic incontinence/urinary issues like mine commonly caused by psychology? My understanding is that there is almost always some underlying physical/bodily cause. I feel a little dismissed...also a little sensitive/judged by these conclusions. But I dont have any other information to go on... I really dont want to have future medical care jeopardized by having notes in my file that I have issues that are “all in my head”. I am also worried that my doctors are going to conclude that I have Münchausen syndrome or something similar, and that I am lying about my symptoms (believe me, I’ve questioned this myself at times — but then when I have had full blown wetting accidents in public, and overnight, my doubts dissipate).

But maybe there is some kind of brain/body connections that I’m not considering well...is that possible/likely? I follow the app Figure1 and sometimes on there they talk about a syndrome where real medical things emerge from the mind that are legitimate - and not based in lies... That seems extremely strange/rare. Just trying to figure out what I should do and how I approach this psych appointment with my fears and issues...

TLDR: My doc thinks my urinary problems over the past 10 months are caused by psychological issues - is this normal? Has this happened to you? Should I give up seeking for an alternate explanation? Have you ever heard of this? Am I being “gas lit”?


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Really, no idea about whether it's in your head or not, but that I'll say: do not underestimate human subconsciousness. It's an immensely powerful tool, that can affect the physical body far greater, than you know would like it to. There were some half-mythical cases, when a person was given a glass of crystal-clear water and died, because he genuinely believed he was given poison. Or when a person was shot at with a dummy gun and actually got wounded not because something hit him, but because he subconsciously believed he was hit by a bullet.
What I'm trying to say is: you have hardly any idea, what is going on in there, in your subconscious part of mind. It is totally possible for these symptoms to be 100% psychologically-created without any physical damage.
And it'd be best of you did check that part of yourself, just for the sake of it.
 
I think I would go to another doctor and get a second opinion. It could be psychosomatic, but probably there is a physical reason.
 
I think this could be a valid conclusion but I would (as Dogboy) said, get a second opinion.
 
If you have done all the medical tests there is a very good chance that it is psychological but incontinence may simply be stress-related, indeed in this case there is no miracle solution other than finding and settling what causes this stress. But actually the first thing to do, is to do all the medical tests
 
I am one of the many people who contribute to this board and who have never received a definitive diagnosis about the cause of our incontinence. Mine supposedly is the result of nerve damage resulting from excessive bleeding after abdominal surgery when I was 14 years. However, the nature of the nerve damage has never been definitely specified, and a couple of physicians have suggested that the problem may be based at least in part on psychological problems. I don’t think the problem is psychological, but who knows? In the end, an incontinence problem needs to be managed whatever the cause.
 
Just because there's no organic reason doesn't mean it's psychological.
 
willnotwill said:
Just because there's no organic reason doesn't mean it's psychological.

Right, my thought as well. Declaring the problem non-organic feels a little arrogant to me. Just because we haven’t discovered the underlying (non psychological) cause doesn’t mean there isn’t one.

But like others have echoed - the mind body connection is complicated - so perhaps there could indeed be some psychological component to this. I’m actually surprised there are some of you on here validating that line of thought...I mean, I’m not against it and am going to visit a psychiatrist in hopes of maybe getting clarity. But my knee jerk is to feel dismissed by it.
 
dogboy said:
I think I would go to another doctor and get a second opinion. It could be psychosomatic, but probably there is a physical reason.

Strangely enough, I’ve seen 2 different urologists for this, my neurologist I see for sleep (and another way back 10 years ago when the night time stuff started), my Gp, and then a surgery center I go to for yearly consults after a procedure they did, also have told my oncologist about it, lol. No one has any idea. I even went to a physical therapist who does pelvic floor stuff and they couldn’t find a physical cause. I’ll keep searching, but honestly, I’m getting wary of seeking more opinions and that in itself is a sign of the Münchausen syndrome thing I mentioned!!! Ugh lol
Thanks for your encouragement though,
 
cm90210 said:
Right, my thought as well. Declaring the problem non-organic feels a little arrogant to me. Just because we haven’t discovered the underlying (non psychological) cause doesn’t mean there isn’t one.

But like others have echoed - the mind body connection is complicated - so perhaps there could indeed be some psychological component to this. I’m actually surprised there are some of you on here validating that line of thought...I mean, I’m not against it and am going to visit a psychiatrist in hopes of maybe getting clarity. But my knee jerk is to feel dismissed by it.

In my opinion, "physiological" doesn't necessarily mean that a psychiatrist will be able to do anything. Non-organic, mental, may mean some kind of nerve pulse misfunction, that may only happen under certain circumstances. Like some kind of short circuit.
 
In 2008 my incontinence was caused by my PTSD and stress 2 years of counseling it just stopped fast forward to 2018 I started wetting the bed again and having daytime accidents I now have weakened bladder muscles don’t empty my bladder fully and have bladder spasms I now have OAB with urge incontinence am diapered 24/7 so it is possible it’s physiological but seek another opinion don’t give up or give in
 
It IS reasonable to consider all of the possible causes. It isn't reasonable tocblame the problem on something they don't understand simply because they don't understand the cause themself.

I went about 18 years bouncing from one urologist to another. It usually started of with them wanting to do a urodynamics study, my pain and inability to pee stopping the test, and the urologist not believing I really had any problems. I get put on some other prescription and eventually drop them due to a lack of results.

It wasn't until I went to the Mayo clinic where they took the time to actually listen to me. My urologist helpded me find a way to get through the urodynamics study, and with actual test results was almost immediately able to get a diagnosis of having urge incontinence and a neurogenic blockage.

So long story, short. Get another opinion. And keep getting other opinions until you find a urologist who will actually stop and listen to you, AND actually try to believe you too.
 
cm90210 said:
Strangely enough, I’ve seen 2 different urologists for this, my neurologist I see for sleep (and another way back 10 years ago when the night time stuff started), my Gp, and then a surgery center I go to for yearly consults after a procedure they did, also have told my oncologist about it, lol. No one has any idea. I even went to a physical therapist who does pelvic floor stuff and they couldn’t find a physical cause. I’ll keep searching, but honestly, I’m getting wary of seeking more opinions and that in itself is a sign of the Münchausen syndrome thing I mentioned!!! Ugh lol
Thanks for your encouragement though,

Two days ago my back was really hurting me. Yesterday my back hurt so much that it was radiating to my stomach and hips. I had decided that if it got any worse, I would go to the E. R. I also felt very anxious and my stomach was upset. Today I had none of those symptoms nor was I experiencing feelings of anxiety. I think it may have have all been related to grief, depression and anxiety, so it's possible that some emotional anxiety is causing your problem. The brain controls the rest of the body, so who knows.
 
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