Psychogenic Origin of Incontinence or Just Denial

[animal]

Hi, I have suffered from the hallmark symptoms of urge incontinence / overactive bladder (urgency, frequency, leakage) for over 10 years now without an obvious underlying cause -- I never made it past having my concerns dismissed by a general practitioner some time ago -- and have gradually convinced myself that it's "all in my head" -- how else would I wake up nearly dry 95% of the time? Surely, how doctors once outed malingers of incontinence when they failed to bedwet when administered opium before bed shows that I am almost surely subconsciously feigning my condition -- I have told myself. Maybe I have a sick fantasy or Munchausen syndrome, or maybe I have spent so much time denying a condition by using likely discredited medical and psychoanalytic literature to admit that I -- a young adult male -- have a problem. I am lost.

[MSUSpartan]

The effects of opioids on smooth muscle contraction aside ...

If you're symptoms are psychogenic, are they any less real? Unless you're causing them consciously, you're a sufferer of them. That alters the course of treatment, not the reality of the situation.

[PB&J32]

Animal.....you should look at a somatoform disorder. Somatization is a condition where there are very real symptoms with no medically explainable reason for them. So you could be incontinent with no way that any doctor could come up,with an explanation. Usually the condition is reported to be chronic. I was told by one of my 12 doctors that I had a somatoform disorder. I think it was a nice way for him to tell me that it's all in my head because he doesn't want to delve into my case any further. I'm exploring interstitial cystitis with a couple different urologists. I don't think its all in my head.

[Patrick]

animal,

Welcome to our group. I hope we can be of service to you.

For years my doctors told me that my list of medical complaints (symptoms) were psychogenic. They called me a malingerer, and worse. Then, one day, my cousin called and said that our family harbored a genetic disease. None of the doctors who had called me a hypochondriac had thought to test for this disease. Overnight I went from being a hypochondriac to becoming an interesting patient. At the medical school the professors used me for research projects and as a subject to instruct their students. A medical geneticist was especially interested, and put me through more exams than I care to remember.

Psychogenic? Well, yes indeed. Managing my medical situation is both physically and psychologically stressful. But there is another good reason why I'm stressed. All those years when doctors, who should have known better, were not curious enough to order the tests and examinations which would have pinpointed this disease. My cousin had to do their work for them.

Too often the diagnosis "psychogenic" is just an excuse a doctor uses to explain something he/she is too lazy to investigate further.

Don't give up. Doctors know a lot; they've spent large fractions of their lives learning human biology. But they do not know everything.

[CJinNM]

Another thought to consider... for it to be truly "psychogenic", there would need to be a fairly obvious or identifiable cause of psychological distress present. People dealing with a variety of stressors and psychiatric diagnoses can experience incontinence as a symptom or "expression" of the disorder they're dealing with not to mention some of the medications used to treat psychiatric disorders have been known to lead to incontinence in some cases as well. You didn't describe anything in your initial post but I'm wondering if you're under some unusual amounts of stress or if you've experienced any significant losses, changes or traumas recently that precede or coincide with the onset of incontinence episodes. Without the presence of significantly elevated stress/distress, it would be difficult for any person to accept the "psychogenic" diagnosis without exhausting all other possible medical causes first. Even with the presence of elevated stress/distress, the APA and our diagnostic manual (the DSM-V) requires a practitioner to rule out any other possible causes before making a psychiatric diagnosis.

CJ