Overactive bladder (OAB) is a condition that causes a sudden and frequent urge to urinate. Some people with OAB also experience urinary leakage, which is known as incontinence.

OAB can feel very uncomfortable and sometimes painful. It can greatly affect your social life and your ability to function in your daily life. Research suggests that rates of anxiety, depression, and stress are significantly higher in people with OAB.

The good news is there are treatment options to help you manage OAB. And meeting with a mental health professional may help you learn to cope and improve quality of life.

Research shows that on top of treating depression or anxiety, some types of therapy may even improve the physical symptoms of OAB.

OAB is a condition that causes a sudden, strong need to urinate immediately. People with OAB may experience incontinence, when they can’t get to a toilet before releasing their urine.

The symptoms of OAB are thought to be caused by a miscommunication between the brain and the bladder, but the mechanism isn’t fully understood. OAB symptoms may affect up to 30 percent of men and 40 percent of women in the United States, according to the Urology Care Foundation.

The following may increase your risk of OAB symptoms:

  • childbirth
  • having overweight
  • changes in hormones
  • frequent constipation
  • pelvic muscle weakness
  • prostate cancer treatment
  • enlarged prostate
  • nerve- or brain-related conditions, such as Parkinson’s disease, multiple sclerosis (MS), or spinal cord injuries

Though OAB is physical condition, the emotional toll can be vast when living with a chronic condition that might make you feel as if you’ve lost some control over your body.

If you have OAB, you may constantly worry about leaking urine while in public. It may be difficult to enjoy your favorite social activities. You may also worry about your sex life.

You may begin to feel isolated. Your friends and family may not be able to understand what you’re going through.

OAB can also affect your sleep. You may find yourself waking up several times throughout the night to urinate. Lack of sleep is also associated with increased risk of stress, anxiety, and depression.

Research from 2018 suggests that people with OAB are at a significantly higher risk of having depression or anxiety.

In a 2011 study, people who categorized their OAB as “bothersome” were significantly more likely to report low quality of life and work productivity than people with minimal or no OAB symptoms. They were also more likely to report high levels of anxiety and depression.

Though more research is needed, it’s also possible that trauma, stress, and anxiety can contribute to OAB symptoms, rather than simply being effects of OAB.

One 2017 study including recently deployed female veterans was designed to better understand the relationship between OAB and mental health. The study excluded people with underlying conditions that could cause OAB, such as MS, stroke, or recent pregnancy.

Results of the study showed that anxiety, depression, and previous sexual assault was associated with OAB symptoms. Remission of OAB occurred less often in those who had already been diagnosed with depression and anxiety when the study began.

A wealth of evidence shows that counseling and therapy can help treat anxiety and depression. For people with OAB, treating any accompanying depression and anxiety through mental healthcare or therapy might even improve the physical symptoms of the condition.

Some methods may even help treat the physical symptoms of OAB itself.

Cognitive behavioral therapy (CBT) is a form of psychotherapy that many studies suggest can help treat anxiety and depression and improve quality of life.

CBT focuses on identifying unhelpful patterns of thinking and behavior. It then teaches strategies to improve coping and problem-solving skills and build self-confidence.

To help people with OAB manage a sudden or frequent urge to urinate, mental health practitioners may use CBT techniques like:

  • lifestyle modifications
  • bladder training
  • self-monitoring
  • breathing exercises
  • muscle relaxation

In one small 2020 study, researchers found that women with OAB who received a specialized form of CBT for OAB showed a significant improvement in overall symptoms and urinary frequency. However, a 2021 analysis of five studies on CBT for OAB concluded that more research is needed to evaluate the efficacy of this type of treatment.

Keep in mind that no form of psychotherapy is a replacement for the treatments prescribed by the doctor who’s treating you for OAB. Instead, it should be used a complement to your OAB treatment.

A few different types of mental health professionals can help treat the mental health symptoms associated with OAB.

It may be a good idea to find a professional who specializes in treating people with OAB symptoms or at least chronic health conditions. They’ll have more experience treating your individual needs.

If you’re unsure where to start, search the American Psychological Association database of therapists in your area. Most list the style of therapy they use and the concerns they commonly address.

In general, you’ll likely choose between one of the following types of professionals:

  • Psychologist. This professional typically has a doctoral degree, such as a PhD or PsyD, and can treat a range of issues through counseling. They can’t prescribe medication in most states.
  • Psychiatrist. This doctor has a degree in medicine (MD or DO). A psychiatrist can treat many complicated disorders and can prescribe medications, if needed.
  • Mental health counselor. “Mental health counselor” is a broader term for a mental health professional who provides counseling, such as a licensed professional counselor (LPC). Not all mental health counselors are licensed, and they can have a range of education and experience. It’s important to ask about a counselor’s education, experience, and licensing before making an appointment.

When searching for a mental health professional, ask if they specialize in CBT.

As mentioned, this therapy is often used to treat anxiety and depression and helps you learn to reframe negative thoughts in a more positive way. It may be helpful for people with OAB, although more research is needed.

Due to the COVID-19 pandemic, telehealth has become increasingly available. Many mental health professionals offer the option to be seen virtually for mental healthcare. Consider these options for booking an appointment with a therapist or counselor:

Cognitive-behavioral therapy can be expensive. A 1-hour appointment can cost over $100 without insurance.

Some clinics offer mental health services on a sliding scale based on your income, especially if they receive funds from the U.S. government. You can find a federally funded health center near you on the Health Resources and Service Administration website.

The National Alliance on Mental Illness (NAMI) has a helpline that offers free advice and can help you locate affordable mental healthcare in your area. You can call the NAMI helpline at 800-950-6264.

If you don’t have insurance, check to see whether you’re eligible for Medicaid. Medicaid offers free or low cost health insurance coverage through the government depending on your income level. To find out if you’re eligible, visit Medicaid.gov.

You may also qualify for low cost health insurance through the Affordable Care Act (ACA). Visit Healthcare.gov to check your eligibility.

OAB symptoms can come with a strong emotional toll and increase your risk of anxiety and depression. It’s important to seek help for these conditions along with treatment for OAB.

A therapist or counselor can help you learn mental strategies to ease stress and anxiety about OAB. When combined with OAB treatments such as pelvic muscle exercises and medications, these strategies may help you better manage your OAB symptoms.