Your mental health is how you think, feel, and behave. Your physical health is the state of your body when you consider the presence or absence of bodily illness and fitness. Your mental and physical health are also connected, meaning that one affects the other.
People living with chronic (persistent or long-term) physical conditions are more likely to experience poor mental health than those who are well, and those who have poor mental health are at a higher risk of developing problems with their physical health.
Prostate conditions including prostate enlargement, prostatitis and prostate cancer, and the treatments that are used to treat them, are no different.
Prostate enlargement and mental health
Lower urinary tract symptoms (LUTS) are the most common symptoms of prostate enlargement. LUTS include storage and emptying symptoms. Storage symptoms include increased frequency of urination, increased urgency of urination, urgency (and sometimes urge incontinence) and needing to urinate more often overnight. Emptying symptoms include poor urinary stream, hesitancy (difficulty starting the urinary stream), terminal dribbling (dribbling of urine after you have finished urinating), and incomplete emptying (not being able to empty the bladder properly).
These symptoms can cause men to feel stressed because they constantly need to plan for bathroom trips. Needing to go to the toilet multiple times throughout the night may lead to mood changes as men may struggle to get an undisturbed sleep.
Prostate enlargement itself or its associated symptoms, like LUTS, may be a source of anxiety and depression in men. Often, doctors will recommend lifestyle changes to try and relieve the symptoms. This does not always fix the problem so medications may be prescribed to help. These medications may affect mood, so it is important to talk with your doctor about possible side effects.
Prostatitis and mental health
For many men living with prostatitis (infection or inflammation of the prostate gland), trouble urinating, pain and discomfort, and lowered sex drive are common symptoms that may lead to poor mental health, particularly depression.
Psychological stress can lead to worsening symptoms of prostatitis, particularly pain and discomfort when urinating. It is not fully understood why stress may cause worsened symptoms.
Prostatitis can be difficult to treat, which can add to feelings of hopelessness. If you have prostatitis, take hope in knowing that while it may take time to uncover the cause and find an effective treatment, once you do, it should quickly help to relieve your symptoms.
Prostate cancer and mental health
Prostate cancer is the second most common cancer in men in Australia. For many men, the diagnosis of prostate cancer is a much greater source of distress than the symptoms of the disease, which often go unnoticed until the cancer is in its later stages.
Men diagnosed with prostate cancer are at a higher risk of mental health issues, such as anxiety and depression, than the general population1.
An impact on mental health can occur for any man after a diagnosis of prostate cancer. Mental illness can persist or come and go throughout treatment and recovery as men adjust to their diagnosis, its management living with possible side effects.
It is important to speak to your health care provider to obtain help if required. In September 2019, the Prostate Cancer Foundation of Australia (PCFA) released a position statement recommending that men be screened for distress following diagnosis. This screening should be undertaken by men at regular intervals throughout their treatment and afterwards.
Men whose prostate cancer is managed using ‘active surveillance’ (which involves routine checking of their prostate cancer by their doctor) may feel distressed at the uncertainty of their condition, even if their doctor reassures that they are safe and well.
It is important to know that your feelings about any prostate problems are valid.
Feeling stressed, anxious or depressed when you are living with troubling symptoms is completely normal and you don’t need to feel guilty or ashamed to ask for support. In fact, asking for support, from your partner, a friend or your doctor, is the first step in the right direction to better health.
If you experience any of the following symptoms, you should consider speaking with your doctor to find out what to do next.
- Sad, down or depressed.
- Tired or a lack of energy.
- Trouble concentrating or lack of motivation.
- Mood swings.
- Increased or reduced appetite.
- Sex drive changes.
- Trouble coping with daily problems or stress.
- Trouble getting to sleep.
- Disconnection from friends and/or family.
- Loss of interest in activities that you normally enjoy.
For more information about prostate cancer, visit the Prostate Cancer Foundation of Australia at pcfa.org.au.
For more information about incontinence, visit continence.org.au.
Read more about prostate health in the July 2020 issue of The Male.
 A systematic review of quantitative observational studies investigating psychological distress in testicular cancer survivors. Smith et al. Psychooncology 27(4): 1129-37, 2018