Writhing in agony, I felt a sense of dread. The pain in my bladder and stomach was now excruciating. Yet again I ran for the bathroom, feeling I was going to wet myself.
When I made it to the loo, though, nothing came out. But my feeling of urgency only became more intense – and started burning.
A red-hot anguish radiated up to my stomach until I felt physically sick.
In my early 20s, this was my every-day reality: suffering from a mystery bladder condition no doctor seemed able to diagnose, let alone cure.
I’d had repeated bladder infections since childhood that generally cleared up with antibiotics or cystitis sachets.
But when I left university after my psychology degree, things became dramatically worse. I was working as a marketing manager when I started to get back-to-back urinary tract infections (UTIs). This time, nothing helped.
Going to pee became something I braced for, expecting severe pain. Often, I couldn’t go at all. I couldn’t relax, socialise and was constantly aware of what loos were accessible.
After months of UTIs and pelvic pain came nightly debilitating migraines, ripping me from my sleep. No painkillers worked, nor did other treatments, including prescription migraine drugs.
Unsurprisingly, I soon became worn down.
That year, I took unpaid sick leave from my job and, for a time, was forced to move back in with my dad.
For months, I spent my days on his sofa – bleary eyed and depressed. I felt suicidal, unable to fathom the point of living if it was going to be so painful.
Endless antibiotics didn’t work, nor did gel pumped into my bladder, which was supposed to coat it and prevent irritation.
I saw GPs, sexual health experts and specialist urogynaecology consultants. Cameras were put up my urethra, with innumerable scans and dyes pumped into my bladder to see what might be causing this. There was nothing.
I’d had repeated bladder infections since childhood that generally cleared up with antibiotics or cystitis sachets, writes Dr Sula Windgassen
What there was, though, was the usually implicit – and sometimes explicit – accusation from the (often male) doctors that this was ‘all in my head’; that I was somehow imagining my symptoms. This only made me feel physically and mentally worse.
Today though, aged 36, I am happy to say my bladder symptoms have been in remission for a decade, and my migraines are only occasional.
My cure was an unlikely one. Put simply, I used psychology to improve my physical health.
And this doesn’t mean my symptoms were ‘all in my head’ – but instead proves how the mind and body are inextricably linked.
The conversation between your psychology and biology is continuous, through your nervous system activity, hormone shifts, chemicals in your brain and more.
But this conversation can escalate into an argument, if you will, with your mind working against your body – and vice versa – which can contribute to conditions such as mine becoming chronic. However, you can stop this ‘argument’ between mind and body (more later on how).
Discovering this mind-body connection completely changed the direction of my life.
Within a year of learning about it, in 2012, my symptoms had abated to such an extent I could pursue a PhD in health psychology, exploring how psychological therapy could physically create changes in gut symptoms – using cognitive behavioural therapy (a type of talking therapy where you’re guided into changing how you think and act), along with simple tactics, such as changing how people held their stomachs in or constantly watched for bathrooms, to ease symptoms.
I’ve also worked on medical trials exploring the use of psychology in irritable bowel syndrome, inflammatory bowel disease and multiple sclerosis (MS) – investigating how, for example, in progressive MS, it could improve quality of life by aiding people to feel at peace with the reality of their condition.
Today I am a health psychologist – first working in the NHS, now privately – treating those with persistent health issues by guiding them in how psychology can physically change their body’s processes (I’ve found this especially relevant in bladder, bowel and gut conditions).
Again and again, I’ve seen the same look in the eyes of my patients that I once had, pleading ‘please take me seriously’.
Sadly, the NHS often offers inadequate support to those with chronic, complex conditions, choosing to look at individual symptoms over the whole patient.
I spent months bouncing from hospital department to hospital department, while doctors struggled to decide what I ‘had’. They generally started by throwing definitive diagnoses and treatments at me.
As nothing worked, I morphed in their eyes from an over-anxious girl het up over a run-of-the-mill infection, to a problem patient.
There was one definitive, they said: stress. Specifically, I should avoid it because it would only make things worse.
Yet feeling so physically awful was inherently stressful.
After talking to my Dad, a psychiatrist, I sought the help of a therapist in late 2011, aged 22.
On the way to my appointment, a migraine struck. My therapist assessed me as I pressed a cold bottle to my right temple.
There were lots of questions about my childhood – and not many about my health.
On my third appointment I told my therapist my symptoms had flared after my boyfriend and I had sex, but that I hadn’t told the urologist this because my Dad was in the consultation and it would have been awkward.
My therapist replied: ‘So even though you were having these awful symptoms… you did not tell your doctor because you were ashamed to talk about sex in front of your Dad?’ He paused, as though he’d said something meaningful. Understandably, his attitude made me despair.
Sadly, the NHS often offers inadequate support to those with chronic, complex conditions, choosing to look at individual symptoms over the whole patient
There are many neurological pathways between the brain and bladder and pelvis that constantly communicate
My turning point came in 2012, not with that therapist – who I never saw again – but with my Dad.
