Needing the toilet when you wouldn't normally is another common form taken by panic attacks.
Just as many people tend to start worrying about, "What if I panic?" as soon as they realise they're somewhere where it would be inconvenient or embarrassing to do so, so too there are others who have developed the habit of believing they must use the toilet whenever they realise this is not possible.
I recently treated a young woman who had developed the habit of thinking, as soon as she found herself on a moving bus, that she needed to use the toilet. The mechanism behind this was obvious.
She had been in the habit of having that thought when on a bus which had no toilet facilities. Over time her survival instinct had learnt to view being on a bus as a threat simply because she always became anxious and had raised negative arousal when on one.
Because she had learnt to associate the fear of needing a toilet with this whole scenario, that was just what automatically happened each time she got on a bus.
She told me that she had learnt to keep it at bay a bit, so as to last the journey, by blocking out those thoughts, but she hadn't succeeded in preventing the fearful thought from happening.
With treatment, however, she learnt how to go about doing just that and succeeded.
Please note that symptoms such as this may not be due to anxiety especially if they suddenly develop for no reason you are aware of. It is vital to get checked out by your doctor before assuming that any physical symptom is due solely to anxiety.
One of the big problems when people have this symptom is that if they cannot control it and the worst happens it can be very embarrassing. Therefore the key to success is usually finding a situation in which if the worst happens it doesn't really matter too much.
The bottom line here is to be able to practise not joining in with the fearful thoughts when you are safe at home. This way you learn to control them fairly well before attempting to do the same in public.
Of all the symptoms of anxiety, this one is probably the most challenging to overcome simply because failure to control the symptoms can result in extreme embarrassment in public.
As is the case with chest pains, feeling you need the bathroom as a symptom of anxiety is best addressed over the long term. Because the belief that you need the toilet has become linked in your mind with certain situations, now, whenever you are in those situations, the brain gives you the sensation of needing the toilet.
But, brains are simply machines that link things! Whenever any two things - be they thoughts, feelings, experiences, etc - occur together, the brain links them. After that whenever you get one of the pair it will give you the other. That is the basic mechanism at the root of anxiety symptoms and phobias.
What the Jack Russell taught me
The power of the brain's linking ability was demonstrated to me by my daughter's Jack Russell Terrier some years ago.
From time to time I would have the dog to stay when my daughter was on holiday etc.
As a child I can recall always being asked by my mother every time we were about to leave the house, "Have you been to the toilet?" We were always told to go before we went out.
I hadn't realised this had become a habit that I followed for not only my childhood, but for all my adult life, until the dog showed me.
The dog didn't like being left alone in the house when I went out for short periods. She had obviously also observed that before I went out I would go upstairs to use the toilet (even though I hadn't realised myself that I did this).
I only became aware when one day, when I had no intention of leaving the house, the dog came upstairs to the bathroom with me and then refused to come down again.
Instead she sat and looked at me from the top of the stairs because she was expecting me to go out. She knew that before I went out I would shut her in the front room. By staying at the top of the stairs she was preventing this!
Since that day I have become aware of my habit and now often deliberately choose not to visit the bathroom before leaving the house if I don't actually need to.
Using a long term approach you teach the brain new links instead. Whilst doing this it is best if you can avoid triggering the old links as that only reinforces them. Therefore, when using the Feelgood Way to overcome anxiety you avoid triggering the responses you want to unlearn until you are sufficiently experienced at the techniques for unfocusing on them when they arise.