Incontinence While Sleeping — or “pooping” the bed — isn’t as uncommon as you may think. While this unexpected night time activity may be embarrassing, it doesn’t have to completely derail your mental health.
There can be many causes for sleeping incontinence but you’ll never discover what they are if you’re unable to move past the psychological trauma. This week we’re sharing honest, personal experiences discussing how to cope without dying of embarrassment. Listen Now!
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About The Not Crazy Podcast Hosts
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Jackie Zimmerman has been in the patient advocacy game for over a decade and has established herself as an authority on chronic illness, patient-centric healthcare, and patient community building. She lives with multiple sclerosis, ulcerative colitis, and depression.
Computer Generated Transcript for “Sleep Incontinence” Episode
Editor’s Note: Please be mindful that this transcript has been computer-generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Not Crazy, a Psych Central podcast. And here are your hosts, Jackie Zimmerman and Gabe Howard.
Gabe: Welcome to the Not Crazy podcast. I’d like to introduce my co-host, Jackie, who not only lives with depression but has not seen Die Hard. Are the two connected? It’s your decision.
Jackie: And I’d like to introduce my co-host, Gabe, who lives with bipolar, his wife Kendall, and has also never seen the movie Now and Then, and I don’t know if that’s like a generational thing, but that was a pivotal movie in my youth.
Gabe: Nobody’s ever heard of it. Like, I keep thinking that you say “Now & Later,” the 80s candy. Because some for now and some for later. Unlike now where it’s just all for now and then you whine.
Jackie: No. No. If you have seen Now and Then, dear listener, please let us know. Comment somewhere. Right, somewhere. Send Gabe hate mail about how he should see this movie with incredibly famous actresses in it.
Gabe: Sure, sure. I’ll check my email. I’ll check my email.
Jackie: Ok, OK. Gabe? Sure. Gabe, you called me this weekend and you had a very serious tone in your voice and you said that you had something to tell me. What did you call me about, Gabe?
Gabe: I told you, I shit the bed.
Jackie: You did, indeed you did. And I, although very respectful of your situation, was thrilled that you called me because I am the person that people call when they have poop issues.
Gabe: The listeners are probably just now starting to realize that I’m not using the phrase shit the bed. I actually shit the bed
Jackie: You did? You did.
Gabe: Like literally and I’m not using literally, figuratively. It was a traumatic experience, to say the least. I have a friend who is a doctor. She was unavailable. Which left you?
Jackie: And I promptly was like, Gabe, this needs to be a podcast episode.
Gabe: And I was promptly no, because that’s just not the kind of thing that you talk about polite society ever at all.
Jackie: But I don’t live in a place of polite society, not to mention, as we talked about on the phone, this is something that happens to people, not just people like me with bowel diseases, but this happens to a lot of people.
Gabe: In my frantic Googling of this, I was surprised to find out just how common this is. You know, it has a million different names from nocturnal diarrhea, persistent diarrhea. A lot of what? A lot of diarrhea. Of course, we’ve all heard all of the commercials where they talk about a side effect of medication being anal leakage. The bottom line is, that while horrifying, it is almost routine how often the average person loses control of their bowels.
Jackie: And we wanted to talk about this, not to perpetually talk about shitting the bed over and over again. So if you’re listening and so far you’re like, wow, this episode is not going to be my bag. Hang in there, because the reason we’re talking about this is because it’s so common. The effect that it can have on your mental health afterwords and how you navigate that.
Gabe: I make my living, as people know, on this podcast and on the psych central podcast and standing up in front of people and talking about all of the things that happened to me because of untreated bipolar disorder. I wrote a book called Mental Illness Is an Asshole available on my Web site, gabehoward.com, because I wanted to talk about all of the awful things that have happened to me because of mental illness. And then this thing happened. And I immediately didn’t want to talk about it anymore. I was like, no, no, no, no, no. This is one step too far. This is not the kind of thing that you bring up that’s really interesting to me because people who know my work and you can just do a Google and find my work would think that I wouldn’t be shy of anything. That’s kind of how messed up this is, right? Even a guy like me who makes my living openly discussing things about mental illness and about health and about life that other people want to sweep under the rug, didn’t want to discuss it.
Jackie: But that’s what makes us a great team. You see, because I shit the bed and promptly told the whole Internet about it.
Gabe: And that’s very interesting because the reason that I called you, Jackie, is because of a story that you published a long, long time ago that I found to be stunningly relatable, even though it was pre bed shitting and it was about how you were in a new relationship. Wasn’t very old at all.
