Can depression and anxiety cause urinary frequency?

From the Guidelines

Depression and Anxiety's Impact on Urinary Frequency

Yes, depression and anxiety can potentially cause frequent urination.

• The relationship between mental health conditions like depression and anxiety and their impact on physical symptoms such as urinary frequency is complex and can be influenced by various factors, including the medications used to treat these conditions 1.
• Medications like selective serotonin reuptake inhibitors (SSRIs), which are commonly used to treat depression and anxiety, may contribute to urinary frequency as a side effect 1.
• It is essential for individuals experiencing frequent urination, especially if they have depression or anxiety, to consult a healthcare professional for a thorough evaluation, as this symptom can be associated with various underlying medical conditions.
• Lifestyle modifications, such as managing fluid intake, practicing relaxation techniques (e.g., deep breathing, meditation), and maintaining a healthy weight, may also help alleviate symptoms of frequent urination associated with depression and anxiety.
• The management of depression and anxiety in patients, including those with cancer, often involves a combination of psychotherapy and medication, with SSRIs being a common choice for treating both depression and anxiety symptoms 1.
• Given the potential for medications to contribute to urinary frequency, and considering the complex interplay between mental health conditions and physical symptoms, a comprehensive approach to managing both the mental health condition and the urinary symptoms is necessary, ideally under the guidance of a qualified healthcare provider.

From the FDA Drug Label

Urogenital System Ejaculatory Disturbance c,d13%0% Other Male Genital Disordersc,e10%0% Urinary Frequency3%1% Urination Disorderf3%0% Female Genital Disordersc,g2%0%

Urinary Frequency is listed as an adverse event in the drug label, with an incidence of 3% in patients treated with paroxetine, compared to 1% in the placebo group 2. However, the label does not explicitly state that depression and anxiety cause urinary frequency.

• Anxiety and nervousness are listed as adverse events, but there is no direct link to urinary frequency.
• Depression is not directly linked to urinary frequency in the label. Therefore, based on the information provided, it cannot be concluded that depression and anxiety cause urinary frequency. 2 2

From the Research

Depression and Anxiety's Impact on Urinary Frequency

• Depression and anxiety can cause physical changes, including bladder dysfunction, which may lead to urinary frequency 3.
• Studies have found that patients with depression and anxiety are more likely to experience lower urinary tract symptoms (LUTS), including overactive bladder (OAB), difficult urination, and infrequent voiding 3, 4, 5.
• The relationship between urinary incontinence (UI) and depression or anxiety has been explored, with findings suggesting that UI is associated with higher levels of depression and anxiety 4, 6.
• Chronic psychological stress, which can be caused by depression and anxiety, may contribute to the development of LUTS, including urinary frequency, urgency, and incontinence 7.

Mechanisms Behind Depression and Anxiety's Impact on Urinary Frequency

• Inflammatory responses induced by chronic stress may play a role in bladder dysfunction, with pro-inflammatory cytokines and chemokines contributing to bladder dysfunction and pain 7.
• The central nervous system and local bladder function may be affected by cytokines, influencing the regulation of micturition pathways and causing detrusor hypertrophy and afferent nerve hypersensitivity 7.
• The use of psychotropic drugs, such as antidepressants, may be associated with UI, although the impact of these drugs on the relationship between UI and anxiety/depression is unclear 6.

Associations Between Depression, Anxiety, and Urinary Frequency

• Anxiety has been associated with OAB without urinary incontinence, moderate or severe LUTS in men, and nocturia and stress urinary incontinence in women 5.
• Depression has been linked to sexual dysfunction, moderate or severe LUTS in men, and stress urinary incontinence, sensation of incomplete emptying, and decreased frequency of sexual activity in women 5.
• The associations between depression, anxiety, and urinary frequency may be influenced by various factors, including age, sex, and the use of psychotropic drugs 4, 6.