Anxiety & Frequent Urination in Teens: Ways to Cope & Treatment Options
Do you feel like you have to stop at the restroom more frequently than your peers or family members? Do you plan activities based on restroom availability? Or perhaps you get anxious about finding yourself in a situation without a bathroom? If you answered “yes” to any of these questions, then you may be experiencing an above-average need to urinate.
The majority of youth do not feel the need to urinate more than eight times per 24-hour period. In fact, frequent urination in teens may be a sign of underlying anxiety. Plus, an overactive bladder can also be disruptive, stressful, and anxiety-inducing. So the link between anxiety and frequent urination may be a two-way street. Stress and anxiety can trigger the urge to urinate, and frequent urination can increase stress and anxiety.
Fortunately, there are effective treatment options for anxiety. If you or your teen has anxiety linked to frequent urination, a mental health professional can provide guidance and support.
This page can also help you better understand the stress and bathroom urgency youth can experience, by exploring:
- How stress, anxiety, and frequent urination are linked
- How bladder anxiety can trigger panic attacks
- Coping strategies you can use to stop panic attacks
- How science-based treatment can reduce anxiety and panic in teens
How Stress and Anxiety Can Cause Frequent Urination in Teens
When a person perceives a situation as threatening, the body initiates a series of automatic physical responses. These include muscles becoming tense, the pulse, breathing rate, and blood pressure increasing, and a person feeling an urge to urinate.1 This is the body’s natural stress response.
These changes, also called the “fight-or-flight” response, are designed to increase a person’s ability to survive a life-threatening situation. And although situations like performing in a school play are not life-or-death events, teen fear of embarrassment can be worrisome enough to trigger the body’s stress response.2
Further, like short-term stress, ongoing anxiety may contribute to frequent urination.3 For instance, one study showed that overactive bladder patients with severe anxiety report more bladder symptoms than patients with low anxiety. Plus, as anxiety increases, so do symptoms of an overactive bladder.4 Another study found that war veterans with anxiety are much more likely to experience frequent urination than veterans without anxiety.
While the link between frequent urination and anxiety is still being explore
How Frequent Urination Can Increase Anxiety in School
A factor that can contribute to school anxiety, bathroom breaks are often “few and far between.” In fact, students may be expected to limit restroom visits to the few minutes between classes, when they must also gather class materials and travel from one part of the building to another. This can be impractical or even impossible, leaving a student to worry about when they can use the restroom. So, with bladder anxiety teens may find themselves so preoccupied with planning bathroom breaks that they find it difficult to focus in class.
Ultimately, teachers may permit a bathroom break upon a student’s request. However, students may sense that leaving class to use the restroom is frowned upon. Further, teens who frequently find themselves asking permission to visit the restroom may worry that classmates will think they are “weird”.
Humans are a highly social species. We have always depended on others for the best chance of survival. As part of normal development, adolescents begin to crave social acceptance and fear isolation. Teens who need to request more bathroom breaks than other students may therefore experience increased stress as they fear disapproval from teachers and peers.
Stress, as noted earlier, can then increase the need to urinate frequently, creating a vicious cycle.4 Plus, in some cases, concerns about managing bathroom breaks during the school day can result in anxiety and panic symptoms.
Common Physical Panic Symptoms Teens Experience
Urination urgency can become so severe that teens may experience panic attacks. This may be because the fear of not making it to the restroom in time and the risk of public humiliation can be highly distressing.
Panic attacks, an “abrupt surge of intense fear or discomfort,” are common among adolescents. They may also get physical symptoms of panic alongside these distressing episodes.
These physical panic symptoms teens can experience include:
- Rapid heart rate or palpitations
- Sweating
- Trembling or shaking
- Shortness of breath
- Discomfort or pain in the chest
- Nausea
- Feeling dizzy or faint
- Numbness or tingling sensations
- Feeling like you are losing control
- Detachment from their body or reality
- Feeling like they might die
Physical, or somatic symptoms in adolescence can be frightening. A panic attack may also be so distressing that a teen’s behavior changes. If you are unsure if you or your teen has experienced a panic attack, changes in behavior patterns may provide some clues.
Common behavioral signs of panic in youth include:
- Sudden avoidance of places where panic attacks have occurred
- Refusal to leave home
- Inability to relax
- Frequent need for reassurance
- Social withdrawal
Additionally, an intense fear of returning to the place where they experienced a panic attack can be highly disruptive and isolating. For these reasons, coping with panic in teens often requires professional intervention.
Treatments for Anxiety and Panic in Teens
The bladder anxiety teens can experience can be highly distressing and uncomfortable. Plus, as mentioned, it can trigger panic attacks.
Untreated panic attacks can affect self-esteem, as well as academic and social functioning. Further, they can increase in frequency, resulting in a more severe mental health problem called panic disorder.
With modern, evidence-based treatment options, teens can reduce the frequency of panic attacks and the need to urinate. Two types of treatment that effectively treat panic attacks and panic disorder include cognitive behavioral therapy and dialectical behavior therapy. We discuss these two approaches below.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a highly effective approach for treating panic attacks.6 It is also useful for treating any underlying anxiety disorders that may be contributing to frequent urination.
CBT is an evidence-based type of psychotherapy in which a therapist helps the patient identify and challenge thoughts and behaviors that may be contributing to anxious feelings.
For example, many people experience cognitive distortions, or “thinking errors,” that contribute to feelings of anxiety.
