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Medical News – Polydipsia: Causes, symptoms, and treatment


Polydipsia is the medical term for extreme thirst, which does not improve no matter how much a person drinks.

It is not a disease by itself but can be an important symptom of certain health problems, such as diabetes. People who have this symptom should always see a doctor.

This article aims to help readers understand polydipsia and how to manage it.

What is polydipsia?

man drinking water
If a person is thirsty all of the time then polydipsia may be the cause.

Everyone knows the feeling of thirst. For example, a person may drink large amounts of fluid to relieve thirst brought on after eating salty food, strenuous exercise, or a day in the hot sun.

This type of thirst usually doesn’t last long and is easily quenched with fluids.

Polydipsia, on the other hand, can last days, weeks, or even longer depending on the cause. An individual with polydipsia tends to be thirsty most if not all the time, despite regularly drinking large amounts of fluid.

Comments such as “I can’t get enough to drink” or “my mouth is so dry” are possible indicators that the person has polydipsia.

Polyuria (large amounts of urine) almost always accompanies polydipsia. One of the kidneys’ primary jobs is to help the body find the right balance of water and other fluids.

Polyuria is defined as passing 3 or more liters of urine in 24 hours in adults.

The kidneys also pass more than fluid. For example, sodium and potassium often leave the body along with urine. This can lead to changes in these salts in the body, which can introduce other problems.

While other symptoms found with polydipsia depend on its cause, a common symptom is a dry mouth.

How much water should I drink every day?

How much water a person needs depends on how healthy they are, how much they exercise, and where they live. There is not one set amount of water that fits everyone.

People can determine how much fluid they drink by starting the day with a measured container of water and then drinking only that water, noting the amount used in 24 hours. People should refill the container through the day as needed.

Remember that fluid is more than just water. When measuring amounts for polydipsia, people should include all liquids, such as fruit juice and coffee.

People asked to measure their urine are usually given a special container for collection.

Causes

Some causes of polydipsia include:

Polydipsia is a common sign of either early or uncontrolled diabetes mellitus.

Insulin helps glucose enter the cells where it is used for energy. With this form of diabetes, high levels of glucose in the blood pull water out of the cells. The kidneys then pass more urine, causing dehydration and thirst.

Common diabetes mellitus symptoms include:

hungry man looks in fridge
Extreme hunger is another possible symptom of diabetes mellitus.
  • polydipsia
  • polyuria
  • extreme and uncontrolled hunger
  • blurred vision
  • extreme fatigue or lack of energy
  • genital itching
  • slow healing of wounds or cuts
  • weight change (gain or loss)
  • frequent or returning infections
  • tingling or numbness in the hands or feet

Diabetes insipidus is a rare condition unrelated to diabetes mellitus. Instead, it relates to a hormone called vasopressin, an antidiuretic hormone that helps control fluid removal through the kidneys.

Diabetes insipidus is caused by low levels of vasopressin, or when the kidneys don’t respond properly to this hormone. A person with diabetes insipidus often passes large amounts of clear, odorless urine.

A person with uncorrected diabetes insipidus usually becomes very thirsty, developing polydipsia. Rarely, severe dehydration may also occur.

Dehydration symptoms include:

  • thirst
  • dry skin or eyes
  • tiredness
  • nausea
  • sluggishness
  • dizziness
  • confusion

People with any of the last three symptoms should seek immediate care, even if they do not think they are dehydrated.

Psychogenic polydipsia is a condition that tends to be diagnosed when a person compulsively feels the need to drink as if dehydrated, even if they are not. They also do not seem to have any other condition to explain their thirst.

Psychogenic polydipsia may occur in certain psychiatric conditions. Those identified to date include schizophrenia, bipolar disease, and depression. Other mental health disorders may have the same symptoms. Many of the medications given for these conditions also increase thirst.

Two terms used to describe this situation are “compulsive water drinking” and “self-induced water intoxication.” While the word “water” is used, a person may seek almost any fluid.

When to see a doctor

doctor holding pot for urine sample
A urine sample may be ordered by a healthcare professional to determine if the symptoms are due to diabetes mellitus.

Anyone with polydipsia should see a doctor for a diagnosis.

People who already have diabetes mellitus may want to check their blood sugar levels before seeing their doctor. If the levels are high, and a person is experiencing polyuria and extreme hunger, uncontrolled diabetes mellitus is the most likely cause.

