Diabetes insipidus (DI) is a rare medical condition that disrupts the body's ability to regulate water, resulting in excessive thirst and an unusually high volume of urine. This condition affects the kidneys' ability to concentrate urine and causes individuals to produce between 3 and 20 quarts of dilute, colourless urine daily, compared to an average of 1 to 2 quarts. It is pertinent to note that DI is not related to diabetes mellitus, which disrupts the body's insulin production.

Types Of Diabetes Insipidus

This condition results from damage to the hypothalamus or pituitary gland, which impairs the production or release of vasopressin, a hormone responsible for water retention. When vasopressin levels are inadequate, the kidneys fail to conserve water, leading to excessive urination. It can result from Brain injuries or surgeries, tumours, infections or inflammation and aneurysms.

Nephrogenic Diabetes Insipidus

This type occurs when the kidneys fail to respond to vasopressin, causing excessive fluid loss. Common triggers include chronic kidney disease, and electrolyte imbalances, such as high calcium or low potassium levels. Additionally, medications like lithium

and urinary tract blockages can also cause Nephrogenic DI.

Gestational Diabetes Insipidus

A rare condition seen only during pregnancy, this occurs when the placenta produces an enzyme that breaks down vasopressin or increases prostaglandin levels, reducing kidney sensitivity to the hormone. Symptoms of this are usually mild and often resolve postpartum but can recur in future pregnancies.

Symptoms And Warning Signs

• Severe thirst, often leading to the consumption of over a gallon of water daily
• Frequent urination (polyuria), sometimes exceeding 20 quarts per day
• Nighttime urination and bed-wetting
• Weakness, muscle pain, and preference for cold drinks

In severe cases, dehydration may develop, manifesting as fatigue, dizziness, dry mouth, confusion, nausea, or fainting. Infants and children with DI may exhibit crankiness, poor feeding, slow growth, fever, or vomiting.

Causes And Risk Factors

DI stems from issues with vasopressin production or response. Central DI arises from damage to brain structures, while nephrogenic DI relates to kidney dysfunction. Risk factors include:

- Genetic mutations affecting water regulation

- Certain medications like diuretics or lithium

- Metabolic disorders that alter calcium or potassium levels

- Brain injuries or surgeries

Diagnosis And Testing

Diagnosing DI involves a combination of medical history, physical exams, and specialized tests:

- Urinalysis: Evaluates urine concentration and glucose levels to distinguish DI from diabetes mellitus.

- Blood tests: Check electrolyte, glucose, and vasopressin levels.

- Water deprivation test: Measures changes in weight, blood sodium, and urine concentration during fluid restriction.

- MRI: Detects abnormalities in the hypothalamus or pituitary gland.

- Genetic screening: Identifies inherited risk factors.

Although DI is rare, affecting about 1 in 25,000 people, early diagnosis and targeted treatment can significantly improve quality of life. Researchers continue to explore its causes and treatments to better support those living with this challenging condition.

As heatwaves have become more frequent and intense across the globe, health experts are increasingly warning that soaring temperatures affect far more than physical health. While dehydration, heat exhaustion, and heatstroke are common physiological effects of heatwaves, extreme heat can also take a significant toll on mental wellbeing.

Mental Health Toll Of Extreme Heat

HealthandMe spoke to Dr. Samant Darshi, Consultant - Psychiatrist & Neuromodulation Expert, Psymate Healthcare, Noida, about the psychological impact of extreme heat.

In hot weather, the human body constantly works to maintain a stable internal temperature. During periods of extreme heat, this process becomes increasingly challenging, placing considerable strain on both the body and brain.

Dr Darshi explains, “The high temperatures during heat waves can have a strong influence on not only physical but also the psychological state of people. The hot weather causes irritation, nervousness, stress, and frustration. Sleep disturbance associated with the hot weather only complicates the process of keeping a good mood.”

