Homebound urgency: Understanding latchkey incontinence and mental triggers

It happens that when turning the key in the door of a house or apartment, we feel an enormous urge to urinate. A specialist explained when the run from the hallway to the bathroom should be consulted with a professional.

Imagine returning home from work or a trip and suddenly needing to use the restroom. The closer you get to home, the more this feeling intensifies, ending in a dash from the front door to the bathroom. This phenomenon, called "latchkey incontinence," is triggered by situational stimuli, such as arriving home. It is common among people with overactive bladder and urinary incontinence, but it can happen to anyone.

For HuffPost.com, psychiatrist Dr. Jessica Stern commented on this behaviour of our bladders. She explained: "The closer you are to that access, the more you’re going to feel that sense of urgency and your body is going to say, ‘Oh, hey, we’re almost there, we have it.'" The brain "tells" the bladder when it can empty. The mind and body are deeply linked and work in tandem, regulating bodily functions, including hunger, sleepiness, and urination.

Dr. Stern stated that the brain and bladder communicate throughout the day to ensure that we urinate only when it is acceptable. During a long drive, with no stops in sight, the brain essentially advises the bladder to "hold off" until a restroom is nearby. When you know you're near a restroom, the brain retracts those inhibitory messages. Relief is getting closer.

The more often we repeat certain behaviours, the stronger the associations become. Dr. Stern emphasized: "The more you go to this place where you’re arriving at home and having to go to the bathroom immediately, the more that pattern is going to start to develop." Our brain likes to save energy by automating behaviours that we frequently repeat. Another example of such behaviour is that we may not remember if we locked the front door. Automated behaviours are less likely to be stored in memory.

Nearly 7% of the population suffers from paruresis, or "shy bladder syndrome." They have difficulty using the restroom when other people are around. They find it hard to use public restrooms at work, school, or restaurants. Dr. Stern explained: "If they are unable to use a restroom all day, by the time they get home, the urge to pee may be intense."

If a strong urge to urinate at the door does not cause problems, nothing needs to be done about it. Dr. Stern emphasized: "The mind can cope with the urge to pee — even if it feels like you can't hold it much longer, you probably can (Until you absolutely can’t, at which point your bladder will just release itself.)." However, if this condition affects the quality of your life, it is worth consulting a mental health specialist. Cognitive behavioural therapy and exposure therapy can be really helpful, especially if there is an element of social anxiety.

For most people, situational "latchkey incontinence" is a harmless condition that occurs when returning home. Dr. Stern summarized: "If it’s not a problem, it’s not a problem — and if it is, that’s when you do something about it."