# Psychotic disorders and water



## Modus.Ponens (Aug 2, 2006)

Hello

I had a marijuana induced psychosis 5 years ago and I've been having residual symptoms ever since. During this period I had two more psychotic breaks and a few days ago I had something close to it. So I'm on a period of recovery.

I never concerned myself with the amount of water I drink per day until recently. In the last days, after the "semi-psychotic-break" (SPB  ) I've been drinking water very frequently. What I noticed is that in the periods of the day that I'm frequently drinking water my symptoms remain calm. If I stop for an hour or maybe more, the symptoms start to grow  . 

Does this make sense? Is this placebo or a real possibility, i.e., can some psychosis be caused by (long term) (semi-) dehydration?


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## David Baxter PhD (Aug 2, 2006)

I can't say I've ever heard of that as a cause of or trigger for psychosis, Modus.


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## Modus.Ponens (Aug 2, 2006)

I read somewhere, that long term semi-dehydration is suspected to cause some mental illnesses, among other things. The problem is that the source was probably not reliable...


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## David Baxter PhD (Aug 2, 2006)

I don't know enough about this to say it's impossible - just that I've never heard of it before.


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## Halo (Aug 2, 2006)

I don't know anything about this either however the thought of being able to drink more water and have a mental illness disappear does sound rather inviting. Not that I am suggesting that anyone try it as I don't think that there is any scientific proof that it works but in a perfect world it would be nice


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## ThatLady (Aug 2, 2006)

Dehydration does impact the electrolytes present in the blood, thereby impacting the entire body, including the central nervous system. Altered mental status is often seen in elderly people who are dehydrated (dehydration is quite common amongst the elderly population). While I've never heard of it causing psychosis, it can cause some very odd psychological symptoms.


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## David Baxter PhD (Aug 2, 2006)

That's true, TL, although I think that is associated more with confusion and disorientation, isn't it?


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## foghlaim (Aug 2, 2006)

can i make a comparison here??? david you can remove it if it's out of line or anything.. at least i hope you do.

isn't water for us... a bit like petrol (gas) is to a car?? i mean if we don't drink enough water.. surely our bodies will react negatively.(dehydrate) and this in turn would surely mean that we couldn't possibly behave in the same manner that we'd be used to.. either physically or logically?? 

If we don't put petrol(gas) in the car.. it will soon run out, slow down and then come to a full stop! (Wouldn't be good to be "stranded" with no petrol would it?)

so we drink water.. we can go....
petrol in car.. we can go... 

does any of this make any sense??  if not just delete it
(maybe i'm rambling again  )


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## David Baxter PhD (Aug 2, 2006)

There's no question we cannot survive for long or function well without water or without sufficient water (and other metabolites). But Modus is wondering whether that can cause psychosis. i don't think under the circumstances he is describing that that is very likely.


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## Halo (Aug 2, 2006)

I completely understood your comparison and where you are coming from NSA. I do think that we need water to survive but what Modus is talking about I think is something completely different and has nothing to do with surviving.

Side note/question?: Is it just water that our bodies need or is any form of liquid?


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## David Baxter PhD (Aug 2, 2006)

It's water. Although water can be extracted from other liquids.


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## Halo (Aug 2, 2006)

But can dehydration be fought off by drinking other things besides water?


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## David Baxter PhD (Aug 2, 2006)

The short answer is it depends on what you drink. Beverages containing caffeine and alcohol contain water but the net effect is to dehydrate you more. Fruit juices and the like should generally be fine.


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## Halo (Aug 2, 2006)

Thanks...that is exactly what I thought but I just needed clarification.


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## ThatLady (Aug 2, 2006)

David Baxter  said:
			
		

> That's true, TL, although I think that is associated more with confusion and disorientation, isn't it?



Most of the time, yes. I have, however, seen people who are severely dehydrated behave in ways that could certainly be mistaken for psychosis. Dehydration just messes with the entire system. If you have problems at any level, dehydration will magnify them, in my experience.


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## David Baxter PhD (Aug 3, 2006)

Well, there you go. I learned something today, which makes it a good day. 

Thanks, TL!


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## ThatLady (Aug 3, 2006)

Welcome!


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## JA (Aug 3, 2006)

Very interesting topic... 

I'm just thinking... so long as this doesn't go overboard (ie drinking more than the recommended amount of water...), if you find it helps, then even if it's a placebo, where's the harm? Who knows, maybe they'll discover something about it someday... but since it's a healthy habit, and most people don't drink enough water...I say if you feel better, then go for it! 

Cheers  (I'll drink a glass of water to that!)


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## ThatLady (Aug 3, 2006)

It's pretty close to impossible to drink too much water unless you have some renal failure, or heart failure. As long as you're a relatively healthy person, your urinary system will get rid of the excess fluids.


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## HA (Aug 4, 2006)

There are also conditions such as *water intoxification* and polydipsia (psychogenic) that are good to be aware of.

