What if someone hears me pee? What if someone sees me while I'm peeing? What if I keep someone else waiting for the cubicle? What if a queue builds up and other people get annoyed? What if I don't manage to pee at all? What will happen?

These are very common thoughts for people who have shy bladder syndrome (paruresis). It might start off as a little niggle, a thought in the back of your mind. But people with shy bladder tend to overthink, and what started as that little niggle can become a huge insurmountable problem.

Overthinking means thinking the same thought over and over excessively, analysing it and looking at it from every angle, until it dominates your thoughts and you can no longer be rational about it. With this constant repetition, thoughts tend to become increasingly negative and extreme. You can become exhausted mentally, unable to relax or sleep, and thinking of the worst possible outcomes can make you increasingly stressed. This can make overthinking worse, which in turn will make your paruresis even worse.

But what can you do about overthinking? Here are a few suggestions to get you started….

• Recognise that you're overthinking. You can only take action to change something if you're aware you're doing it.
• Distract yourself. It can be really hard to do that if you're feeling negative, but doing something else that takes your attention can help manage unwanted thoughts.
• Prioritise relaxation. Some people find yoga, mindfulness, or online guided meditations helpful; choose something which feels right for you.
• Do something nice for someone else. Concentrating on other people helps to take the focus off your persistent thoughts.
• Give yourself credit for your achievements, however small they seem. Being kinder to yourself can give you a more positive outlook.

On the UK Paruresis Trust website you'll find information about paruresis and how to tackle it so that it has less of an impact on your life.