Living in higher temperatures is slowly becoming the new norm in several countries. With climate change driving longer and more intense heat events, understanding the psychological impact of extreme heat has become more important than ever.

Extreme Heat Can Worsen Serious Mental Health Issues

Additionally, research has shown that prolonged exposure to heat can worsen stress, anxiety, irritability, and even increase the risk of severe mental health crises. Moreover, people's ability to think logically is affected by heat; memory, attention, and overall productivity decrease in extreme temperatures.

Dr Darshi says, “People with some pre-existing mental health conditions (depression, anxiety disorders, schizophrenia, etc.) can suffer from worsening their symptoms during prolonged heatwaves. The side effects of some medications that are used for the treatment of mental illnesses include the disturbance of the processes of thermoregulation in the organism.”

High temperatures can also disrupt sleep, hamper hormone levels, and affect neurotransmitters like serotonin and dopamine, which play a key role in regulating mood. Sleep deprivation, a common consequence of hot nights, can further intensify emotional distress, making people feel more anxious, irritable, or overwhelmed.

Heatwaves Drives Isolation

As temperatures soar, people generally avoid stepping out, becoming increasingly secluded. Lack of social interactions triggers the brain’s primal ‘survival threat’ alarm, which can lead to excessive stress, poor emotional regulation, and increased risk of anxiety and depression.

It especially affects older people and other vulnerable groups. Social isolation can cause psychological problems in terms of loneliness and depression. In extreme cases, prolonged exposure to heat causes aggression, self-harm, and other mental health crises.

How To Protect Your Mental Wellbeing During A Heatwave

While one has little to no control over the weather, certain measures can help reduce the mental strain caused by extreme heat:

• Staying hydrated throughout the day.

• Keeping indoor spaces cool using fans, curtains, or air conditioning where possible.

• Avoiding strenuous activities during the hottest hours.

• Prioritizing good sleep hygiene and keep bedrooms as cool as possible.

• Checking in regularly with family members, friends, and neighbours, particularly those living alone.

• Seek professional support if feelings of anxiety, depression, or distress become overwhelming.

Leptospirosis gained attention after its cases surged in Kerala recently. The infection has also been reported in Maharashtra, Gujarat, Tamil Nadu, and Karnataka. The bacterial infection typically spreads via contact with water or soil that has been contaminated by the urine of animals infected with leptospirosis, especially during floods.

As monsoons are right at our doors, know why it is important to detect and nab dangerous infections like leptospirosis early.

What Is Leptospirosis?

Leptospirosis is a potentially serious bacterial infection sometimes called the "rat fever" because it can cause symptoms similar to the typical symptoms of common viral infections, which may not be noticeable in the early stages. It is caused by the bacteria of the genus Leptospira that are excreted in the urine of infected animals, including rats, cattle, dogs, and pigs.

In the monsoon season, there is a risk of waterlogging and contaminated animal urine mixing with floodwater and soil. Infestation occurs through direct contact with contaminated water or mud on cuts or abrasions or on the mucous membranes of the mouth, nose, and eyes. Those involved in outdoor work, sanitation, farming, construction, or who are walking in flooded streets are especially at risk.

Combating Leptospirosis In Monsoon

Health and Me spoke to Dr. Sundar Krishnan, Senior Consultant - Internal Medicine, KIMS Hospital, Thane, about how to tackle leptospirosis this monsoon.

Dr. Krishnan says, “In the early stages, it may have flu-like symptoms, and that makes early recognition challenging. Symptoms are sudden onset of high fever, chills, very severe headache, muscle pain especially in the calves and lower back, fatigue, nausea, vomiting, and red eyes.”

The expert also said that occasionally, the patient may also have abdominal pain or diarrhea. He also says it can escalate quickly to jaundice, kidney failure, difficulty breathing, meningitis, internal bleeding, or multi-organ failure and can require immediate medical care.

Dr. Krishnan recommends several prevention tips to tackle leptospirosis in monsoon:

• Avoiding contact with contaminated water by staying out of flooded areas whenever possible.

