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Picture this: You’re out on the road with your buds, and it’s hot. Like, “I chugged a huge water bottle to stay hydrated” hot.

You’re pulling into the next road stop, and of course, you really need to pee. But can you? If you’re the kind of person who would run into the bathroom without a care, and have no idea why this would be an issue, you probably don’t suffer from paruresis.

Often called “Shy Bladder Syndrome”, paruresis is the inability to pee in public. The good news is though, with a little psychological wizardry, it’s super treatable. This condition affects all kinds of people, and while researchers don’t have a great estimate of how many it affects, the International Paruresis Association gives a cautious estimate of around 7%.

There are differing levels of severity, and symptoms can include a wide array of things, like fear of people hearing or smelling you pee, negative self-talk, the inability to pee at home when guests are around, or the need for complete privacy when going to the bathroom. It can also result in someone not drinking enough so they won’t need to urinate in public, or avoiding travel and social events. In the DSM-V, which is the main manual doctors use to make mental health diagnoses, paruresis is listed as a kind of social phobia.

And as with many phobias, it can be hard to pinpoint the exact cause. For some people, it might have come from a specific bathroom-related incident, but for others, it could be part of a more general social anxiety. In general, studies show that people with the condition often anticipate that they might somehow be judged for peeing.

That, in turn, makes them freeze up, so they can’t relax and just go with the flow. Of course, psychological conditions like this are often on a spectrum, so if you’ve found it hard to pee in public once or twice, you’re probably fine. But if you’re having ongoing or significant problems with this, and there’s no evidence of something physically stopping you from urinating, it’s likely worth talking to your doctor.

Also, if you do happen to suffer from a shy bladder, you’re in luck. There are treatment options, and they can be very effective. Some people find relief in relaxation techniques, like doing some breathing and trying to mentally put yourself elsewhere when you’re in a restroom.

Others might turn to cognitive behavioral therapy, which is aimed at addressing the negative beliefs surrounding psychological issues. For example, if someone isn’t peeing because they think people might judge them, they’ll gradually work through what’s propping up that false belief until it’s no longer an issue. There’s also graded exposure therapy, where someone works up to facing their fear by taking smaller, more manageable steps, usually over the course of a few weeks.

For paruresis, that involves trying to pee in increasingly public bathrooms. And this particular therapy is often the first port of call to get over phobias. So if you’re holding it in about having to hold it in, you can always go talk to your doctor!

It’s likely they’ll be able to help. This episode of SciShow is brought to you by our patrons on Patreon! Thanks to Oliver Fernandez for asking the question, and to everyone who voted to have it answered.

If you want to ask a question yourself, vote on the next one we talk about, or just support the show, you can go over to patreon.com/scishow. [♪ OUTRO].