is The Cold Water Therapist, based in West Lothian, Scotland. She is qualified in cold-water therapy, open-water safety and rescue, and mental health first aid and response.
is The Cold Water Therapist, based in West Lothian, Scotland. She is qualified in cold-water therapy, open-water safety and rescue, and mental health first aid and response.
Social media is full of images of people plunging into freezing lakes and icy baths, with influencers touting the benefits of cold exposure in one form or another. You may have been wondering what it’s all about and whether should you try it.
As a qualified cold-water therapist, allow me to take you through my own journey with the cold – and then I’ll show you how to give it a try.
Until recent years, I had little interest in being outdoors, let alone swimming in freezing waters. Pop me on a hot beach with a fruity drink, and I was in my element. This changed, rather drastically, five years ago, starting with the diagnosis of my mother’s terminal cancer. I didn’t realise it at the time, but this news, coupled with a change to my job and months of homeschooling, uncertainty and lockdowns during the COVID-19 pandemic, set me on a path of very poor mental health.
Come Christmas 2020, I was completely burnt out. I was prescribed antidepressants and anti-anxiety medication, but they made no difference. I spent a few more months barely coping, when my brother suggested a cold-water dip.
This seemed ludicrous: I’d always hated being cold. But after discussing it with my GP, and desperate to give anything a try, I went with my brother to Loch of Clunie, Perthshire in Scotland – his hometown. I felt nervous as I anticipated the freezing cold water rushing into my borrowed wetsuit. Stepping into the loch, I gasped and froze as adrenaline pumped through me. Never one for quitting, I proceeded further until I was in over my shoulders. ‘Jeez, that’s cold, I can’t breathe,’ I gasped. ‘OK, I’m in – I did it. Wow, I did it! That’s amazing.’
It’s a cliché, but it really was as if a switch had been flicked. I realised I had experienced a few moments of controlled thought (aka, mindfulness), a skill I thought I had lost forever to my new, anxiety-ridden brain. I felt proud of myself, and I experienced happiness for the first time in almost a year.
The benefits of cold-water therapy
I felt compelled to understand my experience. I read reports, research papers and any books that were even loosely based on cold therapy.
Although cold water as a medicinal therapy is far from a new concept (notable figures from ancient history, such as Hippocrates, are known to have advocated for it), the formal scientific research into its benefits, including for mental health, is still in its infancy. But the research we do have all points in the same positive direction, and I’ve found this is consistently backed up by anecdotal feedback from my clients.
Cold-water therapy, encompassing practices such as cold-water immersion and ice baths, has been associated with several physical health benefits, according to research. This includes improved circulation and reduced inflammation. However, I think it’s the psychological benefits of cold-water therapy that are driving its growing popularity.
There are many layers of reported positive effects and attributes. To take a specific example: in 2022, researchers surveyed 53 participants with a range of depression severity levels before and after they took part in an eight-session outdoor swimming course on the North Devon coast. Afterwards, 81 per cent of them felt ‘recovered’, and 62 per cent showed ‘reliable improvement’ to their mental wellbeing.
Of course, the key beneficial ingredients are tricky to pin down. Other studies show that simply getting outdoors, being in green and blue spaces, is good for us. If we swim with others, there are the benefits of human connection and community too.
The shock of the cold
However, there is something special about the effects of cold water on the body and mind. Exposure to cold water provokes positive mood changes and brain changes associated with emotional control; it also triggers the vagus nerve (which runs from your brainstem to your abdominal organs). This nerve stimulates the parasympathetic nervous system, which controls the body’s ‘rest and digest’ functions. It’s basically the opposite of fight or flight. Its activation calms us after stress, slowing our heartrate and breathing pattern.
This resonates with my personal experience. After my first cold-water dip, it was only on reflection that I realised how focused on the present moment I had been in the freezing water. That is exactly what mindfulness is – being fully present in the moment. I had previously confused mindfulness with an idealised notion of meditation (where one works to clear the mind of all thought). There were most definitely thoughts in my mind, but instead of the usual anxious worries, it was more: What am I doing? This is cold, wow – look at that bird, oh, this feels OK now (you get the idea). It was such a relief to know that I wasn’t broken beyond repair, and I could indeed tear my thoughts away from worry and angst. The cold water demanded it from me. This was followed by the ‘natural high’ that cold-water swimmers rave about.
