Parents, Children Struggle with Secret Shame of Adolescent Bedwetting

By Hugh C. McBride

Teen pregnancy. Adolescent substance abuse. Childhood depression, behavior disorders, eating disorders and related mental health challenges. Once upon a time issues such as these were discussed in hushed tones (if at all), leaving many young people and their families with the impression that they were somehow “abnormal,” and that they were virtually alone in their search for answers.

Thankfully, public awareness and a willingness to openly address the many challenges facing young people and their families have resulted in a reduction in the “shame factor” and an increased access to quality care.

However, even in these more enlightened time, this general sense of acceptance appears to have its limits, with some problems still considered too shameful to be talked about openly, honestly, and (perhaps most importantly) with compassion and understanding.

Among the conditions to which the code of shame and silence unfortunately appears to apply is enuresis, the clinical term for the problem of bedwetting by young people over the age of 3.

About Enuresis

If your child or even teenager has a bedwetting problem, the first thing you need to know is that you are not alone.

Experts estimate that about 15 percent of children wet their beds at least once after their third birthday, and conventional medical thought appears to suggest that occasional bed-wetting between the ages of 3 and 6 is hardly unusual. Though bedwetting by adolescents is neither unheard of nor cause for undue alarm, it is not an issue to be ignored, either.

Another matter of primary importance is that enuresis is not a disease, and it is not necessarily an indication of an emotional disorder.

According to information posted on the website of the American Academy of Child & Adolescent Psychiatry, enuresis is a fairly common occurrence that, in most cases, is either a symptom of either delayed bladder development or a sign that the child is having difficulty dealing with a source of stress or tension:

There are a variety of emotional reasons for bedwetting. For example, when a young child begins bedwetting after several months or years of dryness during the night, this may reflect new fears or insecurities. This may follow changes or events which make the child feel insecure: moving to a new home, parents divorce, losing a family member or loved one, or the arrival of a new baby or child in the home.

The health information website FamilyDoctor.org lists the following as among the most common causes of bedwetting by children and adolescents:

Genetics (enuresis tends to run in families)
Small bladder
Difficulties waking up
Stress or tension
Delayed development of the central nervous system (reducing the child's ability to stop the bladder from emptying while the child is asleep)
Urinary tract infections
Urethral valve abnormalities (boys only) or ureter or spinal cord abnormalities (girls and boys)

The Emotional Aspect

A young person whose bedwetting persists into adolescence or beyond puberty should be evaluated by a medical doctor to identify (or rule out) causes such as the physical or developmental abnormalities noted in the list above.

In cases where no physical factor can be identified, parents should take a closer look at their child’s life to determine if any pressures or stresses could be causing the problem. From seemingly innocuous events (such as moving to a new house) to obviously traumatic experiences (such as the death of a family member or friend), a wide range of events can cause a young person to develop a bedwetting problem.

And while we would like to believe that our children’s lives are stress-free, the harsh reality of the matter is that today’s teens and tweens are exposed to myriad issues that might result in emotional despair. Here are a few:

Problems keeping up in school or anxiety related to a desire for academic perfection
Bullying (direct physical harassment and indirect intimidation via rumor-spreading, ostracism or cyber-bullying)
Financial worries (They may not read the newspaper, but kids know when times are tough, and may be anxious about the troubles they fear their parents are facing.)
Relationship problems (Even young children can experience stress related to friendships or cliques, and adolescents often struggle with their newly developing romantic feelings.)
Family problems (Fighting with parents, listening to parents fight with each other, dealing with divorce, discovering they were adopted – each of these can cause considerable emotional upheaval among children and teenagers).

Addressing the Problem

Young people who wet the bed may be doing so for a variety of reasons, but it is almost certain that everyone who does so has a few things in common – namely, that they are embarrassed, confused and perhaps even angry about their problem.

Regardless of how old or young your child is, responding to enuresis by scolding, demeaning or otherwise punishing the child is never appropriate. Even if a physical cause for the bedwetting is identified and addressed by a physician, your child may still feel a sense of profound shame. Make sure that your words and actions reinforce the fact that enuresis is not an indication that your child is bad, sick or otherwise “wrong.”

If no physical cause for the bedwetting can be identified, you should educate yourself on the behavioral and therapeutic solutions that are available. The matter may be resolved simply by ensuring that your child doesn’t drink anything within an hour or so of going to bed, or it may require a few sessions with a therapist to reveal and alleviate an underlying emotional strain.

Bedwetting by older children and teenagers can be a particularly confounding experience both for the child and the parents. But your willingness to support your child, and to address the manner in a respectful and dignified manner, can go a long way toward solving the problem and strengthening your family.

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