Open water swimming is seeing increased uptake in participation because of the profound and immediate impact on our physiology and mental health. Dr Judith Mohring, Consultant Psychiatrist and Associate at Cognacity and expert in Lifestyle Psychiatry, prescribes open-water swimming, and regularly participates herself, following personal experience during lockdown.
Dr Judith Mohring explains that when we swim in cold water the body adapts quickly to moving and survival mode which puts the body under immediate adaptive stress. It releases large quantities of the stress hormones; noradrenaline and adrenaline, which raise the heart rate and blood pressure. The hormones also act centrally in the brain increasing mental sharpness, motivation and drive. Natural environments are strongly associated with improved wellbeing and allow us to experience awe, an emotion associated with calm and joy, as well as building our mental and physical resilience.
The physical act of jumping and swimming in cold water, causes an involuntary gasp reflex followed by rapid breathing (hyperventilation). This is a similar pattern to that seen in a panic attack. In cold water there is an obvious reason for the gasping, and an immediate need to calm the breathing. Practicing this response strengthens the ability to respond in a similar way on dry land during a panic attack by self-soothing and slowing the breath, improving the conscious control of panic.
As the blood supply to the skin constricts and cardiac output increases, swimming in very cold water can feel painful but endogenous opioids are released leading to a natural high. Cold water swimming is challenging and requires a strong mental mindset to overcome the fear drowning or freezing. Facing these fears and overcoming them, by avoiding avoidance is an evidence-based technique from cognitive behavioural therapy called exposure and response prevention. Cold water swimming combines increasing levels of neurotransmitters just like an antidepressant, and facing and overcoming fears, just like CBT. However, cold water also impacts directly on our central nervous system physiology which is where our embodied fear responses lie, which helps to reduce anxious responses in mind and body long term.
The sea temperature in the UK is rarely above 19 degrees, even in summer, making it ideal for a cold water swimming treatment. While there is no clinical trial establishing that cold water swimming is an effective treatment for depression and anxiety, there is strong anecdotal evidence and an emerging research interest. Most people then continue open water swimming or exposure once or twice a week to maintain the benefits.
Dr Mohring has found the following conditions have benefited from open water swimming: mood changes associated with menopause and perimenopause, grief, post traumatic stress disorder, anxiety disorders (panic, phobias and OCD), addiction recovery, depression, stress and burn out, neurodiversity, especially autism and also pain and fatigue associated with hypermobility or EDS.
Before taking the plunge, Dr Judith Mohring advises:
- Ensure you are a competent enough swimmer for the conditions, always take time to acclimatise to cold water, even if you are a competent swimmer.
- Go with a swim coach or friend and choose a location with lifeguards.
- Wear a brightly coloured hat or tow float, and take plenty of warm clothes even in summer.
For more info, please visit: www.swimming.org/openwater/swimming-safely-sea
Dr Judith Mohring, Consultant Psychiatrist, is a member of the Royal College of Psychiatrists, American Psychiatric Association and the British Society of Lifestyle Medicine. Dr Judith Mohring is also an expert in neurodiversity and is a trainer with the UKAAN (UK Adult ADHD Network).