• Wearing waterproof boots and gloves for extra protection.

• Covering cuts or wounds with waterproof dressings before entering flood water.

• Maintaining good personal hygiene, washing hands and feet extensively after contact with flooded and stagnant water.

• Getting out of wet clothes as soon as possible.

• Taking measures for proper waste disposal to control rat infestation.

• Raising awareness and educating the public about the risk of leptospirosis during the rainy season.

If leptospirosis is diagnosed early and treated with antibiotics, recovery is much quicker, avoiding life-threatening complications. But if detection and treatment are delayed, the kidneys, liver, lungs, and even the brain may be affected.

The expert advises that people who are ill after being exposed to flood water and are facing fever or flu-like symptoms for more than two days should also seek medical help as soon as possible, informing their doctor about their flood water exposure.

Even though the risk of leptospirosis is high during the monsoon, the best way to steer clear of this infection is to educate the masses about its symptoms and prevention. Early clinical intervention can help de-escalate the situation promptly.

Headaches are one of the most common health complaints and are often caused by stress, lack of sleep, dehydration, excessive screen time, skipped meals, or other lifestyle factors. While most headaches are benign, experts said that frequent or unusual headaches should not be ignored, as they may signal an underlying medical condition that requires evaluation.

The experts told HealthandMe that paying attention to changes in headache frequency, pattern, and associated symptoms can help identify when medical attention is necessary.

Increasing Frequency Is a Warning Sign

According to Dr. Rajneesh Kummar, Vice Chairman & Unit Head, Neurology, Max Super Speciality Hospital, Dwarka, one of the most common concerns is increasing frequency.

“If someone who previously experienced occasional headaches starts getting them several times a week or finds that painkillers are needed more often than before, it is worth getting evaluated,” he told HealthandMe.

“People should seek medical attention if they have headaches more than 10 to 15 days a month, if the headaches are getting worse, or if they are beginning to interfere with work, daily activities, or quality of life,” added Dr. Praveen Gupta, Chairman, MAIINS, Marengo Asia Hospitals, Gurugram. He also noted that medication-overuse headaches can result from taking painkillers regularly, leading to a cycle of recurrent pain.

Also read: Shingles Vaccine May Help Fight Dementia, Suggest Studies

Watch For Changes In Headache Pattern

A change in the pattern of headaches should not be ignored. Dr. Kummar said a headache that feels different from what a person has experienced in the past, particularly after the age of 50, deserves medical attention. Headaches that wake a person from sleep, are worse in the early morning, or are associated with vomiting should also be assessed further.

Dr. Gupta advised prompt medical evaluation for people over the age of 50 who develop a new type of headache. He also recommends seeing a doctor if a person has a history of cancer, a weakened immune system, or develops a headache after a head injury.

Symptoms That Need Immediate Medical Attention

The neurologists highlight several "red flag" symptoms that require urgent medical assessment. They advised immediate consultation if a headache is accompanied by

• weakness on one side of the body,
• difficulty speaking,
• double vision,
• confusion, seizures,
• loss of consciousness,
• Numbness
• balance problems

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Not Every Headache Is a Brain Tumor

Dr. Kummar stated that many people worry that every headache is related to a brain tumor or another serious brain disorder. Fortunately, this is rarely the case.

However, persistent or unusual headaches should not be self-diagnosed, and timely consultation helps identify the cause and ensures appropriate treatment before the problem begins affecting quality of life, the expert said.

Early Diagnosis Key

Dr. Gupta told HealthandMe that early diagnosis can help manage common neurological disorders such as migraines, cluster headaches, and chronic tension-type headaches. A thorough history, neurological examination, and imaging studies, when appropriate, can help determine the cause.

The experts emphasize that if headaches are becoming more frequent, changing in patterns, or affecting daily life, it is time to consult a neurologist. Early diagnosis can provide relief, prevent complications, and improve overall quality of life.