Am J Psychiatry 1988; 145:675-683 
Copyright ? 1988 by American Psychiatric Association 
http://ajp.psychiatryonline.org/cgi/content/abstract/145/6/675

*Polydipsia and hyponatremia in psychiatric patients*
BP Illowsky and DG Kirch 
Clinical Brain Disorders Branch, National Institute of Mental Health, St. Elizabeths Hospital, Washington, DC 20032. 

Many psychiatric patients have polydipsia and polyuria without identifiable underlying medical causes. Hyponatremia develops in some polydipsic patients and can progress to water intoxication with such symptoms as confusion, lethargy, psychosis, and seizures or death. This syndrome is sometimes called "compulsive water drinking," "psychogenic polydipsia," and "self-induced water intoxication." 

Although the underlying pathophysiology of the syndrome is unclear, several factors have been implicated in producing polydipsia and symptomatic hyponatremia. These include a possible hypothalamic defect, the syndrome of inappropriate secretion of ADH (SIADH), and neuroleptic medication. Evaluation of psychiatric patients with polydipsia includes a search for other medical causes of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities currently available include fluid restriction and medications. 

*Polydipsia (psychogenic)*
http://www.gpnotebook.co.uk/cache/-2100297680.htm

Psychogenic polydipsia is an uncommon clinical disorder characterized by excessive water-drinking in the absence of a physiologic stimulus to drink. The excessive water-drinking is well tolerated unless hyponatraemia supervenes (1). The level of hyponatraemia used in one study was below 130 mmol/L (2). Classically this disorder has been described in hospitalised schizophrenics. Also it may occur in children, as a symptom of emotional difficulties or as an isolated phenomenon in a child who simply enjoys drinking. 

The diagnosis of psychogenic polydipsia is one of exclusion and requires specialist investigation and management; the most important test is the water deprivation test which should be undertaken carefully. Note that chronic psychogenic polydipsia may actually impair the response of the kidneys to ADH, and therefore reduce the renal concentrating ability. Equivocal results should be interpreted with caution.

Clozapine is an atypical antipsychotic drug that has been demonstrated to be a highly effective treatment for polydipsia in schizophrenic patients. There has also been the successful use of clozapine in psychogenic polydipsia in a non-schizophrenic patient (3).

Reference:

Psychogenic polydipsia with hyponatremia: report of eleven cases. Am J Kidney Dis. 1987 May;9(5):410-6. 
Arch Intern Med. 1995 May 8;155(9):953-7. 
Hum Psychopharmacol. 2002 Jul;17(5):253-5.


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## ThatLady (Aug 6, 2006)

While polydipsia is certainly something to be concerned about, it isn't very common in healthy persons, as the article you've posted says. In people who are worried about dehydration, for the most part, the renal system will take care of excess fluids, if your renal system is healthy. The medical conditions that can cause polydipsia are mentioned in the article, as well.

Psychogenic polydipsia is really very uncommon. It's good to know, though, that there is an effective treatment.


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## HA (Aug 6, 2006)

Thanks ThatLady!

It would be interesting to know how often psychogenic polydipsia does occur. It's also good to know that the body kicks in and takes care of excess as you described. 

Cheers


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## ThatLady (Aug 6, 2006)

I don't know the exact percentages, HeartArt. I do know it can occur in hospitalized psychiatric patients; particularly, those who suffer from schizophrenia. The reasons are not known at this time.

During these very hot days, it's critically important that healthy people drink a lot of water! Don't worry about too much water unless you have been diagnosed with a condition that might cause polydipsia, or are on a medication for which you have been warned that polydipsia might be a problem.


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## ^^Phoenix^^ (Aug 6, 2006)

I go through phases with my enjoyment of water. Some months, I'll enjoy nothing more than an ice cold water to glug back, drinkin a couple of pints, one after the other. Then some months, the idea of water seems so boring and dull that I'll actually dislike it! Water is the _only _thing that I fluctuate this widely about. 

I don't know about its link to psychosis, but I aggree with NSA (what you said a while back about the similie to car petrol?) If we're 80% water, lack of water has just got to be bad - (duh, major understatement robin!)


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## David Baxter PhD (Aug 6, 2006)

I don't know... I find drinking water is a very different experience from drinking gasoline (aka petrol)... 

But I do agree with you... I never seem to get tired of a couple of pints...


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## Halo (Aug 6, 2006)

Okay so now that we are still on the topic of water I am going to ask a serious question. I drink excessively.....anything and everything that I can get my hands on. Many people have commented on the amount of fluid that I drink in a day from coffee, tea, water, juice, pop, flavoured water (which is my new addiction ) and sometimes I even have up to 3 different drinks going on my desk at the same time. It is like I can never get enough to drink and that I am always thirst. I don't know if it is a habit that I always have to have something to drink in my hands or if I am really thirsty. I can just finish a bottle of water and I am opening another one. Another thing that surprises people and myself actually is that I can drink so much during the day however I do not use the bathroom more than three times from morning when I wake up until night when I go to bed. Okay, that was probably more information than anyone needed to know :red: but I am very curious as to where all this liquid in me is going and can there be a medical reason to need so much fluid?

