Overactive Bladder? Try Mind Over Matter

**By Una Lee, MD**

mindful-woman-webAre you someone who feels sudden, strong urges to urinate despite no easy access to a bathroom? Maybe you’re on an airplane and the “fasten seat belt” light is still on, or you are in a meeting and it would be disruptive to get up. It’s common for people to experience “gotta go” bladder sensations, then have to delay the urge until a more convenient time. Is there anything you can do when the time to go is a no-go?

Research shows that by applying the techniques of mindfulness, the cycle of thinking that leads to urinary urgency can be broken. Your thoughts and your bladder function involve different parts of your brain in a complex network of connections. One of those connections — between the prefrontal cortex, which processes complex thoughts, and the amygdala, your brain’s emotional center — gets interrupted when you activate a part of the brain, called the insula, that manages information about the physical state of your body.

Using mindfulness to cope with an overactive bladder works by moving your attention to other physical sensations, like the soles of your feet as you walk, the rise and fall of your chest as you breathe, or to the act of squeezing your pelvic floor muscles five times quickly. Doing this can interrupt the runaway thought cycle and send a new, calming message to your brain. Now your mind is focused on a different physical sensation and away from the uncontrolled sense of urinary urgency.

Try the following techniques as a one-minute override of the thought loop that contributes to overactive bladder symptoms. The more you practice, the better you will get at engaging this mindfulness exercise when you need it to decrease feelings of urgency.

  • First look around and observe.
  • Then close your eyes and notice the details of your environment and sounds around you, whether it’s a car horn honking, the hum of a machine, or the physical sensation of yourself in your chair. Focus on any physical sensations.
  • Take one deep breath to settle yourself.
  • Follow your breath. Notice the air entering your nose as you inhale. Feel it fill up your chest. When you exhale, noticing the air as it exits your body.
  • Take your time and calmly take five deep breaths.
  • When you are done, notice how you feel. You may feel calm or more refreshed and your bladder urgency may be decreased.
  • When you do go to the bathroom, go in a slow and controlled way, with an open and calm heart and mind.

Even allowing 30 seconds or less for focusing on something else, such as your breathing, can have a powerful effect. If you are interested in learning more about mindfulness and how it can help you in everyday situations, watch the video “One-Moment Meditation: How to Meditate in a Moment” by Martin Boroson. Or click here for free resources and guided meditations from UCLA Mindful Awareness Research Center.


Lee_UnaUna Lee, MD is a urologist who specializes in overactive bladder, pelvic organ prolapse, and urinary incontinence at Virginia Mason. She sees patients in Bellevue and Seattle.

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