Difficulty urinating when I have a girlfriend, along with anxiety. for 12 years

  I have been experiencing difficulty urinating along with extreme anxiety since I was about 16.  I am now 28.  I've tried all the SSRI drugs as well as many tricyclic antidepressants and  Buspar and Wellbutrin.  My main problem is I can't urinate when I have a girlfriend and this causes anxiety.  I am now on klonopin, and have been for 2 years.  I feel it is causing memory loss and fatigue.  Are there any muscle relaxants that only focus an the sphinctor muscler or the abdomen?  Can you recomend anything.

[HFHSMD-TB]

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Dear David,
Difficulty with urination can be due to a number of problems, some psychological and some organic.  I assume you have discussed your problem with your physician to assess any physical factors that may be contributing.

Although I do not have all of the details of your problem, it appears that trouble with urination occurs only when you have a girlfriend.  There is a psychiatric disorder, called Social Phobia or Social Anxiety, in which people feel inhibited in social or performance situations, especiallywhen they fear possible scrutiny by others.  The individual may fear humiliation or embarassment, and become very anxious or have a panic attack.  Social anxiety is a common disorder, the third most common in the United States.
The good news is that it is treatable, often with a combination of antidepressants and psychotherapy.  Some specific types of psychotherapy, particularly cognitive or behavioral therapies are helpful.  The SSRI, which you mentioned, are usually the agents of choice.  One could also try other medications including the monoamine oxidase inhibitors, tricyclic antidepressants, effexor or serzone.  Sometimes drugs like Klonopin can be helpful.  They may cause a slowing or blunting of cognitive abilities and fatigue.  There may be no specific drugs that work on the sphincter per se.
I would recommend that you see a mental health professional regarding your symptoms.  If you would like to be seen at Henry Ford Hospital by a mental health professional please call 1-313-874-6680.  I hope that this information has been helpful to you.  It is provided for educational purposes only and should not replace consultations with your physicians.