Emotional wellbeing

Having a bladder or bowel problem doesn't just affect you physically - it can affect your emotional health too. So, how can you help ensure peace of mind?

"My bladder was controlling me, and I did not like it one bit. I had gone from being a confident, independent person to become this stranger. Gone was the smiling happy person, in control of her life. Now there was an isolated reject, someone who had lost confidence, self-esteem and dignity." NB

If Incontact's Ex Project Manager for Scotland, Cathy McKerrell's estimation is correct, then the case study above reflects only one of many who are affected emotionally by their bladder or bowel problems.

Cathy reported: "Many of those who contact us are in desperation and are living not only with continence issues but also mental health problems that would often appear to be related. Most suffer from depression, loneliness and very often isolation and this has a huge effect on their quality of life and relationships. Although there is little statistical information available on this I feel it is an area that requires future research. My observations, from working with people living with incontinence, indicate that as many as 70% of people are affected by depressive illnesses."

Having a bladder or bowel problem can affect your self-esteem, your dignity and your independence. It can also lead to isolation, distress and depression.

One study¹ monitored 115 patients with bladder problems (36 had stress incontinence, 44 had urge incontinence and 25 had mixed symptoms). They were asked if they had any history of depression and filled out a Beck Depression Inventory (BDI). A BDI is a multiple-choice test with 21 questions, designed to establish if the participant is showing signs of depression. The score for each question is out of 3 (0 showing no indication of depression, 3 showing strong indication of depression). The test was also given to 80 people without bladder (or bowel) problems.

A BDI of 12 was scored by 30% of those with bladder problems, compared to just 17% of those without problems. Also, the cause of the problem seems to affect the occurrence of depression: a very high BDI was noted in 60% of those people with urge incontinence with an unknown cause. Those with stress or urge incontinence due to problems with the nervous system or an obstruction were no more likely to have depression than people with no problem at all.

So, if your problem does get you down, what can be done? It always helps to talk about your problems. If you have supportive friends and family, tell them how you are feeling. It helps to get things off your chest rather than bottle everything up.

If you would rather speak to someone else, there are many organisations that can help:

• The Samaritans Have a 24 hour helpline 08457 909090
• Mind Work for a better life for everyone with experience of mental distress 0845 766 0163
• The Fellowship of Depressives Anonymous Run by people with experience of depression 0870 774 4320
• Depression Alliance Provides information, support and understanding and helps with symptoms and treatments 0845 123 23 20

There are also many self-help books available. Try:

'Being Happy: A Handbook to Greater Confidence and Security' by Andrew Matthews, ISBN 0843128682

'Anxiety and Depression: A Practical Guide to Recovery' by Robert Priest, ISBN 0091812666

'Don't Make Me Laugh' by Nicky Astbury and Helen White, ISBN 0954141806 (Available from the Continence Foundation: call 0845 345 0165, or visit www.continence-foundation.org.uk)

'Overcoming Low Self-esteem: A Self-help Guide Using Cognitive Behavioural Techniques' by Melanie Fennell, ISBN 1854877259

If you are having difficulty managing your bladder or bowel problem and it is preventing you from going out and carrying on with your life, it is important that you see a continence advisor. They deal with bladder and bowel problems everyday so you needn't feel embarrassed when telling them about your problems. We can give you the number of your nearest continence advisor - please call us on 0870 770 3246.

1. 'Urinary Incontinence and Depression', Zorn, Montgomery, Pieper, Gray and Steers, The Journal of Urology, 1999.

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