Jackie: And I was sleeping over at his house and I shit the bed in the middle of the night. I was horrified. I contemplated just leaving and never talking to him ever again because what is the alternative? It’s actually talking to somebody and saying, hey, you guy who thinks I’m amazing. I just shit in your brand new bed, by the way. Brand new bed. It was something I could not even dream, a conversation that was impossible to have. So I stayed up all night. I cried and I cleaned the bed. I woke him up and asked him to leave to the living room. And I contemplated all the ways that he was probably gonna break up with me the next day because he was likely just as horrified as I was. Well, he wasn’t and he didn’t. And instead, he broke up with me months later for a really dumb reason, but not because of this. And that’s important to remember.
Gabe: The phrase “shitting the bed,” of course, is a well-known phrase. It just means you fucked up. I have used this phrase probably my entire adult life. I try to run an event and it doesn’t go well. I shit the bed I get on stage and nobody laughs at any of my jokes. I’m pretty sure that if they had tomatoes, they would throw them. And I was like, you know, Gabe, how did your show go? Ahh, I shit the bed, it was awful. I’ve said it about so many people, Jackie. We talk about language a lot on this show, you know. Are you bipolar? Are you a person living with bipolar? You know, words matter. We need to change our speech patterns. And you and I have long held that. Look, we just need to talk about this, because getting it out in the open is what’s important. And I thought of the phrase “shit the bed,” everybody uses it, but the phrase, oh, you shit, the bed is actually quite problematic potentially for people. Well, like you, Jackie. People like you know me now. Yeah. We all do it. Not to make this a show about language all of the sudden, but it just shows you that there’s just a ton of phrases that have a meaning that you don’t realize until you realize. I thought the phrase shit, the bed was just a phrase. It had no meaning and it had nothing to do with me. Now I want you to know I’m still gonna use the phrase. Love the phrase. The phrase is fantastic. And I hope that when people come up to me and say, Hey, Gabe, you shit the bed, they’re telling me I did a bad job because I don’t want this to be my thing. But yeah, just it’s it’s out there now. It’s out there now that this is something that happens to people.
Jackie: Well, you’re acutely aware of it now. Right. It’s personal at this point. Whereas before it was just a phrase. Now it’s something that you actually have lived through. That’s what made me feel like this would be a good episode because I have lived this many times. But as somebody who does not live with a bowel disease, you’ve experienced it now. And I think a lot of people who listen to our show, specifically those who take psychiatric medications, also may experience this because that is a common side effect of a lot of these medications.
Gabe: So that’s a very interesting thing that you bring up first we got to define the word common. We don’t want everybody to freak out. You know, common is something out there. You know, one in one hundred thousand is common because there’s three billion people in the world. So the word common, you know, can be problematic. I only say that because I don’t want everybody to stop taking their medications for fear of shitting the bed.
Jackie: It’s a good point. It’s not common in that it’s going to happen to everybody. But when you get your medication, it comes with that little piece of paper that has a bunch of teeny tiny words on it and it’s called the P.I, which is the package insert. And on that lists all the side effects, everything you could possibly ever know. And everybody I know promptly rips it off the front of their package and throws it in the trash. You could read it. I read them, which maybe makes me an overachieving nerd, but I read them. I want to know what could possibly happen. And I think if you read yours, there’s a chance that side effect is on there.
Gabe: And you can see why it would be on there. I mean, if you really stop and think about it. Medication interacts with your body and everybody is different and our bodies job. The whole reason that we expel waste is to get bad things and unnecessary things away from us. So it really kind of makes sense that a common medication side effect could be anal leakage or diarrhea or that kind of diarrhea that happens in the middle of the night when you’re not expecting it. And I was really surprised at how common it was. And again, when I say common, I mean, it’s just happened to everybody at least once. I thought that I was the only person that this ever happened to save for my friend Jackie. And I was kind of lucky. Right. And I’m being very sincere here because you were open and wrote the article about shitting the bed. And because we’ve talked about it before on the show, I’ve seen your speeches at conferences where you talk about this illness and all of the things that you went through. And it made me feel not so alone. But the reality is, most people don’t know a Jackie. The reality is, most people don’t know a Gabe. Most people don’t know anybody. A lot of people are managing these things all by themselves. They’re managing especially mental health issues, especially mental illness. And they don’t want to talk about it. And I want to be very clear that this is something that is going to happen to probably every adult. And when I say every adult, I don’t mean every 80 year old. I don’t mean every person in a nursing home. No, we’re talking 20, 30, 40, 50 year olds. We’re talking young people, middle aged people. It is the body doing what the body is supposed to be doing. You know, in the most scary and traumatic of ways.
