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Overcoming Paruresis: A Personal Journey

9/14/2025, 7:40:22 AMMale25-34

Hello, I’m a 40-year-old man standing at 5 feet 10 inches and weighing 210 pounds. I manage chronic obstructive pulmonary disease (COPD) alongside type 2 diabetes, but I don’t smoke, and my diabetes is stable. I’m reaching out for some guidance. As I age, I’ve found it increasingly difficult to urinate in public facilities, often seeking out locations that offer single-occupancy restrooms. The mere thought of others being around causes me significant anxiety when I attempt to use the bathroom. This challenge has even led me to decline job opportunities at workplaces that lack single-user or family restrooms. My situation is becoming overwhelming, and I’m unsure of how to cope. I have been seeing a psychiatrist, and I requested to start taking buspirone in hopes of alleviating my discomfort. Since I’m in recovery, traditional anti-anxiety medications like benzodiazepines are off the table for me, even though I recognize they could be beneficial due to my condition. Currently, I am on Suboxone, which I’ve been taking for several years, and I'm beginning to wonder if this might be contributing to my issue. I would greatly appreciate any suggestions or insights, particularly regarding medications that I could discuss with my doctor. Has anyone else experienced similar challenges or can relate to what I’m going through? Any shared experiences or advice would be very valuable to me.

Crohn's DiseaseCOPDEndocrinology

Answers (1)

Cony

9/14/2025, 7:40:38 AM

OpenHealth AI

Main Points: You're experiencing difficulty urinating in public due to anxiety, which is impacting your daily life and opportunities. Since you're in recovery and currently on Suboxone, it's important to explore non-benzodiazepine options to alleviate your anxiety while managing your chronic conditions.

Explanation: It’s understandable to feel overwhelmed by paruresis (the fear of urinating in public), and your concerns are valid especially as it affects both personal and professional aspects of your life. Paruresis is often related to social anxiety, and while medications like benzodiazepines can be effective, there are alternative approaches that might be more suitable given your recovery journey.

Buspirone is one option that can help with anxiety without the sedative effects associated with benzodiazepines. Other non-benzodiazepine medications may include certain antidepressants, like SSRIs (selective serotonin reuptake inhibitors), which some find effective for anxiety disorders. Additionally, cognitive behavioral therapy (CBT) techniques are also valuable in addressing specific anxieties and can be complemented with medication.

Next Steps:

  1. Open Dialogue with Your Doctor: Discuss your experiences and concerns with your psychiatrist. Ask specifically about buspirone and other non-benzodiazepine medications or SSRIs that could help manage your anxiety without interfering with your recovery.

  2. Therapeutic Approaches: Consider exploring CBT with your psychiatrist or a psychologist. It’s a structured, effective method for overcoming social anxieties.

  3. Gradual Exposure: Work on gradually exposing yourself to public restrooms in low-pressure situations, practicing relaxation techniques beforehand. Techniques like deep breathing or visualization can help you feel calmer in these environments.

  4. Support Groups: Look into support groups for anxiety or paruresis, where you can share experiences with others who understand your challenges.

  5. Mind-Body Techniques: Incorporate mindfulness or relaxation strategies into your daily routine to help manage anxiety, such as meditation, yoga, or controlled breathing exercises.

Please keep these steps manageable, focusing on one or two at a time as you progress. Your journey is significant, and taking small steps towards overcoming this challenge is key.

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