Psychotic disorders and water

[Modus.Ponens]

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?

 

[David Baxter PhD]

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

 

[Modus.Ponens]

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...

 

[David Baxter PhD]

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

 

[Halo]

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

 

[ThatLady]

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.

 

[David Baxter PhD]

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

 

[foghlaim]

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 )

 

[David Baxter PhD]

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.

 

[Halo]

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?

 

[David Baxter PhD]

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

 

[Halo]

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

 

[David Baxter PhD]

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.

 

[Halo]

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

 

[ThatLady]

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.

 

[David Baxter PhD]

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

Thanks, TL!

 

[ThatLady]

Welcome!

 

[JA]

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!)

 

[ThatLady]

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.

 

[HA]

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.