POTOMANIA: SYMPTOMS, CAUSES, CONSEQUENCES AND TREATMENTS - ECONOMÍA - 2024

The potomania or primary polydipsia is a disorder of organic or psychological origin whose main symptom is an extreme need for liquid consuming. It is generally associated with water, but it can also produce strong desires to consume other substances, such as beer or alcohol.

Thirst is a fundamental component of human behavior. However, in cases where potomania appears, the person can drink up to 15 liters of water a day. This behavior can have very serious long-term consequences, as it disrupts the fluid and electrolyte balance in the body.

The causes that cause the appearance of this disorder are very diverse. In some cases, the underlying problem is totally physical; while in others they have more to do with some kind of psychological problem. However, most of the time there is a combination of different factors that cause potomania.

In this article we will see in depth what are the main symptoms of primary polydipsia, as well as the most common causes for which it appears, the different types and related diseases that exist, and what are its most common consequences. In addition, we will also study the different treatments that exist for this problem.

Symptoms

Compulsive drinking of water

The most characteristic symptom of potomania is an irrepressible desire to consume large amounts of water. The person can drink up to 15 liters a day in the most serious cases, which can cause all kinds of physical problems due to the excessive presence of this liquid in the body.

People with potomania often report feeling thirsty even after drinking large amounts of water. This thirst can be caused by physical causes (such as a kidney problem that forces them to urinate excessively), psychological, or a mixture of both.

Anxiety

As is the case with other eating disorders, people with potomania frequently experience high levels of stress or even acute anxiety when they cannot access the amounts of water they want. In fact, anxiety is one of the main keys to diagnosing this disorder.

Thus, when potomania is mild, the person may simply feel uncomfortable when not near a source of drinking water. In the most extreme cases, on the other hand, you may even suffer from panic attacks if you cannot quickly access this fluid when you feel thirsty.

Hyponatremia

Excessive water intake can lead to an alteration in the balance of sodium and potassium levels in the body. People with this symptom often experience severe headaches, muscle cramps, spasms, and difficulty falling asleep that appear to be caused by low levels of sodium in the blood.

Changes in habitual behavior

As in the case of other eating disorders, people with potomania tend to alter their daily routine to try to always be near a source of drinking water. This usually brings complications in their normal life, which will be more serious the more severe the problem.

For example, a person with a very strong case of potomania may refuse to go anywhere that does not have immediate access to a tap, such as a beach, a park, or simply the center of a large city.

These behavioral changes often contribute to increased anxiety, which in turn may make other symptoms worse.

Causes

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Potomania is an eating disorder slightly different from the others, in the sense that it is usually caused by a mixture of physical and psychological causes. In this section we will see which are some of the most common.

Underlying diseases

There are many physical pathologies that can cause an excessive thirst response in a person. In cases where a disease is the main cause, we would be talking about organic and not psychological potomania. Treatment, then, should focus on solving the underlying problem.

Some of the most common illnesses that can cause a case of organic potomania are certain types of diabetes, and chronic kidney problems.

Alterations in the hypothalamus

The hypothalamus is the part of the brain that is responsible for regulating the thirst response, among many other functions. Various neuroimaging studies carried out in people with potomania show that there are certain anatomical differences between this part of their brain and that of a person without this pathology.

These alterations may have occurred either due to genetic causes (which is why they would be present from birth), or as a product of some type of brain damage, as in the case of a stroke or head trauma.

Dementia and psychotic disorders

Apparently, many cases of potomania are caused at least in part by the presence of certain serious psychological illnesses.

It is known that individuals with disorders such as schizophrenia, bipolarity, or certain types of dementia are more likely to suffer from this eating disorder.

The relationship between all these types of disorders is not very clear; but it is believed that it may have to do with alterations in certain brain regions, which would be involved in the appearance of all of them.

Body dysmorphic disorders

Potomania can also appear as a consequence of the presence of other psychological disorders; specifically, of those that alter the perception that the person has of their own body. The best known is anorexia, but there are others that can also cause excessive water intake.

In the case of anorexia, the person may compulsively increase their fluid intake in an attempt to fill up without having to eat calories. This behavior would end up becoming addictive, which in the medium or long term could cause the rest of the symptoms of potomania to appear.

Another of the dysmorphic disorders most related to excessive fluid intake is vigorexia (the obsession with exercise and very muscular physiques).

People who suffer from this pathology could develop certain irrational beliefs about the benefits of water that would lead them to suffer potomania in extreme cases.

Learning by reinforcement and punishment

Finally, the behavior of drinking excess fluids may have been learned simply through a purely behavioral process. Drinking water is a very reinforcing and pleasant action, while thirst is a natural "punishment."

