PhD/PsyD Take a cold plunge for your mental health

[R. Matey]

Anyone else encountering people touting the miracles of cold plunges for your mental health? I haven't found a real study that supports it, but I was wondering how folks are talking about it with patients.

Edit: Just found this lower quality one: https://onlinelibrary.wiley.com/doi/full/10.1002/lim2.53

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[WisNeuro]

Lower quality is right. Participants chose which group they wanted to be in, and there was no intervention of any sort in the "controls." So we have clear selection bias up front, and an intervention condition that is primed for a placebo effect.

That being said, I enjoy cold showers/baths. My ideal gym time is a sauna session after a workout followed by a cold shower.

 

[PsyDr]

No one ever noticed this in cold pressor tests? Yeah, right.

 

[PsychPhDone]

no thanks
I'll just be depressed but warm

 

[Spydra]

No, but I think this kind of thing is subjective. If it makes them feel good in the moment and there's no objection from their physician then to each their own, but this will not "cure" their mental illness.

 

[R. Matey]

No, but I think this kind of thing is subjective. If it makes them feel good in the moment and there's no objection from their physician then to each their own, but this will not "cure" their mental illness.

In all of the lay discussion I hear around what's 'therapeutic' , there is no real distinction made between enjoyment and beneficence.

 

[BuckeyeLove]

Basic bro twitter/social media and the rise and grind/hustle lifestyle dudes are ALL about cold showers and ice baths. They’re real big on touting “manufactured hardship” as we all have gone soft, at least millennials into Gen Z.

 

[cara susanna]

I agree that the study is badly designed, but I wonder how this relates to the TIPP skill from DBT and the dive reflex (fun fact: I once tried it out myself and it was awful. It worked, but it was awful. You're supposed to hold your breath for like 30 sec and I could barely make it to 10. Do not recommend unless you're desperate).

 

[clausewitz2]

Hydrotherapy was a popular intervention in asylums back in the day (though not always cold). With how popular GLP-1 agonists are now for weight loss amongst the people who are savvy enough about accessing healthcare to get their hands on them, are insulin comas becoming a Thing again very far behind?

 

[PikminOC]

Anyone else encountering people touting the miracles of cold plunges for your mental health? I haven't found a real study that supports it, but I was wondering how folks are talking about it with patients.

Edit: Just found this lower quality one: https://onlinelibrary.wiley.com/doi/full/10.1002/lim2.53

Yes as Jack Dorsey does it so it must work 🙄

 

[smalltownpsych]

If a patient feels that something helps them and there is no clear evidence that it doesn’t, then I’m not going to tell them not to. In my experience, patients who are doing things to help themselves even if some of them are a bit kooky tend to have better outcomes than those that don’t. If they were psychotic and wanted to go off their medication regimen because hydrotherapy is all they need, I would be a bit more clear in my stance against that treatment plan.

 

[R. Matey]

If a patient feels that something helps them and there is no clear evidence that it doesn’t, then I’m not going to tell them not to. In my experience, patients who are doing things to help themselves even if some of them are a bit kooky tend to have better outcomes than those that don’t. If they were psychotic and wanted to go off their medication regimen because hydrotherapy is all they need, I would be a bit more clear in my stance against that treatment plan.

I would hope you'd consider saying to your patient "be sure to consult your doctor about any adverse health risks" before they spend ten minutes in a cold room or three minutes in an ice bath.

 

[smalltownpsych]

I would hope you'd consider saying to your patient "be sure to consult your doctor about any adverse health risks" before they spend ten minutes in a cold room or three minutes in an ice bath.

I would definitely state concerns about potential risks and defer to a medical depending on risk and would document that. On the other hand, I was working with some healthy 20 something’s that liked to jump in the very cold lake in early spring for fun and I didn’t even bring it up.

 

[ClinicalABA]

Hydrotherapy was a popular intervention in asylums back in the day...

I remember reading old client notes from the State Hospitals back when I was working Gero- notes from the 50's-70s (I was reading them in the 90's and early aughts). Some would use the euphemistic term "hydrotherapy," but many used the more colloquial term "packout," as in "patient agitated, 10 minute "packout" with remediation of symptoms". The "procedure" involved disrobing the patient, wrapping them tightly in a bed sheet, and then placing them in a tub of ice water. Miraculously, hypothermia will reduce the intensity of agitated behavior.

