In this brief blog, we are going to talk about toilet anxiety, what is toilet anxiety? And how can it be treated?

Is there a fear of pooping?

Believe it or not, some people have a  genuine fear of pooping. In most cases, the fear of pooping is brought about due to the anxiety of using public toilets. In some cases, the anxiety of actually pooping can be so bad where it actually turns into a phobia. Toilet phobia is actually experienced by a lot of people but it is rarely talked about by most people. If you have toilet anxiety and a serious fear of pooping in public then there are a lot of treatments for toilet anxiety.

What is the fear of toilets called?

The fear of toilets is known as paruresis. Paruresis is a fear of defecating in public places or the fear of using public toilets to pee or poop. You may experience toilet anxiety which is a phobia and can cause you to have panic attacks. If you suffer from this fear of toilets then you should seek medical help.

Can anxiety make you feel like you need to poop?

 Yes, anxiety can make you feel like you need to poop but this is mostly with people who have irritable bowel syndrome and people can feel much more stress and anxiety which leads them to need to poop. Anxiety can make you have abdominal pain, cramps and make you feel so sick that you need to poop.

What is Coprophobia?

Coprophobia is quite different from toilet anxiety. Coprophobia is the fear of faeces, excrement, or defecation. The term coprophobia came from the Greek meaning of faeces and fear. Coprophobia is clearly a particular type of phobia which can affect many people.

toilet anxiety

What is toilet anxiety?

Toilet anxiety is the phobia of using toilets. It is very common but not well spoken about, it is the anxiety of fear that surrounds your need to use the toilet. 

Toilet anxiety can manifest as different things. It can be a sensation or feeling that you need to go to the toilet, you may worry that you can’t get to a bathroom on time, it could also be a fear of the sensation of going to the toilet, you may be concerned that you will ease yourself without a bathroom and may need to be next to the bathroom all the time.

Toilet anxiety is a real mental health problem and you may be experiencing it as you experience any of the below:

  • You are scared of being in small confined spaces such as a cubicle
  • Scared of how clean toilets are
  • Scared of the feeling of actually relieving yourself at the toilet
  • Fear of being too far from a toilet
  • Fear of other people hearing you when you go to the toilet
  • Fear of using a public toilet
  • Fear of having an accident in the public

What is the history of toilet anxiety?

According to the toilet anxiety website, the history of toilet anxiety goes as per the below.

Paruresis

The term “paruresis” was first coined in 1954 by Williams and Degenhardt. Before this time, research into urinary dysfunction tended to focus on possible failures of the bladder and associated structures. While some references were made to a psychological influence on urinary function, Williams and Degenhardt were the first to describe a disorder of micturition (urination) in which the inability to pass urine was associated with social conditions.

Since then, a lack of clarity around definitions has become apparent. While some authors use terms such as paruresis and psychogenic urinary retention interchangeably, others argue that there is a distinction to be made. Specifically, that paruresis refers to an inability to pass urine in the presence of others, while psychogenic urinary retention refers to a chronic inability to pass urine that is not alleviated by a change in social conditions. Additionally, in 2002, Vythilingum, Stein, and Soifer altered the definition of paruresis from being a difficulty initiating the flow of urine in the presence of others, to the fear of not being able to urinate in the presence of others.

In the limited papers published on the topic, there has also been ongoing disagreement over the classification of paruresis as a social anxiety disorder. In the DSM-IV-TR, paruresis is considered to be a variation, or a symptom, of social anxiety disorder. Paruresis has also been described as a type of performance anxiety, which is often seen in social anxiety disorder. However, it has been suggested that paruresis may be a distinct condition, which merely overlaps with the symptoms of social anxiety disorder.

Parcopresis

Even less is known about parcopresis, and much of what has been written about the condition seems to be based on paruresis research. In the absence of an appropriate medical term for anxiety around defecating in public places, the creators of shybowel.com began to utilize the term “parcopresis”. The term has since appeared in scientific literature and on specialist toilet phobia websites.”

toilet anxiety

What causes toilet anxiety?

There are various things that cause toilet anxiety to develop. They include:

Family ties

If your father or mother experienced fears of using the toilet you may find that you subscribe to the same fears as you could see toilets as being a scary place.

Past experience or trauma

If you have had a bad experience which caused you trauma in the past and this incident was related to using the toilet then you may find that using the toilet in the future could potentially be difficult. Things that could cause trauma which ends up developing to toilet anxiety could be: having a toilet accident in childhood, being embarrassed or teased in a bathroom, being bullied in a bathroom or being unable to produce a urine sample.