Serendipitously, he was doing a master’s degree in mindfulness – where you focus on the present moment, and take note of your body’s sensations and thoughts without judgment or fear, which reduces anxiety. Mindfulness, Dad insisted, would help my overwrought mind and frazzled nervous system regulate – and reduce my physical symptoms.
Within weeks of starting, I felt calmer and less alarmed by my symptoms.
Months on, I felt no pain and my migraines were gone. I still felt bladder discomfort and needed the loo frequently, but it no longer terrified me.
Eventually, as I continued with mindfulness techniques and learned more about how my mind and body were linked, I reached the point I’m at today.
This approach is backed by solid biological reality, especially when it comes to bladder conditions like mine, such as over-active bladder (where you get a sudden need to pass urine) or chronic prostatitis (inflammation of the prostate gland).
There are many neurological pathways between the brain and bladder and pelvis that constantly communicate, partly to determine whether your bladder is full and whether it’s appropriate to ‘go’.
There are multiple brain regions involved in this, including the pre-frontal cortex (PFC), which controls attention and focus.
It’s the reason the urge to pee may increase as you put your key in the lock of your door – the PFC has logged you’re nearly at your loo, a safe place to wee, and has given the bladder the go-ahead, leaving you hopping about. The hypothalamus, which regulates our stress response, also has pathways to the bladder. A study published in Frontiers in Neuroscience in 2018 showed such pathways can become dysfunctional when we’re stressed.
Our nervous system is meant to tell our bladder to relax and release our urine.
But when you’re stressed about bladder symptoms, it’s difficult to do this.
Your body may automatically brace, creating muscular tension. This can cause bladder muscle spasms, urinary retention, pain and even sensations that feel just like UTIs.
Another study, published in Neurology and Urodynamics in 2014, shows that, when under psychological stress, the bladder’s nerve cells can get more reactive – meaning you experience more sensory messages from it.
You may feel premature bladder fullness or odd sensations indicating an infection or irritant, even when they’re not present.
And when you force yourself to pre-emptively go to the loo, or hyperfocus on what the bladder or pelvic region feels like, you’re unknowingly entering into a feedback loop: you think about the area, feel more stressed, which only fuels biological responses that worsen the condition itself.
A similar process occurs in gut conditions.
I have treated many patients whose psychological experiences have impacted their gut health, some to such an extent they have given up exercise and developed elaborate toileting rituals such as pre-emptively going to the loo. Some have even given up work.
And because the brain is primed to perceive unusual gut symptoms as a health threat, any unpredictable toileting issues cause more activity in the nerve cells in the gut that communicate with the brain.
This causes a vicious circle between mind and body – and this nerve ‘visceral hypersensitivity’ affects 30 to 40 per cent of IBS sufferers, according to a study in Nature Reviews Gastroenterology & Hepatology in 2011.
But, as I discovered myself, developing something called interoceptive awareness – being alert to your internal bodily sensations, an integral part of mindfulness and distinct from hyperfocus, because it is an observational awareness rather than one that is full of urgency and analysis – is vital to managing chronic conditions.
Studies have shown the more interoceptive awareness you have, the more able you are to reduce the intensity of uncomfortable emotions.
And building interoceptive awareness has been found to improve mental health and physical symptoms in chronic conditions such as MS, stroke recovery, diabetes and chronic pain.
A study in 2022 for instance showed that in stroke rehabilitation, bodily awareness training – which is physiotherapy with an emphasis on increasing attendance to physical signals – improved the recovery of motor functions. And in diabetes, in 2008 researchers found interoceptive awareness improved blood glucose control: this involved building awareness of internal cues, such as foggy thinking and mood changes. Checking into these several times a day ‘retunes’ the brain to hear the body’s warning signals.
Perhaps most significantly, interoceptive awareness helps chronic pain.
A review of multiple studies, from the University of Connecticut, found those who suffered chronic pain experienced relief from both the intensity of their sensations and pain-related disabilities – such as not being able to do chores or work – after improving their interoceptive awareness.
Methods for doing this ranged from mindfulness to Qigong, a practice involving meditation and slow deliberate movements.
Significant pain reductions followed, with the most-effective interventions tending to be mindfulness based.
Certainly, this is something I can identity with. The days of my burning agony in my urethra and stomach are, thankfully, gone.
You may think that what changed my belief from ‘I’ll never feel better’ to ‘things can be OK’, was actually because my symptoms were receding.
But my beliefs started to shift before my symptoms reduced. And it was this simple fact which eventually changed my biology for good.
Adapted from It’s All In Your Body by Sula Windgassen (Bluebird, £22), published February 5. © Sula Windgassen 2026. To order a copy for £19.80 (offer valid to 17/02/26; UK P&P free on order over £25) go to mailshop.co.uk/books or call 020 3176 2937