By continually exposing ourselves to a stressor (the cold water) and overcoming the shock, we are also building resilience, a key tool in the toolkit of good mental health. We are learning to manage stress, and this is cross-adaptive to other stressful life scenarios.
One of my earliest experiences of this was at my mother’s funeral, for which I had written a poem to read. As I stood, my mind was racing, legs weak, and I couldn’t speak. I took a moment to close my eyes and channel the calmness that I feel when in cold water. I imagined myself in the water, breathed as I would in the cold and, after a minute, was able to talk.
Many of my clients have shared similar stories of how they feel better equipped to deal with difficult situations because they have habituated themselves to stress.
Do you feel ready to give cold-water therapy a try? Here are some practical steps, starting gently and building up to a cold-water swim. Because cold-water immersion can be dangerous for people with certain medical conditions, please remember to check with your doctor first.
Key points
The mental health benefits of cold water. Growing evidence suggests that cold-water therapy (cold showers, ice baths and outdoor swimming) acts as a form of mindfulness, and can relieve anxiety and depression. Get a medical checkup before trying it out.
The shock of the cold activates the parasympathetic nervous system. If you can stay in the cold until the shock passes, this activates the part of your autonomic nervous system that is for rest and relaxation – lowering your stress and helping you learn to cope with stress in other situations.
Start slowly with a splash of water. A simple way to get started is to splash cold water on your face or dunk your face in cold water.
Take a daily cold shower. With control over the temperature, this allows you to build up your tolerance to the cold. You can use cold showers as your own form of long-term cold therapy, or build up to cold-water swimming.
Take a swim in cold water. For the maximum benefits, try weekly cold-water swimming – start in the warmer months and then work towards colder temperatures. There’s no need to stay in for longer than two or three minutes.
Start slowly with a splash of water
Has anyone ever advised you to splash cold water on your face and neck after you’ve been angry, upset or stressed? There’s a scientific reason it might help. The application of cold to the back of the neck is a quick and easy method for stimulating the vagus nerve.
A more dramatic effect can be achieved by fully immersing your face in cold water, which triggers the trigeminal nerve (the fifth cranial nerve) in your face, which then signals to your brain that you’re underwater. In turn, this activates the vagus nerve, to slow your heart rate and breathing. This is known as the ‘mammalian dive reflex’. It’s another easy method of using cold water to reduce stress.
Take a daily cold shower
You will find all sorts of cold-shower plans if you look online, differing depending on the aims. Some people will be using them as a method of acclimatising to the cold – working up to cold-water swimming or ice baths. But you can use your shower as a standalone method of cold exposure.
Remember that the calming benefits of cold-water immersion come after the initial shock. That’s why it’s important to develop a practice that works toward you being comfortable in the cold – at least for a short while. Although it might be unavoidable at first, if you jump around and scream and shout the whole time, you’re just staying in the stressor part of the experience, and may not gain the maximum benefits.
Three steps to follow on your first try:
Take a stopwatch into the shower. Start with a warm shower as normal. Then slowly reduce the water temperature. There is no formal definition of what counts as cold water, but scientists researching cold-water benefits usually take 15°C (60°F) or lower as cold. You may need to work down to this over time. As a rough guide, try turning down the temperature until it feels slightly uncomfortable and triggers a gasp breath.
As your gasp reflex kicks in – breathe! Do not practise any form of forced breathwork (this can be highly dangerous in water as you may pass out), but just aim to control your breath. Inhale through your nose and out of your mouth. I often find that a noisy breath helps me to maintain a good pattern.
Try to stay under at least until you feel the shock subside. Don’t set yourself a target duration after that, but do have your stopwatch running so you can see how long you were in for.
Over time and with daily practice, you will likely notice your initial shock response subsides and that you are able to tolerate the cold for longer.
Some say that the best time to take a cold shower is in the morning to kick-start your system.
Personally, I find a cold shower more of a challenge than an ice bath or outdoor swim. Maybe it’s because I’m not fully submerged the whole time? Just as soon as the front of my body gets comfortable, I then have to turn round and start all over again on my back!
Take a swim in cold water
Having your body fully submerged in the cold is the ultimate cold-water exposure.
It doesn’t matter whether you’re in the sea, a river, a lake, an outdoor pool (or even a purpose-made ice bath), cold water is cold water. It’s the safety precautions that vary hugely in different bodies of water. Never go alone.