Jackie: It’s true. This could happen to just about anybody for just about any reason.
Gabe: We’ll be right back after these messages.
Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player.
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Jackie: And we’re back, talking about, ah, we’re talking about shitting the bed, that’s what we’re talking about. And the reason I really wanted to talk about it was not only just to be like, hey, you’re not alone. Shit the bed twins, right. But was also because I wanted to say this thing could happen and it could happen to any of us at any time. How do you make this thing not become a massive trigger to tank your mental health? Because it could if you let it right. If you bought into the stigma of the phrase shit, the bed, the embarrassment that’s associated with the digestive tract. All of these negative feelings around this natural thing that we do. It’s easy to see how that could have a really negative effect on you. And I think that it’s important to touch on that because one, we’re a mental health podcast. But two, because this is something that if it hasn’t already happened to you, could be in your future.
Gabe: And there’s nothing that you can do to avoid it. I hate to say it that way, but my, my, my. Yeah. Yeah. You know, it’s the middle of the night. You’re just waking up. It’s groggy. You realize something horrific has happened. You don’t know what to do because this is not something that people make a game plan for because nobody ever thinks it’s going to happen to them. And you know, you’ve got to be practical. You got to clean this up. But then you’ve got to decide, like, what to do. And as much as I hate to say that we’re going to cover, you know, post shit self-care methods. I think that we need to discuss it because when and if this happens to you, I don’t want it to derail your entire mental health plan because frankly, that would be worse. Nobody wants to shit the bed. But that’s a one time occurrence. That’s something that happens to you once every day of your life. You’re managing mental health and mental illness. And that is like your whole entire outlook. And you don’t want something that might happen or something that has happened once to become the focal point of your self-care routine. Jackie, as the expert, what do you do?
Jackie: Well, there’s a couple different things that I think you should do, especially if we’re talking about this in context of likely the cause being some kind of psychiatric medication. The first thing to do, well, not the exact first thing, but maybe after you do some other things, is probably to call your doctor. And that’s important for a couple reasons. One, to report to your doctor that this happened and put it in your file. So if it keeps happening, maybe you need to reassess your medication. The other reason is because this kind of event is so underreported. It does not become known as a side effect of medications because we don’t want to talk about it. So then we don’t talk to our doctors about it because whoa, embarrassing cannot possibly do that. And then they don’t know to tell the other patients. This could be a thing to happen, too. So call your doctor. And if you can do it over the phone, it feels less invasive when you’re not face to face having this conversation. Send an email if you have a patient portal. There’s a lot of ways that you can do this. Protect yourself. Potentially help other patients without having to be face to face, which I know I have done. It is a very uncomfortable conversation to have, even when this is something that happens to you on the regular.
Gabe: It’s also important to bring it up to your psychiatric service providers because it might not have anything to do with your medication. It might not have anything to do with your mental health. It might not have anything to do with your mental illness. It could just be bad luck. People do get sick. People do get diarrhea. You decide to eat at that sketchy joint that just opened and you’re like, hey, the prices are good. You get steak for $5.99. And it made you sick. Also, as we age, the foods that we can eat and not have issues surrounding really does change. My mom used to say that I had a cast iron stomach. Clearly that is no longer true.
Jackie: The next thing that I would do is find someone you trust in your life and tell this story to just verbal vomit. What happened? Get it out of you and then hopefully never talk about it again. And the reason why is because and this is maybe, maybe this is just me, but if I have something traumatic and horrifying and embarrassing that happens, I want to keep that shit inside. Ha ha.
Gabe: I see what you did there.
Jackie: Horrible pun. I want to keep it inside. I want to internalize it. I’m probably going to isolate about it. And that’s not good. I’m going to perseverate on it. I’m going to keep reliving it. It’s going to probably have a really bad effect on how I’m feeling about myself, how I’m feeling about life. It could really take things bad quickly. And I think that by getting it out into the world, it’s one of those things that maybe who you tell is like, oh my god, me too. I totally do that, too. You never know. I just think it’s really important to share it with someone. Maybe it’s your therapist. Maybe that’s the safest place for you. But I I would not keep this inside. I think to preserve mental health. It needs to sort of live on the outside.