Thanks


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## ThatLady (Aug 6, 2006)

It could be habitual, or it could be indicative of a problem somewhere. The only way to know for sure is to have some blood tests done to ensure that all your electrolytes are in balance, and that your blood sugar is within normal ranges. If everything checks out okay, you probably just have a bladder the size of Montana.


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## Halo (Aug 6, 2006)

I do know that my sugar levels become out of whack very easy. If I dont eat enough or often enough than I have been known to have the shakes (quite often) and I have even passed out a couple times. 

And yes I have always had a bladder the size of Montana  Lucky for me on road trips 

Thanks TL for your post.


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## ThatLady (Aug 6, 2006)

You're welcome! I happen to have one of "those" bladders, as well. They're convenient, eh?


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## Halo (Aug 6, 2006)

Glad to hear that there is someone else like me  Convenient....definitely..especially with those plane bathrooms so small


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## ThatLady (Aug 6, 2006)

Yep. I've lived all over the world. I used to tell people my home was a 747. I flew everywhere. I've rarely even been IN an airplane bathroom! If the plane is in the air for 12 hours, so be it. Let there be flooding in Montana, but I ain't goin' in that bathroom!


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## Halo (Aug 6, 2006)

I attempted the airplane bathroom only once when I was sick coming back from a trip and it was not pleasant...TG for the large bladder....it does come in handy sometimes


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## Into The Light (Aug 7, 2006)

nancy i seem to have this vague idea that excessive thirst may be related to diabetes - i could be wrong but it would be worth looking into. any thoughts on that?


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## ThatLady (Aug 7, 2006)

Excessive thirst CAN be a sign of diabetes, but isn't necessarily so. It is, however, important to let the doctor check you out to be sure all is in good working order.


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## Halo (Aug 7, 2006)

I have spoken to my doctor before about my sugar levels and diabetes (especially since it is so apparent on my fathers side) but he didn't seem concerned. I know that that was a few years ago and I probably should have it tested. I have neve actually been tested but we just talked about healthy eating and making sure I eat. To come to think of it I have never really mentioned my excessive thirst and drinking before.......maybe it is time to go to see him again?


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## ThatLady (Aug 7, 2006)

Yep, it sure is! If diabetes runs in your family and you're experiencing what might be excessive thirst, it's definitely time to mention it to your doctor.


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## David Baxter PhD (Aug 7, 2006)

Probably. Of course, it might also be a side-effect of SSRIs... but it's wise to get these things checked out from time to time. I just went last week to "drain a vein" for my "annual tests" because it turns out I lost the last requisition my doctor gave me and it had been almost 3 years since my last "annual tests". mg:


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## Halo (Aug 7, 2006)

I know that I should go but to be honest I think that I would rather have a root canal than have to face an annual. The last time I had one (2 years ago) he mentioned that it had been like 10 years since my last one. I told him that I am on the 10 year plan and when I was done I said that I would see him in 2014 

I know I am just kidding. I should probably go but I really dislike it. I guess I will have to venture up the nerve to do it though......courage, courage, courage.

P.S - The excessive thirst and drinking is not something that is new. I have been like this for as long as I can remember. Now if it were something new than I probably would be to the doctor sooner rather than later 

Thanks everyone for the input.


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## ThatLady (Aug 7, 2006)

I can't imagine anybody who LIKES going to the doctor and being poked and prodded and tested and tried. Yet, we gotta do it. Since you've always been one to drink a lot of fluids, it's probably nothing. However, the genetic predisposition for diabetes is in your family, so it requires close watching. It's in my family, as well; albeit, back a couple of generations, but I do keep a close eye on it through yearly physicals.


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## Modus.Ponens (Aug 7, 2006)

Hello again 

My question was about a long term semi-dehydration. I've always drinked few water... I do however have the psychological factors for psychosis, although I think that this time I am finaly getting out of this (not because of water though lol). I guess I would change the question a litle bit and ask if it can help the psychosis process or not?

Best wishes


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## ThatLady (Aug 7, 2006)

Drinking enough water to prevent dehydration is important to keep your body healthy. If your body isn't healthy, your mind is going to suffer. Staying healthy may not cure psychosis, but being unhealthy and/or dehydrated isn't going to do it any good, either.

I hope that answers your question.


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## Modus.Ponens (Aug 8, 2006)

ThatLady  said:
			
		

> Drinking enough water to prevent dehydration is important to keep your body healthy. If your body isn't healthy, your mind is going to suffer. Staying healthy may not cure psychosis, but being unhealthy and/or dehydrated isn't going to do it any good, either.
> 
> I hope that answers your question.



I was thinking something along those lines. What puzzled me was the imediate effect of the water. I was expecting that someone had some information about this. Maybe it was just a coincidence or maybe it was placebo, or a combination of various factors. Gonna stay on water though haha!


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## Halo (Aug 8, 2006)

I think that staying on the water is probably a good choice....especially since it seems to be working for you.

Take care


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## ThatLady (Aug 8, 2006)

There is no real "immediate" effect received from drinking a glass of water. However, there is a lot to be gained by consistently taking in sufficient non-dehydrating fluids for the overall health of your body systems.


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