Teen suffering from Overactive Bladder / Anxiety

[Hugga]

Does anyone have advice for an anxious teen suffering from an overactive bladder? My DD is fine when at home but has been experiencing the strong need to urinate constantly whilst at school and has now stopped attending because it's so stressful for her to be having to leave the classroom multiple times during a lesson. I've spoken with her doctor who recommended pelvic floor exercises and said she could take Oxybutynin Chloride to manage the symptoms. The pelvic floor exercises are ok I don't like the look of the potential side effects and also she wants to have a permanent solution. I think the fear of this happening any time she tries to go to school is overwhelming now and there's definitely a psychological aspect to it also but I don't know what a counsellor could say that would help. For DD who is very self conscious even having to ask to leave class once is stressful and she's then worried that she will take too long and get in trouble with the teacher so it spirals.
Thank you

I work in health and many teens are on the medication. I’d say give it a trial at least, and get her back into education.

No help with a teenager having it but Dc2 had that drug (probably age 8-10), I had it after dc1. It was helpful for both especially dc. The dry mouth was the only side effect we both had.

Thank you so much @DustyLee123 and @Bathroombedroomlounge please could you let me know how long the drug took to start working and how long you needed to take it for? Ideally DD would go back to school and not feel the sensation so she can get her confidence back but as the feeling only happens at school I'm not sure how long to wait before she can go back if that makes sense? Also DustyLee123 do you feel that seeing a counsellor is important in this situation and if so does it need to be an anxiety disorder specialist? Thank you!

Yes, I’d be looking for a CAMHS referral or private counselling, you’d be quicker going private and CAMHS often refuse referrals anyway.
It sounds like anxiety, but it would be worth a trial of the drug to be sure. You don’t want to go down the anxiety route if its actually physical.
Its so important to get her back into education before she won’t ever go back.
IMO the most important thing with counselling is to find someone she clicks with, there’s no point going if she doesn’t trust and believe the counsellor. Very often they will suggest someone else when they can see the problem and know that a specialist is needed.

Yes - I had this exact situation with my DS when he was at school @Hugga but during Covid, when they were in bubbles at school and so you couldn't be excused to go to the loo, the teacher had to radio a colleague to come and get you and stand outside the loo whilst you went, to make sure you didn't come into contact with another bubble. It was insanely stressful and so DS wouldn't eat or drink anything after 6am each day, which made the problem worse and worse.

He had an overactive bladder which caused constipation, anxiety and ultimately school refusal. The school were really helpful and accommodated this. He did his GCSEs in a side room which had a loo attached so he could go whenever he needed to without worrying.

Oxybutynin was a great help. He also had private counselling which really helped. He moved up to sixth form and so that made it easier because he was in and out of school a lot more (and did one of his A levels remotely) so typically each period of time in school was shorter, the loos were more accessible. It was still a major factor every day to think when the loo breaks would be, could we ideally stop off at home to have a wee there.

Even now when he's fully better and can do things like full day field trips to places in Snowdonia with no loo at all, he still plans his loo trips carefully. I make sure he knows on any long car journey we can stop at any time to find a loo.

Can the school support your DD in coming in for part sessions? That's how we rebuilt confidence whilst the medication was taking effect.

The only thing I'd add, although I would found this no help whatsoever at the time, is that in hindsight I'm glad this happened whilst he was at school and not at uni (if it had to happen at all). It would have been an absolute nightmare having to try to manage this at a far distance, and it was extremely stressful as it was. Just writing this post has really taken me back to that difficult time. Help is out there - take all of it, make sure she drinks plenty of water and don't underestimate the impact on your own wellbeing.

I've tried pumpkin seed extract on my male teen with similar issues-it works vv well

I can’t comment about teens but I was on medication for overactive bladder once 15 years ago. Something happened and I needed to travel to see my parents (not in UK) and sort it out and I was unable to leave the house practically because of overactive bladder so stressed about the issue I was.
I went to GP and was prescribed something ( don’t remember the name but it was something for an overactive bladder) and had referral to a physio who advised pelvic floor exercises. I think I took medications and did exercises for about 6 months, maybe less but not more - to cover before trip, the trip itself and after. It helped enormously, I didn’t have any side effects, I got my confidence back and was able to function again.
My point is that maybe the medication route is worth to try, it’s not for life definitely I understand your concern about side effects I’m always worried about them but in this case it’s temporarily as she won’t be at school forever. And schools are particularly stressful environment for an overactive bladder considering all the rules for going to the toilet.

Totally agree @pizzaHeart and I should add my DS hasn't taken Oxybutynin for several years now.

Thanks you so much @@tribpot I'm so glad to hear that this is no longer an issue for your DS. If it's not too intrusive to ask would you say personality wise he is shy and anxious in general? My DD is fine when in her comfort zone but has always struggled with being self conscious and new situations and I wonder how she will manage at university and how best to build social confidence especially when she's dealing with this issue.