Gabe: I think that’s exactly right because I know how I internalize it and catastrophize things. I’m still having arguments with my ex-wife in my head thinking, what if I would have said this? Then she would have said that. Then I would have done this and then I would have won the argument. And it would always start off this way. Oh, I’m sad that this happened. Oh, but that time, she said this. Oh, I could have said that. Oh, I am so angry. And it never ends in a good place. And when I finally started to talk it out with people, one of those people being my therapist, I stopped doing that. If you keep something this big in your head, you’re going to keep thinking, oh, my god, what if I wouldn’t have eaten this? What if I would’ve taken my pills at a different time? What if I would have just woken up? What if I would have? And you’re going to what if yourself to death? Because there is no end to your imagination. And if you are anything like me, my imagination is mean to me. I always think about all of the things I did wrong. And all of the reasons that I’m an awful person. And as much as I didn’t want this to happen and as much as I never want it to happen again, which is why I’m following up with my doctors and doing everything I can to make sure that this never happens again. It was helpful to find out how common this is. It was also very helpful to find out that more likely than not, I’m not in any danger. The body was doing what the body does, and while it’s unfortunate and not happy, it’s not necessarily unhealthy. I need to follow up with my doctor to find that out 100 percent, but for the most part, shitting the bed, not life threatening.
Jackie: Much like Brene Brown, who I respect a boatload, says, this could create a shame storm. And the problem with the shame storm is that if you don’t get it out of you and maybe share it with somebody, God forbid it happens again, then what do you do? Right. You’ve already created this thing you can’t talk about. It already makes you feel terrible. Then it happens again. And just the potential for the downward trajectory is huge. So I feel like for you, for the people around you, for the other people in the world who also shit the bed. It’s very important to share this experience. You don’t have to do it on the Internet like I did multiple times at this point. You don’t have to share for the greater good in that sense, but preserve yourself and make sure that everything’s cool and that your mental health is going to be preserved regardless of this incident.
Gabe: Jackie also think it’s worth pointing out severe and persistent mental illness as a cause for incontinence, both urination and bowel issues. When I was so depressed, I was suicidally depressed. I did not want to get out of bed. And even though I knew that I was going to urinate, I did not have the strength to move. I just couldn’t. And I was so depressed, I didn’t care. I would rather lay there in my own waste than walk the 10 steps to the bathroom. And that was just the reality of where I was. The same thing can happen the other way. And when we consider psychosis, when you’re literally out of your mind, when you don’t know where you are, this can lead to all kinds of things that aren’t desirable. It’s not just thinking that you’re being chased by people that aren’t there. It’s also about not understanding the needs of your physical body, which going to the bathroom is some of those. It really just is common for many, many reasons. And the reasons are going to be individualized. I don’t think that I can state that enough. I don’t want anybody to listen to this podcast and say, hey, the Not Crazy people said that I did this because of X. No, the Not Crazy people said, tell your doctor, see your doctor, get to the bottom of it. But more likely than not, it’s not that big of a deal. That’s what the Not Crazy people said.
Jackie: Gabe, I know that talking about, we’ll say things of the disgusting nature, is not your forte. You have mentioned that on numerous occasions.
Gabe: I hate it.
Jackie: I think it was really brave of you to call me and to be willing to put this in a podcast. And I use the term brave rarely because it’s not my favorite term, but I do think that it was brave. So if you’re feeling the way that Gabe feels or you have shit the bed, the way that Gabe did and I have as well, let’s be real here. If you take nothing away from this episode, let it be these few things. One, you’re not alone. At least you know Gabe and I have also shit the bed. Two, please call your doctor, make sure that everything is ok. And three, do not internalize this. Share it with someone, someone you trust, someone who will not judge you and just make sure that you’re taking care of yourself both physically and mentally after something like this.
Gabe: And hey, after you’re done doing all of that, share this podcast everywhere. Thanks, everybody, for tuning into this episode, please. Wherever you downloaded this podcast, give us as many stars or hearts as humanly possible and use your words. Tell us why you liked it. Love something about the show? Hate something about the show? Want to give us an idea? Or hey, just like emailing strangers? Hit us up at show@PsychCentral.com. Stay tuned after the credits for an outtake, and listen on a show like this, it’s probably going to be a good one. We’ll see everybody next week.
Jackie: See ya.
Announcer: You’ve been listening to Not Crazy from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. To work with Jackie, go to JackieZimmerman.co. Not Crazy travels well. Have Gabe and Jackie record an episode live at your next event. E-mail email@example.com for details.