In cases where potomania is primarily behavioral, the person may have learned to avoid thirst at all costs and to seek the reinforcement of constantly drinking water.

If there was some type of previous vulnerability (such as the presence of a very neurotic personality or an anxiety disorder), the person could end up developing episodes of potomania after a while.

Types

The vast majority of cases of potomania are related to excessive water consumption. In fact, the most serious consequences of this disorder occur due to the properties of this liquid, especially its high potassium content, which can cause all kinds of imbalances in the body.

However, some researchers propose including an alternative version of potomania in official manuals: one that would be characterized by excessive beer intake.

The argument used by these scientists is that, despite being an alcoholic drink (and therefore its excessive consumption could fall within the disorder known as dipsomania), the characteristics of beer mean that it can cause consequences very similar to those produced by water when consumed in high quantities.

In fact, several studies in this regard have shown that the consumption of four or more liters of beer per day as the only liquid can also cause hyponatremia (lack of sodium in the blood). Therefore, today the debate is open as to whether to accept beer potomania as a real disorder or not.

Consequences

The main problem with potomania, as we have already mentioned, is the danger that the person suffers from altering the balance between the levels of sodium and potassium in the body.

This can cause from mild discomfort such as headaches and muscle cramps, to extremely serious consequences.

Next we will see the most common consequences, divided into three groups: mild, medium, and serious.

Mild consequences

In less troublesome cases of potomania, the person may experience drowsiness and fatigue, headaches, nausea, and muscle cramps. These consequences tend to disappear very soon after excessive water intake is reduced.

Medium consequences

In more worrisome cases of potomania, the person may begin to experience a decrease in some of their psychological abilities. For example, it is common for the patient to find it more difficult than usual to concentrate on a task, or to keep her attention focused on a single thing.

On the other hand, it may also happen that the individual feels that he is losing part of his mental agility. This would be caused by very low levels of sodium in the blood; the damage could become very difficult to fix if the problem persists for a long time.

Serious consequences

In the most extreme cases, the alteration of sodium and potassium levels in the blood can lead to very serious problems, such as difficulty using certain muscles, body paralysis or even coma.

Even, on some occasions, potomania can lead to a multi-organ failure that ends up producing the death of the affected person. Fortunately, this outcome is quite unusual.

Treatments

Depending on the underlying causes of each case of potomania, the treatment to be applied will be different. Next we will see which are the most common options to alleviate the most serious symptoms and solve the problems underlying this disorder.

Serum administration

As we have already seen, the main danger of potomania is the alteration of sodium and potassium levels in the blood. Therefore, in cases where there is hyponatremia, the first step of treatment will consist of intravenous administration of serum until this alteration has been corrected.

This step is carried out to avoid the most serious dangers to the health and life of the patient; But once the levels of sodium and potassium in the blood have been regulated, it will be necessary to combat the causes of the problem to prevent it from recurring later.

Behavioral therapy

One possible way to combat potomania is through behavioral training. Through reinforcement and punishment, the patient learns to reduce the frequency with which he carries out his problem behavior (in this case, drinking water or beer), while finding alternative ways of behaving that are not harmful.

Cognitive therapy

When potomania is caused mainly by certain irrational ideas related to fluid intake, one of the most effective ways to solve this disorder is precisely to change these thoughts for more adaptive ones.

Generally, the most widely used techniques of this style are cognitive restructuring, rational debate and belief confrontation. Normally, in addition, cognitive therapy is usually used together with more behavioral techniques.

Medication

As we have seen previously, in some cases potomania is produced by the alteration of certain areas of the brain, mainly the hypothalamus.

In these cases, the best solution is to use psychotropic drugs that help alleviate its effects and reduce the most serious psychological symptoms of this disorder.

The use of medication can also be key to treating those cases of potomania that are caused by the presence of a medical disorder of another type, such as kidney problems, schizophrenia or diabetes.

In any case, even when medication is used as the main form of treatment, its use is usually combined with the application of some type of psychological therapy.

References

1. "Potomania: symptoms, causes and treatment" in: Psychology and Mind. Retrieved on: November 30, 2018 from Psychology and Mind: psicologiaymente.com.
2. "Polydipsia (excessive thirst)" in: Health Line. Retrieved on: November 30, 2018 from Health Line: healthline.com.
3. "Potomania: when hydrating becomes an obsession" in: Very Healthy. Retrieved on: November 30, 2018 from Very Healthy: muysaludable.sanitas.es.
4. "Potomanía" in: Web Queries. Retrieved on: November 30, 2018 from Web Consultas: webconsultas.com.
5. "Primary polydipsia" in: Wikipedia. Retrieved on: November 30, 2018 from Wikipedia: en.wikipedia.org.