Repetive urination before bed, need a CBT approach

[Juliex]

Hi everyone

I saw a psychologist about 15 years ago for this and it worked for a while, but it's been back a long while too.  Every night the same problem.  I want to go to bed and I always empty my bladder before bed, but the problem is I know I'll go into the bathroom and won't be able to come out for ages.

The problem for me is that my bladder never feels empty once I've actually emptied it.  It feels like there's a tingle there all the time telling me to urinate again, that I've left some behind, etc.  There's no urgency, just a completely wrong feeling about ignoring it and going to bed.  It's almost impossible to do.

I know the treatment is ERP, but ignoring my bladder, walking out of the bathroom and going to bed feel impossible.  For a start it will keep me awake for hours if I don't 'give in' to my bladder. 

Can anyone give me a revision on what I need to do to get this problem under control. I'm going to bed later and later and getting too exhausted.  I just need a plan to follow.  I'm not considered severe enough for nhs treatment and I've had it in the past but I can't remember the specifics.  I am motivated to work on this if I can find a way to overcome the 'pull' that is keeping me in the bathroom, mainly this is that my bladder feels like it didn't empty properly and 'one more push' will do it, BUT it never does, it seems to just create more irritation and hence I don't know when to stop.  I've had medical tests and they all come back normal, there's a slight retention of urine but it's not severe enough to warrant treatment.  The doctor told me that my bladder retains a small amount of urine after I've emptied it, but that most people would not be aware of this.  My ocd makes me aware.  The repetitive bladder emptying then causes a real irritation in the bladder which makes it all worse.

Thanks for any help in advance.  I need a plan which I'd stick to and give feedback on if anyone could offer one.

 

Thanks.

 

 

 

 

 

 

[taurean]

Are you sure that this is psychological? Do you only get this feeling at night? 

It sounds like you already know what you should be doing - but you say that you can't put it into practice. 

But we all must making significant thinking and behavioural changes to tackle the disorder, each and every one of us. 

Assuming the issue is an OCD one, and there is not a medical cause for it, then you need to work on resisting the compulsive urge which follows the mental message that you haven't emptied your bladder. 

Since it's you who must actually carry out this behavioural response, how do YOU  think you might manage to start gradually doing this? 

 

[onepunch]

Treat that "wrong feeling" like how you would treat anxiety. Ignore it and move on. It's going to be hard at first but try to keep at it and stay consistent. If it's psychological, it will get better. There are things you can do to help you go to sleep like deep breathing exercises. 

[biscuitcat]

I used to feel like this when I got on the train, anxiety of social situations made me feel like I would wet myself. I suppose it's similar because it's all I could think about everytime I got on the train, or in your case bed. 

I would recommend a distraction technique. Do you read before bed? Reading always makes me tired and switches my mind off from other thoughts.

Pop to the loo, then go to bed at normal time, read for a little while and see how tired it makes you. 
If that works the one time, it might help convince you you don't need to keep emptying your bladder.

[worriedjohn]

Just to say that I have exactly same problem. Just before bed urinating repeatedly to make sure I have not left any urine and will not feel urge to urinate while on bed. I know it is a tough problem. If you think about "urination" and give it an attenetion you will feel it. In my case solution was to urinate once and twice before bed and then stop it. If I feel about urine later on bed, which I feel is not actual but just my mental false feeling, I try not to go for it unless it is really strong urge. I felt that sometimes this is not actually urination urge but just a feeling like that due to paying attention to the matter. May be this is wrong for health but as with every OCD urge, resisting compulsion to some extend (which in case is urinating) works. 

Edited July 25, 2016 by worriedjohn

[Lynz]

I'm the exact same. Sometimes I would go over 7 times before settling off to sleep. I've been working at reducing these times though, so at the moment I've reduced it to 3 times. Once when I first go to the bathroom and brush my teeth etc, once after I've finished in the bathroom (which is usually 15 mins later), and then I usually lie in bed on my phone for half an hour or so or read a book, in which case I'll go again after I've finished doing that and before going to sleep. I'm currently working on reducing this to two times - once when I first go to the bathroom, and then again before going to sleep, which is probably about right as I do drink water or tea in bed when I'm reading/on my phone.

[Lynz]

I think mine stems from being overly cautious in avoiding cystitis, as I'm really prone to this and when I do get it it's really awful as I'm allergic to nearly all of the antibiotics that can be taken for it, but I do accept that going twice before settling off to sleep is enough in preventing it and that's what I'm working on.

[taurean]

I hadn't come across this particular obsession before - what a beastly one. 

You all seem to recognise it as OCD at work, and there are what look like some good ideas being shared. 

But as Lynz points out, we have to be comfortable there is no more clinical reason for it, in need of treatment. 

[Juliex]

15 hours ago, taurean said:

Are you sure that this is psychological? Do you only get this feeling at night? 

It sounds like you already know what you should be doing - but you say that you can't put it into practice. 

But we all must making significant thinking and behavioural changes to tackle the disorder, each and every one of us. 

Assuming the issue is an OCD one, and there is not a medical cause for it, then you need to work on resisting the compulsive urge which follows the mental message that you haven't emptied your bladder. 

