The physical effects of overactive bladder are obvious. But not much is said about the emotional impact. You may avoid road trips with friends, playing sports, or visiting your grandchildren because you’re afraid of leaks or having to stop a lot to go to the bathroom.

“People are starting to live their lives around controlling their bladder,” says Aqsa Khan, MD, a urologist at the Mayo Clinic in Phoenix, AZ.

Even at home, OAB can make the simplest social interactions stressful. Khan says one of her patients, a 50-year-old woman, described having a nice chat with her neighbor in her yard when she suddenly started urinating in the middle of the conversation. To cover it up, she turned the garden hose towards herself.

Loss of control, Khan says, can be devastating. “It’s losing something that really defines you as a social being,” he says. “It makes you feel infantilized, in a way. It makes you go back to wearing diapers.”

OAB can also affect intimacy. You may avoid sexual activity because you are worried about leaking. This can lead to bigger relationship problems. If your partner doesn’t know what’s wrong with you, they may think it has something to do with them. Do your best to open up and trust that your partner will support you.

The challenges of intimacy are difficult enough for couples who have been together for decades. They can be even more overwhelming when you’re in the dating game. “[OAB] can be a big elephant in the room when entering into those more intimate relationships,” says A. Lenore Ackerman, MD, PhD. She is the director of research for the Division of Women’s Pelvic Medicine and Reconstructive Surgery at UCLA Health.

You may wake up four times a night, but fall back asleep each time. Others may only get up twice a night. But they have such a hard time getting back to sleep each time that it has a huge effect on their quality of life. “It’s torture,” Khan says.

This is because when you don’t get enough rest, your body doesn’t have a chance to recover. This could lead to other problems, including problems with brain function. There is a strong link between OAB and depression, Ackerman says, and lack of sleep is a key factor. “Sleep is really important for all of this,” he says.

Anxiety surrounding OAB can also worsen your physical symptoms. Just as you might clench your jaw without realizing it, people with OAB often clench their pelvic floor muscles, says Veronica Asence, DPT. She is a physical therapist at Lahey Hospital & Medical Center in Burlington, MA, specializing in pelvic health.

“Your pelvic floor is always active: it supports your pelvis, it supports your organs,” he says. “If we tighten the pelvic floor muscles in relation to the need [to pee] and the anxiety that surrounds that impulse, it’s like we’re constantly wagging our tail.”

This constant pressure can wear them down. So much so that they lose control when you need them most. You could see a big change in your symptoms simply by working on ways to relieve your anxiety and the pelvic floor tension that accompanies it.

If you’re older, you might think that urinary problems are a normal part of aging. (They’re not.) But if you’re young, OAB can carry an extra level of shame and guilt. You may be wondering how this can be happening or what is wrong with you.

Shame can be a major barrier to asking for help, but OAB is more common than you think. “Talk to your friends,” Ackerman says. “Chances are some of them have it too.” In fact, Ackerman says that the first thing he does when he meets a new patient is tell them about his own urinary problems.

By talking more about this, other people with OAB will likely feel more comfortable seeking long-term treatments rather than simply managing symptoms with pads, back-up underwear, catheters, and other items. They can be a great way to regain control. For example, new products are often designed with lightweight, flattering fabrics that secretly retain a lot of fluid. But sometimes they prevent people from seeking professional help, Ackerman says.

“You don’t have to deal with this alone,” Ackerman says. “This happens to many of us, there is treatment and we want you to receive treatment.”

“Doctors go into this line of work because they want to help patients,” says Dr. Sevann Helo, a urologist at the Mayo Clinic in Rochester, Minnesota. “We can’t improve something we don’t know is a problem.”

If your doctor doesn’t know how to treat OAB, he or she should refer you to someone who does. With help, you can take control. “It doesn’t matter if you’re 28 or 88,” Asence says. “Your bladder can be retrained at any time in your life.” The key, she adds, is to be persistent and take complete care of yourself. “Bladder’s personality is a lot like that of a young child: she performs best with structure, discipline, and a healthy environment.”