Can cold-water therapy treat depression?

man swimming in ice hole
 
Have you ever heard of using cold water to treat depression?
 
Some people believe in using this type of hydrotherapy as a “natural remedy” to treat a variety of ailments, including depression. It’s based on the idea that applying water of different temperature to our skin can change our physiology and subsequent mood.
 
Because depression is so prevalent and debilitating, many alternative treatments for depression have been proposed in popular media, including using cold water, laughter or humor therapy. Yet none of these have been proven to work.
 
There is no rigorous scientific evidence that exposure to cold water or laughter produces lasting or meaningful improvements in depression.
 
When my patients ask about trying these alternative therapies, I explain that many of these treatments have not been subjected to any standardized research studies.  And I remind my patients that it’s critically important to pursue evidence-based interventions for depression. Your doctor can help you weight risks versus benefits regarding any treatments you wish to pursue.
 
What does “evidence-based intervention” mean?
 
More than 20 years ago, the American Psychological Association published criteria for empirically supported treatments. This movement helped established validated procedures for treating specific psychological problems to be disseminated to practitioners, consumers and stake holders.
 
Based on specific criteria for the amount of research support, treatments are categorized as well-established, probably effective or controversial. This process has allowed for a consensus regarding first- line treatments for specific disorders.
 
The American Psychological Association has recently emphasized evidence-based practice guidelines, which are broader and encompass assessment, case formulation, relationship factors and treatment decision-making that help clinicians work with patients to achieve the best possible outcome.
 
Why is it important to seek out “evidence-based interventions” to help with depression?
 
By this criteria, evidence-based or well-established treatments for depression have been the most rigorously tested and achieved the best outcomes in research trials. Thus, these are the treatments that have the best chance of alleviating symptoms of depression.
 
This is similar to a patient presenting to their general practitioner with hypertension. That practitioner would collaborate with the person and consider the specific patient characteristics in choosing a first-line medication to treat that condition.
 
What are examples of evidence-based interventions to help with depression?
 
Treatments for depression that are well-established or have strong research support are Cognitive Therapy for Depression, Behavioral Activation for Depression, Interpersonal Psychotherapy for Depression and Problem-Solving Therapy for Depression.
 
How long should you expect to be in treatment for depression?
In controlled research trials, treatment typically lasts 12 to 16 weeks, with varying degrees of follow-up. In real life, where conditions are less controlled and presenting problems may be more complex, treatment typically takes longer than this. However, treatment for depression can and should be time-limited.
 
It’s important to be a smart consumer of mental health treatment. The American Psychological Association Division 12 website is designed to be consumer friendly so you can see what treatments have the most support for your specific diagnosis or presenting concern.
 
Treatment planning should be a collaborative process and you can ask your mental health provider about what type of treatment they’re trained to provide. 
 
Sophie Lazarus is a psychologist at The Ohio State University Wexner Medical Center and an assistant professor of psychiatry and behavioral health at Ohio State’s College of Medicine
 

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