Since it's you who must actually carry out this behavioural response, how do YOU  think you might manage to start gradually doing this? 

 

Thanks Taurean

I'm a taurean as well, lol.  I have a medical issue only in so far as there's slight residual urine left in the bladder, but the doctors are clear that most people wouldn't notice that.  It does mean that I have empty my bladder twice each time, but during the day that doesn't become an issue and I'm in and out in the same time as most people.

At night it's a whole different ball game, lol.  And I suppose it's the fear that if I get into bed and am uncomfortable, then I'm going to have to get back out, etc, and I won't go to sleep, etc, which will wreck the next day.....

And I think the treatment is that I have to avoid the compulsion, like you said, but I also have to be prepared to accept the consequences (hopefully only short term) of that, not sleeping, a wrecked day at work the next day, etc.  Hmmm....that's made me think though, by the second night I'd be exhausted, so I'd probably sleep....maybe this wouldn't take so long after all.  I'm just so averse to trying to get through a day without sleep though, I find it so hard as I do have fatigue issues, but these are linked to thyroid issues.  But it's my choice isn't it, ultimately I'll get more sleep as I'll go to bed (I'm currently typing this at 00.38, I could have gone to bed hours ago but I avoid the whole pilaver, lol)

 

 

[Juliex]

5 hours ago, Lynz said:

I think mine stems from being overly cautious in avoiding cystitis, as I'm really prone to this and when I do get it it's really awful as I'm allergic to nearly all of the antibiotics that can be taken for it, but I do accept that going twice before settling off to sleep is enough in preventing it and that's what I'm working on.

Good luck with it Lynz.  I'm not getting cystitis, and I have a whole host of thoughts that play out, 'you'll never be comfortable,' 'you won't sleep,' 'you can't go to bed feeling like this!' etc....

[Juliex]

8 hours ago, worriedjohn said:

Just to say that I have exactly same problem. Just before bed urinating repeatedly to make sure I have not left any urine and will not feel urge to urinate while on bed. I know it is a tough problem. If you think about "urination" and give it an attenetion you will feel it. In my case solution was to urinate once and twice before bed and then stop it. If I feel about urine later on bed, which I feel is not actual but just my mental false feeling, I try not to go for it unless it is really strong urge. I felt that sometimes this is not actually urination urge but just a feeling like that due to paying attention to the matter. May be this is wrong for health but as with every OCD urge, resisting compulsion to some extend (which in case is urinating) works. 

It's awful isn't it.  You sound like you have more control of this situation than me though, I don't see any of the sensations as mental rather than physical.  I do as I'm typing this but not when they're happening.  I just seem to have lost the automaticity that urination usually has.  So I guess I have to impose a strategy on myself and hope it becomes automatic once I stop monitoring all the sensations.

[Juliex]

14 hours ago, biscuitcat said:

I used to feel like this when I got on the train, anxiety of social situations made me feel like I would wet myself. I suppose it's similar because it's all I could think about everytime I got on the train, or in your case bed. 

I would recommend a distraction technique. Do you read before bed? Reading always makes me tired and switches my mind off from other thoughts.

Pop to the loo, then go to bed at normal time, read for a little while and see how tired it makes you. 
If that works the one time, it might help convince you you don't need to keep emptying your bladder.

Reading in bed is a pleasure I lost years ago due to this problem.  I'm too busy monitoring my bladder, lol, if I got in bed and read after all that hard work trying to achieve an impossibly empty bladder, I'd maybe be awake long enough to notice more sensations.  Once I manage to escape the bathroom I have to get into bed and get the light out really quick before I change my mind again.  Luckily due to being so sleep deprived I do go straight to sleep then, but only if I've not left the bathroom uncomfortable.  Crazy, lol

[Juliex]

15 hours ago, onepunch said:

Treat that "wrong feeling" like how you would treat anxiety. Ignore it and move on. It's going to be hard at first but try to keep at it and stay consistent. If it's psychological, it will get better. There are things you can do to help you go to sleep like deep breathing exercises. 

I believe it's psychological and have had medical tests, plenty of them.  I just hope it will get better if I ignore the 'wrong' feeling, lol.  The way I could describe it is if someone deliberately cut off the flow of urine before they were finished and then went off to bed,  it would feel weird..and wrong.  Thats how it feels, but I haven't stopped halfway through.  Too much information I know, but it's ocd nonetheless, lol

[onepunch]

16 minutes ago, Juliex said:

I believe it's psychological and have had medical tests, plenty of them.  I just hope it will get better if I ignore the 'wrong' feeling, lol.  The way I could describe it is if someone deliberately cut off the flow of urine before they were finished and then went off to bed,  it would feel weird..and wrong.  Thats how it feels, but I haven't stopped halfway through.  Too much information I know, but it's ocd nonetheless, lol

Yeah it should get better. If it's OCD and you treat it as such then it's only logical that it will get better. If you have a smart phone, you can download an app called Virtual Hope Box. The app has a feature where it guides you in deep breathing. It has a bar that goes up as you inhale, and goes down as you exhale. All you do is match your breathing to the bar and it plays relaxing music in the background and nice forest scenes. It helps me go to sleep when I feel restless. It has a 'Distract Me' feature as well, where you can play sudoku, mahjohng, word search, and other puzzle games to distract yourself from your OCD thoughts. I hope this helps!