This information should still be given to the doctor, along with a history of fluid intake if possible. Doctors will likely order blood and urine tests to check blood sugar levels and help identify whether the symptoms are due to diabetes mellitus.

A common blood test called HbA1c measures a person’s sugar levels over the previous 3 months and can be used when diabetes mellitus is first diagnosed.

For pregnant women, a doctor may also order an oral glucose tolerance test.

Doctors may order other tests when diabetes mellitus is not the cause, or not the only cause, of an individual’s symptoms. These tests include:

  • checking vasopressin levels
  • checking sodium and potassium levels in the blood
  • a fluid deprivation test

Some drugs may cause or add to polydipsia and polyuria. For this reason, people should take all of their medications with them when they visit the doctor.

A diagnosis of psychogenic polydipsia can be difficult. Caregivers, family, and friends need to watch for all fluids a person drinks. Fluids may be more than water and include drinks, such as juice and coffee.

If a doctor suspects that a person may have psychogenic polydipsia, they may test for low sodium levels in the blood, which may or may not accompany this cause of polydipsia.

Treatment

Treatment of polydipsia depends on the underlying cause.

For diabetes mellitus, the goal is to bring high blood sugar levels back down. The best way to stabilize sugar levels is to following the doctor’s advice regarding exercise, meal plans, and medication.

Medication may be insulin for type 1 diabetes, medicine by mouth for type 2 diabetes, or both. Once blood sugar levels are back to normal, polydipsia should resolve.

Diabetes insipidus is often managed by simply drinking the amount of water advised by the doctor. This is meant to help treat or prevent dehydration. In some cases, a doctor will prescribe a medication called desmopressin, a man-made form of vasopressin.

People with psychogenic polydipsia may require counseling to help them overcome their compulsion to drink large, but unneeded, amounts of fluid.


Outlook

Early recognition and treatment of polydipsia is key to preventing possible problems.

In most cases, polydipsia is easily managed and unlikely to return once its cause is corrected.



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Medical News – Bipolar disorder: Signs, symptoms, and diagnosis


Bipolar disorder is a mental health condition that is characterized by alternating periods of extreme high and low mood. But what are the signs and symptoms of this mood disorder?

Over 18 percent of Americans will experience some sort of mental health problem over the course of any year. Bipolar disorder is not uncommon, with over 4 percent of people in the United States living with the condition.

When not well managed, experiencing bipolar disorder can have a disruptive impact on a person’s life. However, if diagnosed and properly treated, people with bipolar disorder can lead happy lives and achieve as much as anyone else.

This article explores the signs and symptoms of bipolar disorder. Being more aware of bipolar can help people access the treatment they need and reduce stigma around this manageable condition.

What is bipolar disorder?

Known in the past as “manic depression,” bipolar disorder is a mental health condition that affects the way people experience moods.

woman looking worried on the balcony
Bipolar disorder can affect a person’s mood and energy levels.

If bipolar disorder is left untreated, it may cause noticeable shifts in:

  • mood
  • energy levels
  • ability to perform daily tasks

The shifts in mood and energy normally range between extreme highs and lows.

For people with bipolar, these alternating moods are more than what people without the condition would call “mood swings.”

High and low periods for people with bipolar disorder can be quite intense. If left unchecked, these episodes may disrupt life, affecting relationships, and the ability to perform well at work.

Manic episodes

Intense good feelings and an unusually high amount of energy classify periods of highs, which are known as “manic episodes.”

These episodes are more than just being happy and energetic. Manic periods may make people experiencing them feel irritable, jumpy, and more likely to take risks.

Depressive periods

During low periods, known as “depressive periods,” people experience extreme sadness or hopelessness.

In a depressive period, energy and activity levels plummet. A person going through a depressive period may have trouble getting out of bed.

Some people may also experience intrusive thoughts, such as those of suicide, which can be very disturbing for the person and their loved ones.

Anyone experiencing suicidal thoughts or ideation should speak to a doctor straight away.

Types of bipolar

There are several types of bipolar disorder. Each type of bipolar disorder shares manic and depressive periods but these periods present differently.