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Anxiety and fear

Anxiety and fear can cause you to have toilet anxiety as you avoid any place which will make you afraid or cause you to have increased anxiety. Anxiety can also affect your ability to pee through some physiological processes which affect the function of some muscles which are the detrusor muscle and the external urethral sphincter which then make it difficult to pee. Your inability to pee could then add to your anxiety.

Comorbidity

Toilet anxiety is associated with a number of other psychological conditions, including social phobia, depression, alcohol problems, and obsessive-compulsive disorder (OCD).

Mental health conditions associated with Toilet Anxiety

There are other health conditions which can be associated with toilet anxiety and can also cause toilet anxiety in some cases.

Depression

Depression is when you have a low mood for quite a long period. You can be depressed if your mood is low for more than two weeks. People who are depressed may avoid doing very simple acts such as going to the toilet.

Agoraphobia

Agoraphobia is a type of phobia which creates the fear of being in places which you may not be able to escape from. This means people who have agoraphobia will usually avoid leaving safe places and entering places which they cannot escape from. Agoraphobia can, therefore, create toilet anxiety as most people are afraid of leaving their house and having to use a toilet which is outside.

Panic Disorder

Panic disorder can also cause people to have toilet anxiety as they may fear that they could develop panic attacks due to a fear of using toilets. If you have ever had a panic attack in a toilet then you may naturally avoid using toilets.  A panic attack is an intense episode of suddenly increased anxiety, sweating increased heart rate, shortness of breath, dizziness, fear of dying and trembling. If you have experienced this in a toilet then it may end up leading to toilet anxiety.

Social phobia

Social phobia (or social anxiety disorder) involves a fear of social situations and any situation that involves social interaction. This means most people with this phobia may not want to use the toilet due to fears of seeing someone they know or having to speak to someone at the toilet.  Social phobia makes people scared of being confronted, judged, spoken about. Seen or even observed and this can lead to toilet anxiety as they avoid places where any of these things can happen, even by strangers.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD)  can cause toilet anxiety as it involves people who have unwanted obsessions such or compulsions which they constantly obsess about. This could be cleanliness for example or even safety. Having OCD could then lead to toilet anxiety as most people avoid public toilets due to the fear of the toilet being clean or safe.

Treatments for Toilet Anxiety

There are various treatments for toilet anxiety which your mental health practitioner may recommend for you if you are suffering from this phobia.

The type of toilet anxiety you may have will differ from one person to the other and hence the treatments that may be recommended to help you get rid of your phobia will differ based on your condition.

When treating your toilet anxiety your mental health expert may need to treat the psychological conditions which accompany it.

Some of the treatments for toilet anxiety include:

Medication for toilet anxiety

Medication isn’t a very common method of treating toilet anxiety and the medication which has been trialled and used so far has not produced any significant benefits so far. In some cases, medication may be used to help any other mental health conditions which could have caused the toilet anxiety.

Hypnotherapy

A hypnotherapy session could help you reduce toilet anxiety by putting you in a much deeper state of relaxation and replacing the negative thoughts you have expressed to your mental health practitioner with much more positive thoughts which are healthier and get rid of your toilet anxiety.

Relaxation training

Relaxation training can help reduce your anxiety and teach you to be much calmer when you are going through the training. It may do this by teaching you yoga, tai chi, mindfulness meditation, progressive muscle relaxation and other forms of relaxing.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is a very good way to replace the negative thoughts you may have about toilet anxiety with much more positive thoughts. Cognitive Behavioural Therapy (CBT)  is one of the most effective ways to get rid of toilet anxiety and one of the most common treatments you will find. You may have to do certain tasks in between your treatment to get you feeling better.

Graduated Exposure Therapy

Graduated Exposure Therapy is a common treatment for anxiety disorders. Graduated exposure therapy involves exposing you to your fears in a safe context which allows you to deal with them. This means you can confront your toilet anxiety and begin to deal with the fears you may have of using the toilet. Graduated exposure therapy will usually be done until you reach a point of having non-phobic response to their feared situation.

Self-diagnosis of toilet anxiety

You may have toilet anxiety if you answer yes to any or all of the below. 

During the last 6 months:

  • Have you experienced fear and concerns around going to the toilet?
  • Have your fears or concerns about going to the toilet influenced your daily life?
  • Have you found yourself anxious about the idea of others urinating in public places?
  • Has the idea of having to use a public toilet left you feeling anxious?
  • Have you found yourself worrying that others may overhear you when using the toilet?

If you are suffering from depression, anxiety, loneliness or any similar mental health issue then seeking help for it may be a good option. Mental health issues such as depression, loneliness and anxiety can affect anyone of us.

If you are under 18 then CAMHS, an NHS run programme may just be the answer for your mental health struggles.

You should look to see if you meet the CAMHS referral criteria and then fill in the CAMHS referral form.

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