In regards to the topic at hand, I think there is a tendency to label a lot of things that just feel good or lead to happiness or a sense of accomplishment as "therapy" or "therapeutic." Having jumped into the cold and icy North Atlantic in January, I can say that the sense of accomplishment of doing something that my primitive brain was telling me very clearly not to do, dealing with the discomfort, and recognizing that my "feelings" about doing something are not always the "facts" about doing said thing felt very nice. It made me happy and proud, at least in the moment. It may have even spurred me to attempt some other "uncomfortable" things in the name of personal growth (though that effect was probably pretty short-term). All those things are good! I'd recommend that anybody- client, friend, stranger on the internet- should seek out such experiences (with all the appropriate medical caveats, of course). Should we call such a thing "therapeutic"? Not unless we can empirically identify the parameters that lead to an practical reduction in the symptoms of a clearly defined mental condition. Do it because it makes you feel good, happy, accomplished, etc., and it is important to feel that way as much as possible. Don't do it to make you less clinically anxious, depressed, characterological, etc. If you do it and don't feel good, happy, accomplished, etc. afterwards, it's not because it "failed." It just didn't do it for you so try something else next time.

TLDR- Not everything that makes you feel legitimately good, accomplished, successful, etc. is "therapy," and not all things that are actual "therapy" will immediately make you feel as good, accomplished, successful, etc. as jumping in the damn ocean in the middle of winter. Do things for what they are, have fun, learn, and grow. While that's probably at least correlated with actual mental illness symptom reduction, it's not a cause of it.

 

[smalltownpsych]

I remember reading old client notes from the State Hospitals back when I was working Gero- notes from the 50's-70s (I was reading them in the 90's and early aughts). Some would use the euphemistic term "hydrotherapy," but many used the more colloquial term "packout," as in "patient agitated, 10 minute "packout" with remediation of symptoms". The "procedure" involved disrobing the patient, wrapping them tightly in a bed sheet, and then placing them in a tub of ice water. Miraculously, hypothermia will reduce the intensity of agitated behavior.

In regards to the topic at hand, I think there is a tendency to label a lot of things that just feel good or lead to happiness or a sense of accomplishment as "therapy" or "therapeutic." Having jumped into the cold and icy North Atlantic in January, I can say that the sense of accomplishment of doing something that my primitive brain was telling me very clearly not to do, dealing with the discomfort, and recognizing that my "feelings" about doing something are not always the "facts" about doing said thing felt very nice. It made me happy and proud, at least in the moment. It may have even spurred me to attempt some other "uncomfortable" things in the name of personal growth (though that effect was probably pretty short-term). All those things are good! I'd recommend that anybody- client, friend, stranger on the internet- should seek out such experiences (with all the appropriate medical caveats, of course). Should we call such a thing "therapeutic"? Not unless we can empirically identify the parameters that lead to an practical reduction in the symptoms of a clearly defined mental condition. Do it because it makes you feel good, happy, accomplished, etc., and it is important to feel that way as much as possible. Don't do it to make you less clinically anxious, depressed, characterological, etc. If you do it and don't feel good, happy, accomplished, etc. afterwards, it's not because it "failed." It just didn't do it for you so try something else next time.

TLDR- Not everything that makes you feel legitimately good, accomplished, successful, etc. is "therapy," and not all things that are actual "therapy" will immediately make you feel as good, accomplished, successful, etc. as jumping in the damn ocean in the middle of winter. Do things for what they are, have fun, learn, and grow. While that's probably at least correlated with actual mental illness symptom reduction, it's not a cause of it.

My friends who are kind of new agey think that all kinds of activities are “therapeutic”. It’s fine for healthy people with typical occasional emotional distress to think these activities are beneficial, as some of them clearly are. When they begin touting some of these as a treatment for real mental illness thats when I have a tough time. Just seen too much pain and even death caused by this type of thinking and our cultures lack of understanding how severe mental illness really differs from everyday experiences. Minimizing and normalizing is almost as bad as stigmatizing.