Potomania: symptoms, causes and treatment

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

So does that mean it's healthy to drink large amounts of water every day? where is the line between healthy and problematic? Do those people who do not part with the bottle of water have a problem? Can water be harmful to our body?

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 multiple factors that can vary the amount of desirable intake: metabolism, the amount of sport performed, the time of year, the stage of life, the amount of vegetables and fruit eaten... In this article we are going to talk about potomania (also known as psychogenic polydipsia), what are its causes and its treatment.

• You may be interested in: "Trichotillomania: the strange obsession with pulling your hair out"

What is potomania?

Potomania, also known as psychogenic polydipsia, is the desire to drink large amounts of fluid, usually water, as a result of a mental or organic disorder.

It is an alteration that is embodied in compulsive acts, and is not governed by the physical sensation of thirst, that is, the person with this syndrome will drink large amounts of water without being thirsty.

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

Symptoms

potomania characterized by compulsive fluid intake, which generates in the person a feeling of relief and pleasure.

Characteristic symptoms of food ingestion that cause clinical discomfort predominate Significant or deterioration in the social, labor, or other important areas of the functioning of the person. For example, feel clinically significant anxiety if they cannot quickly access fluid what do you want to drink. The desire to ingest liquid governs the person, who cannot lead a normal life.

In the most serious cases, you can drink between 8 and 15 liters of water a day. At the moment in which the person consumes more than 6 liters of water a day, they should consult a doctor immediately, even if no other symptoms appear to appear.

There is high anxiety when they do not have access to the liquid they want to ingest, trouble sleeping, 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 ingestion, related to stressful external elements, which generates very maladaptive behaviors.

Negative consequences in the body of potomania

What can happen to our body if we exceed the intake of water 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 may disturb fluid and electrolyte balance.

Some symptoms that indicate that our body is hyperhydrated are:

• Muscle cramps, feeling of fatigue and tiredness (consequence of the dilution of potassium and sodium in the blood).
• nausea and headache.
• Reduced concentration and loss of mental agility (low blood sodium concentration affects brain function).
• Drowsiness and bodily 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 a lack of fluid in the body through the thirst signal. An alteration in this brain structure could generate episodes of potomania. Another possible organic cause to consider is diabetes mellitus.

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

1. Psychotic disorders and dementias

diseases like schizophrenia, bipolar disorders, or Alzheimer's can influence its appearance.

2. Anorexy

In these cases the person drinks large amounts of fluids with the goal of being satiated without ingesting calories, or to gain weight before passing a medical examination.

• Related article: "Types of anorexia (symptoms, causes and characteristics)"

3. vigorexia and orthorexia

His motivations would lie in distorted beliefs about the benefits of drinking certain liquids.

4. Medicines

It is also necessary to highlight as causes the use of certain medications, such as some anti-inflammatories, diuretics and lithium, 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 to control 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 that are indicated to reduce the intake of liquid. In extreme cases, the clinician may be forced to reduce patient mobility to a specific area that lacks sources of liquids.

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

• Techniques to reduce anxiety: muscle relaxation, controlled breathing, deep breathing, self-instructions…
• Techniques to gradually reduce water intake: drink a certain limited amount of water a day in small sips, full attention to each sip of water...
• Techniques aimed at redirect the patient's attention when they feel the desire to drink water.
• Token economy: in some cases this system can be implemented to reinforce self-control behavior, such as in people with schizophrenia.
• cognitive restructuring In cases where there are distorted beliefs in relation to water intake (eg. g., existing myths about the benefits of drinking large amounts of water).