There are three main types of bipolar:

  • Bipolar I: In Bipolar I, manic periods last at least a week or are so severe they may require hospitalization to manage. Depressive periods lasting 2 weeks or longer break up the manic periods. Sometimes, episodes that have both features of manic periods and depressive periods may occur.
  • Bipolar II: In this type of bipolar disorder, people experience depressive periods with milder periods of mania, known as hypomanic episodes. Full-blown manic episodes generally do not occur with bipolar II.
  • Cyclothymic disorder: In cyclothymic disorder, people have experienced at least 2 years of depressive periods interspersed with hypomanic symptoms. However, the episodes of hypomanic periods and depressive periods generally do not meet the criteria to classify them as a clinical episode of mania or major depressive episode.

Signs and symptoms

Bipolar disorder has many signs of symptoms. The symptoms vary based on whether or not the person is experiencing a manic or depressive state.

Manic and hypomanic symptoms

Symptoms of a manic or hypomanic bipolar episode include three or more of the following:

  • feeling unusually jumpy or jittery
  • unusual extreme energy
  • restlessness
  • talking excessively fast
  • decreased need for sleep
  • agitation or irritability
  • racing thoughts
  • inability to focus
  • feelings of overconfidence and euphoria
  • tendencies towards reckless behavior, such as extreme spending or risk taking

Depressive symptoms

People experiencing a depressive episode have different symptoms than those experiencing a manic episode.

Symptoms of a depressive episode may experience the following:

closeup of hands indicating anxiety
Symptoms of a depressive episode include low energy levels and excess worrying.
  • extreme feelings of sadness or feeling very down
  • excess worrying
  • sleep troubles (either not being able to sleep or sleeping too much)
  • low energy levels
  • decreased activity and difficulty accomplishing tasks
  • suicidal thoughts and tendencies
  • forgetfulness
  • inability to enjoy normally enjoyable activities

Sometimes people with bipolar disorder may experience symptoms of both mania and depression at the same time.

In other instances, people experiencing hypomania may have some of the symptoms of a manic episode but feel really good and not realize anything is wrong. However, friends and family may notice out of character behavior.

Diagnosis

A doctor or mental health care professional can diagnose bipolar disorder. However, for some people experiencing bipolar, reaching the point of diagnosis is difficult.

Having a series of high and low periods may be intense and could be disruptive. However, some people who experience this may not view it as problematic.

A willingness to accept highs and lows, and not to see this as something that needs treating, may delay people getting the help they need.

Bipolar and related illnesses

People experiencing bipolar disorder may also exhibit traits of other health problems.

If someone is experiencing other health problems as well as bipolar disorder, it may take some time for a doctor to recognize the signs of bipolar. When they do, they may refer the person to a psychiatrist for further evaluation of bipolar disorder.

Similar conditions that may lead to misdiagnosis include:

  • Substance abuse: In addition to bipolar, some people may also use alcohol or drugs excessively. This can lead to poor performance in work or school and relationship problems. Those around the person may not realize that the behavior may be related to bipolar disorder not a separate substance abuse issue.
  • Anxiety disorder: Psychiatrists may misdiagnose bipolar as an anxiety disorder. As a person with bipolar may tend towards excess or extreme worry that gets mistaken for an anxiety disorder. The anxiety disorder may exist separately or be misdiagnosed during a depressive period.
  • Schizophrenia: It is not unusual for a person experiencing an extreme period of mania or depression to experience psychosis, delusional thinking, or hallucinations. Due to these symptoms, a psychiatrist may misdiagnose bipolar disorder as schizophrenia.

Treatment and management

Once diagnosed, bipolar disorder is very treatable and can be managed with a proper care plan.


talking to a therapist
In conjunction with medication, talk therapy is usually recommended for managing bipolar disorder.

Management of bipolar usually involves both medications and therapy. Medication for bipolar disorder includes:

Additionally, a primary care doctor or psychiatrist may recommend different kinds of therapy.

Talk therapy can help people with bipolar disorder deal with the changes in mood they experience in constructive ways that mean their behavior is not affected.

Certain lifestyle factors, such as poor diet, lack of exercise, and poor stress management can exacerbate mental health conditions.

Leading a healthful lifestyle, understanding triggers, reducing exposure to them, and taking regular exercise may also help manage bipolar disorder.

During a period of intense mania or depression, a person may need to be admitted into the hospital or mental health facility for therapy. This is generally temporary and designed to help people get through through the worst of the high or low safely.

As people can experience relapses in their condition, finding long-term methods to manage bipolar disorder is important. Most doctors will recommend ongoing medicinal and talk therapy as the safest means of managing the condition.



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