Dr Gauri Seth is the co-founding Director of the London Bladder Clinic, supporting the emotional wellness pathway for holistic and integrated care. Gauri has worked as a psychiatry doctor, psychotherapist and clinical academic. She now works as an emotional wellbeing coach, supporting parents and individuals connect with their authentic self, enabling them to better connect with others, so they can thrive. We asked her for her advice on how we can all nurture our mental health while dealing with bladder weakness, leaks and overactivity.
Hello, Dr Gauri! Thank you for joining us on The Drip and sharing your advice. What is the biggest impact on mental health that you see in your professional capacity?
We see that leaking can lead to low mood, depression, and anxiety. Underpinning these negative states, there are issues of shame, guilt, embarrassment and anger.
We see that people have put up with leaking for years before getting help from a urologist/urogynecologist, meaning for some time there may have been a sense of denial that this is an issue for them which needs turning towards, and resolving. Denial is a common defence, which we can all find ourselves doing, for a range of reasons.
With leaking, I think because of the shame, the fact people don’t talk about it, the feeling of loneliness that this is only impacting them and no-one else ( which we know isn’t the case as 1 in 3 women leak) it is understandable that mean and women make do with superficial strategies, deny the issue and hope it might resolve.
There is a lot of shame around this issue - Oftentimes, people are seen as if they have become like children again and have lost control of themselves and their bladder function. How do you support people with these feelings?
I am very scientific about the fact that for our bladder is a structure with muscle and as with the rest of our bodies, bladders are not perfect- no-one said they should be. So many factors can impact our bladder which aren’t in our control- age, pregnancy, childbirth, other physical health conditions, menopause. We have to see the process as a separate thing in itself, rather than something we have caused and need to now feel guilty about or shamed about. Nothing in life is perfect, including our bladders. Sometimes the support is around discussing perfectionism, the roots, and sometimes we find out the high standards apply to other areas of life too, and the shame and guilt of the bladder ends up being a hook for a deeper conversation around things being 'good enough' vs ‘perfect’.
The main things to focus on are:
🧡 You are not alone, many people leak, at least one in three;
🧡 It's not your fault!
🧡 Turn towards the problem rather than deny it, so you can get the support that is out there. There are so many options to support, from behavioural interventions to non-invasive botox injections to the bladder, to surgery. There is no need to suffer in silence.
Are there any specific techniques or tools that people can use if they are navigating bladder weakness and feel like their mental health is suffering?
Yes, absolutely. Specific tools include:
🧡 Avoid comparing yourself to others- comparisons create so many distortions, and can drive unhelpful patterns of thinking, and this can impact mental wellbeing
🧡 Avoid thinking in all or nothing terms- rather than seeing the bladder as working or not working, see things as dimensional - and that a bladder which leaks is not completely worthless - there are things we can do to optimise the bladder working better, and this can be the focus
🧡 Sleep is an extremely important aspect of good mental health, and studies looking at incontinence show that quality of life, low mood and depression are associated with night time weeing. If you feel disturbed sleep is impacting your mood, and your overall state of mind, consider things you can do differently, to address this. See a specialist, and get help.
🧡 Talk about it! You will be surprised to know how many pope within your social circle either leak themselves or know someone who does. When you feel less alone with a problem, it can take the anxiety away and you can feel more motivated to problem solve
🧡 You are worth it - many mean and women struggle with the idea of spending time or money on their wellbeing, especially bladder leaks as it can feel like only a ‘quality-of-life compromise’. I advise a mindset shift where we recognise the importance of our emotional wellbeing, and have no shame in optimising it, so we can thrive, live our best life and connect with our authentic self. If we can connect with our authentic self, and live a life according to our authentic values, we can connect with others better too- whether that’s our children, partners, friends, parents etc. It’s much easier to connect to our authentic self if we are not leaking! Whether that’s linked to being able to laugh freely, jump on a trampoline, go out dancing, without fear. Overall the collective well-being of a family can be improved if we all turn in and meet our emotional needs. For those who feel guilty about doing something for yourself- please don’t! Get help- you are worth.