Potomania: symptoms, causes and treatment

A strange mental disorder related to the uncontrolled intake of water and other liquids.

Water is essential for the body and to be healthy.. It has usually been stated that we should be hydrated all day long to make our body's work easier and prevent problems such as constipation.

So, does this mean that it is healthy to drink large amounts of water every day? Where is the line between healthy and problematic? Do people who do not part with their water bottle have a problem? Can water be harmful to our organism?

In general terms, it has always been recommended to ingest between 1 and 2 liters of water per day for the proper functioning of the body, although this statement is subject to many factors that can vary the amount of desirable intake: metabolism, the amount of sport performed, the time of year, the vital stage, the amount of vegetables and fruit ingested... In this article we are going to talk about potomania (also known as psychogenic polydipsia), its causes and treatment.

What is potomania?

Potomania, also known as psychogenic polydipsiais the desire to drink large quantities of liquid, usually water, as a consequence of a mental or organic disorder.

It is a disorder that takes the form of compulsive acts, and is not governed by physical sensation. is not governed by the physical sensation of thirst.that is to say, the person with this syndrome will drink large quantities of water without being thirsty.

At the nosological level, potomania is not included in any system of classification of psychiatric disorders., but because of its characteristics it could be included within the DSM 5 heading "Eating or food intake disorder not otherwise specified" (APA, 2013). Other professionals advocate including it within impulse control disorders.

Symptoms

Potomania is characterized by compulsive liquid ingestionwhich generates in the person a feeling of relief and pleasure.

Symptoms characteristic of food intake that cause clinically significant discomfort or impairment in social, occupational, or other important areas of functioning of the person predominate. For example, clinically significant anxiety if they cannot quickly access the liquid they want to drink. they want to drink. The desire to ingest liquid governs the person, who cannot lead a normal life.

In the most severe cases, it is possible to ingest between 8 and 15 liters of water per day. When the person consumes more than 6 liters of water per day, he/she should consult a doctor immediately, even if apparently no other symptoms are present.

There is high anxiety when they do not have access to the liquid they want to drink, sleeping problems, panic attacks and headaches..

On the other hand, potomania is often confused with dipsomania.. The latter is the irresistible tendency to abuse alcoholic beverages. It refers to an impulsive form of drinking, related to external stressors, which generates highly maladaptive behaviors.

Negative consequences of potomania on the body

What can happen to our organism if we exceed our water intake systematically and over time? It is known that drinking more than 3 liters of water a day is no longer beneficial for the body because it it can alter the balance between fluids and electrolytes..

Some symptoms that indicate that our body is overhydrated are:

• Muscle cramps, feeling of fatigue and tiredness (a consequence of the dilution of potassium and sodium in the blood).
• Nausea and headache.
• Reduced concentration and loss of mental alertness (low blood sodium concentration affects brain function).
• Drowsiness and body paralysis.
• In very extreme cases, coma and death.

Psychological and organic causes

We must highlight the hypothalamus as the main organic cause. One of the functions of this region of the brain is to warn of the lack of liquid in the organism through the thirst signal. An alteration in this brain structure could generate episodes of potomania. Another possible organic cause to be taken into consideration is diabetes mellitus.

However, experts say that the origins of this syndrome are mostly due to certain mental illnesses, delusions and eating disorders. Among the causes, the following stand out:

Psychotic disorders and dementia.

Diseases such as schizophrenia, bipolar disorders, or Alzheimer's disease can influence its appearance.

2. Anorexia

In these cases, the person drinks large quantities of liquids with the objective of satiating oneself without ingesting caloriesor to gain weight before passing a medical examination.

Vigorexia and orthorexia.

Their motivations would lie in distorted beliefs about the benefits of the ingestion of certain liquids.

4. Medications

The use of certain medications should also be noted as causes, such as some Anti-Inflammatory drugs, diuretics and lithium, which interfere with kidney function.which interfere with kidney function.

Treatment

In this section we will explain the psychological treatment of this syndrome. It should be noted that in severe cases psychological treatment must be accompanied by medical and/or pharmacological treatment for the control of hypnoatremia (low sodium level).

One of the great challenges for psychologists when treating this syndrome is that the person is not able to control the intense desire to drink water, so it is difficult to follow the guidelines and recommendations to reduce fluid intake. In extreme cases, the clinician may be forced to reduce the patient's mobility to a particular area that lacks fluid sources.

Fundamentally, the treatment of psychogenic polydipsia will be based on the restriction of fluid intake accompanied by the therapist (the patient should ingest between 1L-1L-1L of water every 24 hours) together with cognitive-behavioral techniques. (the patient should drink between 1L-1.5L of water every 24 hours) together with cognitive-behavioral techniques. Some of them are:

• Techniques to reduce anxiety.Muscle relaxation, controlled breathing, deep breathing, self-instructions...
• Techniques to reduce water intake gradually: drinking a limited amount of water in small sips per day, mindfulness of each sip of water...
• Techniques aimed at redirecting the patient's attention when he/she feels the desire to drink water..
• Token economy: in some cases this system can be implemented to reinforce self-control behavior, as for example in people with schizophrenia.
• Cognitive restructuring in cases where there are distorted beliefs regarding water intake (e.g., in people with schizophrenia). e.g., existing myths about the benefits of drinking large quantities of water).