[Lynz]

9 hours ago, Juliex said:

Good luck with it Lynz.  I'm not getting cystitis, and I have a whole host of thoughts that play out, 'you'll never be comfortable,' 'you won't sleep,' 'you can't go to bed feeling like this!' etc....

Yes I get these thoughts too. When I meant mine stems from cystitis I meant it started out as wanting to prevent that but now it's developed into an obsession.

I think trying not to pay any attention to it helps, difficult as that might be. It's funny because before I go to bed I get anxious about being uncomfortable and not sleeping etc., but then if I wake up during the night and need to go, if I'm tired I just think "screw it I'll go later" and usually I'll drift off back to sleep, unless I REALLY need to go. So it's obviously psychologically driven with me.

[biscuitcat]

7 hours ago, Lynz said:

Yes I get these thoughts too. When I meant mine stems from cystitis I meant it started out as wanting to prevent that but now it's developed into an obsession.

 

Mine started the same way, I was at work and had cystitis and had never had it before. Then had to get on a 45 minute train home and kept having to get off. This will get better. I no longer suffer and it was difficult to be able to switch my mind off from it, but once you manage it it will provide so much relief, far more than following out a compulsion does. 

Likewise, sometimes I really need to go before bed, but i'm comfortable and can't be bothered and nothing terrible happens. Definitely psychological!

[Guest Robyn]

On ‎26‎/‎07‎/‎2016 at 01:14, onepunch said:

Yeah it should get better. If it's OCD and you treat it as such then it's only logical that it will get better. If you have a smart phone, you can download an app called Virtual Hope Box. The app has a feature where it guides you in deep breathing. It has a bar that goes up as you inhale, and goes down as you exhale. All you do is match your breathing to the bar and it plays relaxing music in the background and nice forest scenes. It helps me go to sleep when I feel restless. It has a 'Distract Me' feature as well, where you can play sudoku, mahjohng, word search, and other puzzle games to distract yourself from your OCD thoughts. I hope this helps!

Aw thanks, I really appreciate the share, I'll take a look.  I tend not to read in bed as I want to get the light off as soon as possible and go to sleep before my brain gets any ideas about going back to the bathroom, lol, it's awful, but I must try and relax in bed again and read, etc

[Guest Robyn]

On ‎26‎/‎07‎/‎2016 at 10:16, Lynz said:

Yes I get these thoughts too. When I meant mine stems from cystitis I meant it started out as wanting to prevent that but now it's developed into an obsession.

I think trying not to pay any attention to it helps, difficult as that might be. It's funny because before I go to bed I get anxious about being uncomfortable and not sleeping etc., but then if I wake up during the night and need to go, if I'm tired I just think "screw it I'll go later" and usually I'll drift off back to sleep, unless I REALLY need to go. So it's obviously psychologically driven with me.

I'm exactly the same.  Once those sleepy chemicals are working I don't care about it, I just wish I could get them to work before bed, but anxiety will always be stronger because of evolution I think.  Anxiety has to win over sleep for survival purposes.  I just have to convince myself when I'm in the bathroom that this is anxiety.  The problem is there is real irritation of my bladder, even though the cause was psychological

[Guest Robyn]

On ‎26‎/‎07‎/‎2016 at 17:25, biscuitcat said:

Mine started the same way, I was at work and had cystitis and had never had it before. Then had to get on a 45 minute train home and kept having to get off. This will get better. I no longer suffer and it was difficult to be able to switch my mind off from it, but once you manage it it will provide so much relief, far more than following out a compulsion does. 

Likewise, sometimes I really need to go before bed, but i'm comfortable and can't be bothered and nothing terrible happens. Definitely psychological!

I really hope I can get that relief from the ocd.  I know it's possible, I just haven't got there yet. 

[Guest Robyn]

Hope its ok to continue posting here for a while, it would help to share my own CBT process on here.  So tonight, my nerves are already bad due to other issues that happen at the weekend that affect my sleep.  So that will now impact on the bathroom issue.  Something tells me the solution to all this is to be prepared for the worst thing to happen.  The worst thing is that my bladder will remain irritated all night, I won't get any sleep and I will go out tomorrow to see my friend feeling ill with exhaustion, I will drag myself through the day and I will make myself ill in the end with it all and I'll never be able to sleep properly again.

There I've done my own script.

In practical terms I am going to (sorry for the TMI) empty my bladder once, then do 4 repeat checks....lol, I don't think anyone needs any more info than that, lets just say it's often more like 20...I don't stop on a number, I stop when it feels right, and that's rare.  Ho hum....why was I born with ocd...

 

 

[Juliex]

oops...I'm so sorry everyone, I have obviously registered here on two separate occasions as two different people, I am Robyn above.  Moderators can I change my account to just be Juliex now?  Apologies, this wasn't done intentionally, I must have forgotten I'd already registered.