He is indeed shy and anxious in general @Hugga . University has been tricky for him, he's struggled to make friends as it seems as if other people already knew each other and no-one has been very welcoming. It hasn't been the experience we were hoping for and I think in retrospect he would have been better going to uni closer to home. He's always had ensuite accommodation, obviously bathroom sharing would be an absolute no-no for him. It was a factor in not choosing to do an overseas field trip for his course this year, but that was as much to do with not wanting to share a room as share a bathroom.

We visited the uni several times before he went (which is normal - you might go to an open day and an offer holders' day) so that gave some reassurance in terms of being to scope out where the bathrooms were.

Thank you @tribpot they sound like they have similar personalities. I often wonder whether my DD is partly like this due to the troubles we had with her father (who is volatile and emotionally abusive). Would you say the shyness and anxiety is purely down to personality in your son's case, not trauma related?
I feel guilty that things were difficult at home prior to me leaving my husband and wonder whether DD would have been more self-assured and relaxed if she'd had a nicer Dad.
By the way I meant to say, the covid restrictions your DS had to deal with at school sound incredibly difficult. I'm so sorry you had to deal with all of that worry, it is exhausting trying to contain your child's anxiety and support them when you're at your wits end yourself!

I think it is personality @Hugga . His temperament is very similar to my mum's.

DD3 has this. It has become quite extreme within a wider picture of OCD. She hasn't been in school for over a year and now can't leave the house. The wheels turn slowly at CAMHS so I would refer immediately.

It always interests me when people will not treat a problem because the treatment has potential side effects.

First, all known side effects are disclosed. A side effect that affected only 10% of people would be considered a very common side effect yet 90% of people wouldn’t experience it. The majority of side effects are much less common.

Secondly, the ‘side effect’ of the problem is extremely serious. She has a ‘side effect’ that is ruining her education, socialisation and enjoyment of life.

I can’t fathom why you wouldn’t try it.

Contact school. Get a Dr's letter to say she needs access to a toilet at all times and that she can leave lessons without the need to ask. And fgs try the medication.

I had this as a teen; I think what really helped me was speaking to someone about ways in which you can manage that urge (clenching your toes is apparently one) and also being logical about how much liquid is in my bladder if I’ve been to the toilet an hour ago. Some mindfulness techniques in the moment definitely helped.
there was something about knowing I had access to a toilet that helped my anxiety (I was fine at home) so could it be agreed with school that your DD doesn’t need to ask but can just slip out of the room (perhaps be seated near the door) and she may find that just knowing she can reduces the need.
Oddly enough going to university is when that stopped for me, maybe because I had more control over my life and day to day plus you don’t need to ask to go to the loo

@PrincessW11 A quick update to say that DD tried the Oxybutynin but unfortunately it's not working for her. I was thinking she could try the pumpkin seed extract but I just realised that I ordered pumpkin seed oil not extract so not sure if that's the same thing? Please could you advise how much you gave to your teen as I don't know what amount to give and also how long it took to work? it would be so great if this helped us too. Thank you!

I started with one tablet in the evening, it seems to be working for us at that dose

My daughter had this when she was 10. I think it was brought on by a stressful situation of a badly behaved, noisy class and the teacher banning children from using the bathroom during lessons. My daughter started feeling really anxious and overthinking and felt the need to go to the loo all the time and that she hadn't emptied her bladder. When she went to the loo there was nothing coming out, so she wasn't going to wet herself but just the horrible feeling. She was ok at home. I did take her to the doctor who reassured us that there was nothing wrong with her physically (although there was a year waiting list for a scan which we never had). I ended up speaking to the school who said she can go anytime she wants, but in a way it didn't help straight away. She was also moved away from the more disruptive children so got a bit more peace. Then said to try and wait till the end of the lesson, she did this and found that once the lesson started she forgot about the sensation. It gradually just stopped on its own. I was worried that when she started secondary school it would start up again as she is still a bit of an anxious child. I think it is much harder to deal with at secondary school but maybe breathing techniques to calm down, maybe wear a pad to start with to give reassurance, ask the school if there is a more private toilet/visitor toilet she could use if she needs to as the pupils ones are often busy and chaotic. Just set small targets like waiting until halfway through lesson, then a bit longer. Not worrying so much about school work to start with as she will just need to try and adapt. Maybe a sympathetic friend who could keep an eye on her if she needs someone to talk to or school counsellor or teacher that is available during the day. I wish you and your daughter all the best.

The exercises will do fuck all, it's not physical, it's psychosomatic. The only thing that worked for me was having my own pass that I could just quietly get up and leave without any attention drawn to it. Once I knew I COULD go, I then didn't need to go anywhere near as often. It was the stress of having to ask and potentially be told no that was triggering it.