One common cognitive distortion is “mind reading.” Imagine that a teenage student asks to use the restroom during the same class two or three days in a row. On the third day, the student believes that the teacher looks irritated by the request. The student assumes the teacher is annoyed and begins to feel anxious that the teacher is angry with them. As a result, they might experience a thought like: The teacher thinks I’m just leaving class to get out of doing the work. Mind-reading reading such as this can contribute to anxious thoughts and physical symptoms of anxiety.
In CBT, this student may learn to identify and challenge such unhelpful negative thoughts and assumptions, reducing anxiety, panic, and the need for urination.
Dialectical Behavior Therapy (DBT)
DBT for panic and anxiety stems from cognitive behavioral therapy and teaches people how to tolerate distress and regulate emotions. It also provides practical steps for self-regulating during panic attacks or other times of intense distress, such as grounding.
As mentioned, the stress response can activate physical symptoms, such as an increased heart rate, rapid breathing, sweating, shaking, and the need to urinate – sparking a sense of panic. However, there are specific actions someone can take to activate the body’s parasympathetic nervous system, counteracting the stress response and bringing the body back to a state of calm. DBT teaches people these actions.
Coping With Panic in Teens
While it’s important for teens who experience frequent panic attacks to seek professional mental health treatment, there are steps that can be taken at home to improve symptoms. These include:
- Grounding exercises: For example, lowering the body’s temperature. Place an ice pack, an ice cube, or cold water on your eyes and cheeks, the back of your neck, or your inner wrists. Alternatively, take a brief, cold shower. Cold temperatures reduce intense emotions.
- Intense exercise: Activity can interrupt the stress response and calm the nervous system. So if you feel panic coming on, engage in brief, intense exercise. This can include jumping jacks, push-ups, pushing against a wall, sprinting, or another high-exertion activity.
- Paced breathing: Slow your breathing to a steady pace, making your exhales longer than your inhales. For example, breathe in for a count of five, then exhale for a count of seven. Repeat for several cycles until you feel more physically calm.
- Progressive muscle relaxation: Concentrate on one muscle group, such as your hands. As you inhale, tighten these muscles for a count of five. Then, exhale and completely relax the muscle group while saying the word “relax” to yourself. Repeat this process, working throughout your body and focusing on different muscle groups.
These four actions can be remembered by using the acronym TIPP. It’s a CBT strategy that stands for Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation.
Coping With Frequent Urination
When frequent urination occurs as a somatic symptom of underlying anxiety, the best way to manage it may be by treating the anxiety. A mental health professional can talk to you about the right form of therapy for your needs.
However, certain behavioral factors may also be contributing to your symptoms. So if you are experiencing frequent urination, to start, you could try limiting food and drinks such as:
- Coffee
- Tea
- Soda
- Citrus food or drinks
Additionally, you could also try bladder retraining. The bladder is a muscle; it can become stronger with practice. Identify how long you can typically “hold it” before needing to go to the restroom. Then, gradually add a few minutes to that length of time until you can urinate less frequently.
However, it’s important to note that a frequent need to urinate may not be caused by anxiety – even if frequent urination contributes to it. A physical check-up with your doctor can help you determine if there’s a physical issue contributing to this symptom. If no physical factor is identified, they may refer you to a mental health professional.
Mission Prep: Professional Support for Anxiety and Panic
Frequent urination can be one of several physical signs of anxiety in youth. If you suspect that you or your teen may be experiencing underlying anxiety, or if frequent urination seems to be contributing to new anxiety, teen anxiety therapy may help.
However, many people don’t know where to start, often turning to search engines and looking up “teen anxiety therapy near me.” If this is the case for you, Mission Prep can help.
Mission Prep offers professional help for anxious teens through inpatient, outpatient, and intensive outpatient care options. At our teen support programs, mental health experts provide nonjudgmental, compassionate, and effective care in both group and individual settings.
Additionally, our therapists offer CBT, DBT, and other personalized evidence-based anxiety treatments so you can be confident about meeting your mental health goals. Take the first step toward overcoming anxiety by contacting our team today.
References
- Hoehn-Saric, R., & McLeod, D. R. (2000). Anxiety and arousal: physiological changes and their perception. Journal of Affective Disorders, 61(3), 217–224. https://doi.org/10.1016/s0165-0327(00)00339-6
- Jwyland. (2025, October 1). The Science Behind Blushing from Embarrassment. UF Medical Physiology. https://distance.physiology.med.ufl.edu/the-science-behind-blushing-from-embarrassment/#:~:text=Embarrassment%20activates%20the%20sympathetic%20nervous,making%20those%20areas%20visibly%20red.
- Shimizu, T., Shimizu, S., Higashi, Y., & Saito, M. (2021). Psychological/mental stress‐induced effects on urinary function: Possible brain molecules related to psychological/mental stress‐induced effects on urinary function. International Journal of Urology, 28(11), 1093–1104. https://doi.org/10.1111/iju.14663
- Lai, H. H., Rawal, A., Shen, B., & Vetter, J. (2016). The relationship between anxiety and overactive bladder or urinary incontinence symptoms in the clinical population. Urology, 98, 50–57. https://doi.org/10.1016/j.urology.2016.07.013
- Hewitt, O. M., Tomlin, A., & Waite, P. (2021d). The experience of panic attacks in adolescents: an interpretative phenomenological analysis study. Emotional and Behavioural Difficulties, 26(3), 240–253. https://doi.org/10.1080/13632752.2021.1948742
- Elkins, R. M., Gallo, K. P., Pincus, D. B., & Comer, J. S. (2015). Moderators of intensive cognitive behavioral therapy for adolescent panic disorder: the roles of fear and avoidance. Child and Adolescent Mental Health, 21(1), 30–36. https://doi.org/10.1111/camh.12122
