Potomania: symptoms, causes and treatment

Water is essential for the body and for good health. It has generally been said that we need to be hydrated throughout the day to make it easier for our body to work and prevent problems such as constipation.

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

In general, it has always been recommended to drink between 1 and 2 liters of water per day for the proper functioning of the body, although this statement is subject to multiple factors which can vary the amount of intake desirable. : the metabolism, the quantity of the sport practiced, the time of the year, the vital stage, the quantity of vegetables and fruits ingested … In this article we are going to talk about potomania (Also known as psychogenic polydipsia) What are their causes and treatment.

    What is potomania?

    Potomania, also known as psychogenic polydipsiaIt is the desire to drink large amounts of fluids, usually water, as a result of a mental or organ disorder.

    It is an alteration which is embodied in compulsive acts, and it is not governed by the physical sensation of thirstIn other words, the person with this syndrome drinks large amounts of water without feeling thirsty.

    At the nosological level, potomania it is not included in any classification system for psychiatric disordersBut for its characteristics, it could be included in the title of DSM 5 “Eating disorders or ingestion of unspecified foods” (APA, 2013). Other professionals advocate including it in impulse control disorders.


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

    The predominant symptoms of food intake predominate and cause clinically significant discomfort or impairment in social, occupational, or other important areas of human functioning. For example, they experience clinically significant anxiety if they cannot access fluid quickly who want to drink. The desire to ingest liquid rules the person who cannot lead a normal life.

    In the most severe cases, between 8 and 15 liters of water can be ingested per day. When the person consumes more than 6 liters of water per day, they should seek immediate medical attention, even if apparently no other symptoms appear.

    Strong anxiety coexists when they do not have access to the liquid they want to ingest, sleep problems, panic attacks and headaches.

    On the other hand, potomania it is often confused with dipsomania. The latter is the overwhelming tendency towards alcohol abuse. It refers to a form of impulsive ingestion, linked to stressful external elements, which generates very inappropriate behaviors.

    Negative consequences on the body of potomania

    What can happen to our body if we exceed our water intake consistently and over time? We know that drinking more than 3 liters of water per day is no longer beneficial for the body, because it can alter the balance between fluids and electrolytes.

    Some symptoms that indicate that our body is overhydrated are:

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

    Psychological and organic causes

    The hypothalamus should be highlighted as the main organic cause. One of the functions of this region of the brain is to warn of the lack of fluid in the body by the thirst signal. An alteration of this brain structure could lead to episodes of potomania. Another possible organic cause to consider is diabetic sugar.

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

    1. Psychotic disorders and dementias

    Diseases such as schizophrenia, bipolar disorder or Alzheimer’s disease can influence its onset.

    2. Anorexia

    In these cases, the person drinks large amounts of fluids in order to satiate without ingesting calories, Or to gain weight before having a medical exam.

      3. Vigorexia and orthorexia

      His motivations would be a distorted beliefs on the benefits of ingesting certain fluids.

      4. Medicines

      It should also be noted that the causes are the use of certain drugs, such as some anti-inflammatory drugs, diuretics and lithium, Which interfere with kidney function.


      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 in 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 given to reduce fluid intake. In extreme cases, the clinician may be forced to reduce patient mobility in a specific area that does not have liquid sources.

      Essentially, the treatment of psychogenic polydipsia it will be based on the restriction of fluid intake accompanied by the therapist (The patient should ingest between 1 L and 1.5 L of water every 24 hours) as well as cognitive-behavioral techniques. Some of them are:

      • Techniques to reduce anxiety: Muscle relaxation, controlled breathing, deep breathing, self-instructions …
      • Techniques to gradually reduce water consumption: drink in small sips a certain limited amount of water per day, pay attention to each sip of water …
      • Techniques aimed at redirect the patient’s attention when they feel the need to drink water.
      • Check the economy: In some cases, this system can be implemented to reinforce self-control behaviors, such as in people with schizophrenia.
      • cognitive restructuring in cases where there are distorted beliefs regarding water consumption (for example, existing myths about the benefits of drinking large amounts of water).

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