Maybe you were commuting home from work, or, perhaps, in the final stretch of your road trip. You really needed to go to the bathroom, and as you inched closer to home, the urge grew. You shifted positions in your seat and tried to distract yourself. As you approached your front door, panic set in — you beelined it to the bathroom with only a second to spare. You made it. Barely.
This phenomenon, known as “latchkey incontinence,” occurs because a situational cue — in this case, arriving home and putting your key in the door — triggers the need to pee. It’s more common in people with overactive bladder and urgency urinary incontinence, but it can happen to anyone. As is the case with hearing the sound of running water or being in cold weather, there’s just something about home that makes us really have to pee.
“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,’” Jessica Stern, a clinical assistant professor of psychiatry at NYU Langone Health, told HuffPost.
The Brain Tells Your Bladder When It’s OK To Pee
The mind and body are deeply connected and the two work in tandem to govern many body functions, including hunger, sleepiness and — you guessed it — urination.
The brain and bladder communicate throughout the day to ensure we are peeing when it’s appropriate, Stern said. When, for example, we’re in the middle of a long car ride with no rest stops in sight, the brain essentially tells the bladder to lay low until a bathroom is nearby.
“The brain sends signals to the bladder, telling it when and when not to contract,” explained Dr. Victor W. Nitti, a professor of urology and obstetrics and gynecology at the David Geffen School of Medicine at University of California, Los Angeles.
When you know you’re getting close to a bathroom, the brain starts to pull back on those inhibitory messages. Relief is in sight.
“As one gets closer to the bathroom, the inhibitory signals from the brain become less and less as the thought of urinating becomes stronger and stronger,” Nitti said.
The more we adhere to certain behaviours, the stronger the association will be. “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,” Stern said. Research has likened it to a Pavlovian response: You essentially teach your brain it’s time to pee when you see your front door.
Many People Associate Home With Comfort
In addition, home provides a feeling of safety and comfort for many. People often feel more comfortable going to the bathroom in a place they’re familiar with compared to a public restroom that may be unsanitary, inaccessible or unsafe, a 2020 study suggests.
This is especially common among people who have urinary or digestive issues, according to Stern. “If people have urinary struggles — or even digestive problems like irritable bowel syndrome — having a place where they feel safe and comfortable can be really important,” Stern said.
Nearly 7% of the population has paruresis, or “shy bladder syndrome,” a condition in which people find it difficult to go to the bathroom when other people are around. They may struggle to urinate when they’re at work, school or in a restaurant. If they are unable to use a restroom all day, by the time they get home, the urge to pee may be intense, Stern explained.
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Can You Unlearn Latchkey Incontinence?
If latchkey incontinence or urgency is not causing problems for you, there’s really not much you need to do about it, Stern said. 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.)
If, however, an intense need to pee as you approach home is affecting your quality of life, it may be worth checking in with a mental health professional. Cognitive behavioural therapy and exposure therapy can be really helpful, especially if there’s a social anxiety component, Stern said.
These therapies can help you become more comfortable going to the bathroom in public restrooms or teach you distraction techniques so your bladder doesn’t start leaking whenever you’re a block away from your front door. Solving a puzzle, playing a game on a computer, counting or reciting a poem can take your mind off peeing so you can break down the association that’s formed between getting home and urinating, research suggests.
If you have any concerns about your urinary habits, it may be a good idea to be examined by a qualified health professional, such as a urologist, who can check for an underlying health issue like an overactive bladder.
But for most people, latchkey incontinence is just going to be an annoying yet benign quirk you experience when you get home. As Stern says: “If it’s not a problem, it’s not a problem — and if it is, that’s when you do something about it.”
