The story of a woman featured on the BBC documentary series The Doctor Who Gave up Drugs in 2016 has become the basis for a new case study published in the British Medical Journal (BMJ) touting the potential of cold water swimming as a treatment for clinical depression and anxiety.
The 24-year-old woman in question – referred to as Sarah in the paper – was diagnosed with major depressive disorder when she was 17, and did not respond to first-line treatment, namely – the SSRI drugs fluoxetine and citalopram.
As she began a programme of weekly swimming in open water that’s no more than 15 degrees Celsius under the supervision of Christoffer van Tulleken, a doctor and researcher at University College London who hosted the above series, her symptoms resolved within 3 months.
The case study later co-authored by Tulleken and published in the BMJ highlights the potentially life-saving effects of cold shock, experienced upon immersion in water that’s colder than one’s body temperature, and argues for the need for more research to determine whether it could work in other patients.
Michael Tipton, another co-author on the paper, noted the already existing (albeit limited) evidence that cold is anti-inflammatory and can provide some relief from pain.
Furthermore, alternating between cold and warm environments could also lead to physiological adaptation which translates into mental resilience:
“One theory is that if you adapt to cold water, you also blunt your stress response to other daily stresses, such as road rage, exams, or getting fired at work,” explained Van Tulleken.
The only way to verify whether the outcome of Sarah’s treatment has been down to simple exercise, being in the outdoors, or a case of the placebo effect is to conduct more research, which becomes ever more pressing given the rising rates of mental illness across the world.
In response, researchers have been working on treatments which do not rely on currently available medications that are effective for only a fraction of those who take them, instead focusing more on alternative interventions which lead to more robust outcomes.
Whether cold water swimming pans out as a potent tool in fighting the blues or not, on one-year follow-up, Sarah – the very person who inspired Tulleken to write the paper – remains medication-free to this day and continues to swim at least once a week.