Wetsuits are optional. You will still experience some level of cold exposure and, if a neoprene suit helps you to overcome any initial fears, and gets you outdoors, then use it (you can always ditch the suit later for maximum cold exposure).
For obvious reasons, it’s often easier to start at the ‘warmer end’ of cold – around 15°C (as a rough guide, this is the kind of temperature you might expect swimming off the Pacific Coast in early summer in the US, or sea swimming in early summer in the UK, or off an Australian beach in the winter). This will help you to acclimatise and prepare gradually for colder temperatures.
Try to go weekly as a minimum. There’s no proven research on how regularly you need to participate, but I find once a week is satisfactory, and that two to three times a week is optimal. If I don’t manage to get in the water for two weeks or more, I find that I start to lose some of my tolerance.
How cold should you go? Endorphins are the primary natural painkillers in the body and improve mood. It could be suggested that colder water will produce greater endorphins. Many of my clients report a higher state of euphoria after dipping in icy waters, but many of them started their cold-water journeys in warmer water and worked towards ice-dipping. Even after a medical check-up, you never know how your body will react, and the safest advice is to take things gradually and see what works for you.
Four steps to follow on your first try (you could ask a friend to read these steps to you as you take the plunge):
Always enter slowly. Yes, this can feel like more of a challenge, but it will allow you to keep control and put the least pressure on your heart. If you are in a natural body of water, take it in stages. Get your feet in and stand for a moment. Take a controlled breath.
Wade in until you’re above the knees. Take a moment – notice the cold and turn to your breath. You may find you’re holding your breath at this stage. Concentrate on breathing in through the nose and out through the mouth. You must be mindful that, although you are not rushing, you also don’t want to take too long to get in. Our bodies lose heat up to 25 times faster in cold water.
Next, aim to get waist deep. At the point that some of your most sensitive areas are going to hit the water, inhale, step forward (or crouch lower in your ice bath) and use your out-breath to get them in. The groin, underarms and neck are usually our warmer spots, and the contrast can feel greater. Continue to breathe calmly until any shock or gasp reflex has lessened.
Finally, it is your aim to get fully immersed. By this, I mean in up to your neck (do not submerge your head or face when starting out). Again, use your breath, inhale, then plunge down until the water hits your neck on the exhale. Sit with it and maintain your breathing. Once you are breathing normally, you have gone past the stress, and your parasympathetic nervous system is fully activated. If you’re just starting out, this is when you need to be thinking about getting out.
Two to three minutes is likely long enough to get over the cold shock response and resume ‘normal’ breathing. Do not try to ‘stay in longer’ than this or challenge yourself to do more. There is really no need when you are simply using the cold as a form of therapy. If at any point it’s too difficult or if you feel unwell, stop immediately.
Following cold-water exposure, you must always remove wet clothing, dry yourself and dress immediately. It takes time for the re-warming process to start, and you must support the process. Gentle movement, such as walking, is most effective to help with re-warming.
Cold-water exposure can be dangerous and comes with risks. Everyone responds differently. I recommend seeking an experienced, qualified and insured practitioner if you want to undertake an ice bath or outdoor plunge for the first time in low temperatures.
As mentioned, everyone should also seek medical approval before participating, but it’s especially important for people with cardiovascular conditions, respiratory issues or cold-related allergies.
Final notes
I am on a mission to encourage everyone to try cold-water therapy and see if it benefits their life in any way. People will often say to me: ‘I couldn’t do that; I hate being cold.’ So do I, when I don’t want to be! No one wants to relax at home of an evening or sit down to work at their desk and feel cold. But choosing to enter the cold, knowing the benefits it may bring, is a completely different mindset. Should you try it, you will, over time, acclimatise and come to love it. I would even say that I couldn’t manage without it now.
It’s not just cold exposure, it’s a method of self-care, a few moments of mindfulness and some off-duty time. I am lucky enough to swim outdoors for a living, across Scotland all year round. I have seen first-hand how this is helping people with their physical and mental health. I hope it benefits you too.
Disclaimer
We work hard to bring you the most trustworthy, expert and up-to-date information on psychology and mental health in our Guides. You can learn more about how we ensure that they are a reliable source of information here. This Guide is provided as general information only. It is not a substitute for independent, professional medical or health advice tailored to your specific circumstances. If you are struggling with psychological difficulties, we encourage you to seek help from a professional source.
