Oh man can I relate. I deal with it completely different now and actually use the protective underwear and it takes away the anxiety completely! Now the thing is you need to get the kind that works best for you and your body type. For me so it's not noticeable at all I use a Tena product for women so it's shaped to fit us better. If I'm at home I can go without of course but if I go out I just slip one on and tada no anxiety, if something happens I know I'm covered! And I have tested this or rather have had accidents and been totally fine!!!
I find spasticity to be a big part of it and if I'm low on baclofen in the system I have a little harder time
I have trouble releasing sometimes which doesn't help but for me cathing created more problems!
Wish you all the best!