Ice Bath for Mental Health: Shifting Our Mindset

Ice Bath for Mental Health: Shifting our Mindset

Ice baths are all the rage right now. Most of us in the fire service are familiar with the “fun” times spent in the ice bath back in the day. If you played any sport, there is a good chance you have had the opportunity to experience the cold. It seems like every other social media post or podcast discusses or advertises an ice bath for at-home use. What once was a luxury reserved for professional athletes is now making it into the fire stations and the homes of millions of people.

When most firefighters think about the ice bath, the physical benefits come to mind: decreasing inflammation/soreness, improving recovery, or cooling off on a hot day (I work in Tempe, AZ, so it gets a bit warm during the summer). While those physical benefits are real and essential, I want to shift your focus to the mental health approach.

Over the last decade, as a Wim Hof Method (WHM) instructor, I’ve researched, practiced, and instructed many different groups of people with ice bath techniques and protocols. The WHM consists of breathwork (not practiced in the ice), gradual exposure to the cold, and commitment. For the sake of this article, we will only be talking about the ice bath; however, understand there is a lot more to the method.

I am constantly getting questions from fellow firefighters about the ice bath and from firefighters I’ve never met before from other organizations trying to “sell” this practice to their administration. Of course, I am not the end-all-be-all expert on cold therapy. I am no doctor. However, I have a degree in Exercise Science and a solid understanding of physiology. Much of my experience comes from my personal cold practice and having taken hundreds, if not thousands, of people from all ages and communities through the ice bath experience. I primarily teach first responders and the military because the stress they endure during their careers is higher than most experience in their lifetime. Some groups we have worked with recently include Navy Seals (active duty and retired), Delta Force, retired 9/11 firefighters, recruit firefighters, and several professional athletes. I do not say this to brag, only to help you understand that this practice can positively impact many cultures.

I am not here to tell my story. If you are interested, I have been on several podcasts that explain why I am so passionate about this work. This article is about you discovering the benefits of the cold, specifically for your mental health.

There are two ways to approach understanding the mental health approach with regard to cold exposure. The first is talking about the “30-thousand-foot view” to understand the primary intention when using the ice as a teacher. The other is explaining, in detail, from a scientific perspective, how this practice impacts your nervous system in real-time. This article will discuss both since some people like to understand the basics, and others want every detail explained. The first discussion will be the basics, so you can read on if you would like the physiological explanation (of course, I recommend absorbing as much knowledge as possible).

Let’s look at the basics of the ice to improve our mental health, including how we respond to a stressful situation.
I think we can all agree that the ice brings up a set of emotions that may be uncomfortable. These emotions include fear, anxiety, panic, failure, etc. If I told you I was kidding and we were actually getting into a nice hot tub, your emotional response would change in real-time. However, the point of the ice is to step into the stress, feel these genuine emotions, and learn that we have a choice. Let the stress control us, or we control the stress. The ice represents every difficult situation you might be currently facing– personal or professional. You could be grieving the loss of a loved one, having financial difficulty, relationship challenges, or work conflicts.

The ice will re-create a stressful environment right now. With the temperatures we are using, your physiology will go into fight or flight as a protective mechanism. Many times in life, when we are put into a stressful situation, we tend to react. This reaction could be based on the hormones being released during the event. We could be going into a situation with fear, anxiety, panic, or trepidation. The main purpose of the cold is to teach yourself that you have a choice in every difficult situation you may find yourself in.

Enduring the discomfort of cold immersion requires discipline and mental toughness, qualities that can be transferred to other areas of life. The ice allows us to measure our current reaction to stressful situations the moment we step into that tub. As you lower yourself into the tub, hormones begin to coarse throughout your body. The natural reaction is to tense up, breathe fast, or even drop a few f-bombs. However, THE WAY THAT YOU DO ONE THING IS THE WAY YOU DO ANYTHING. Regardless of how uncomfortable you are at that moment, you still have a choice regarding how you react. You can let the environment control who you are or learn how not to let the environment dictate anything about you. We are always in charge of how we think, act, and feel. The ice simply gives us the opportunity to learn a lot about ourselves in real-time. Do you give away all of your power to the stress, or do you maintain who you are and how you want to be, regardless of your environment?

It all starts with your breath. As I mentioned, the Wim Hof breathwork is NEVER to be practiced in the ice bath. However, the breath is extremely important when you are putting yourself in a very uncomfortable and sometimes painful situation. As you begin to immerse yourself, the goal is not to let the cold impact how fast you are breathing. Rather, can you maintain long, slow, rhythmic breathing despite the discomfort you are feeling? By doing this, we are training our nervous system to respond more mindfully in stressful situations. Remember, how you do one thing is how you do everything.

The harder you fight through stress, the harder it fights through you. During an ice bath, a very natural reaction is for a person to “white-knuckle” through it. This means gritting your teeth and doing anything necessary to get through and survive the situation. Unfortunately, we learn nothing about who we are when we do this. Moreover, this approach wires us to white-knuckle our way through other stressful situations in life. By tensing up, squeezing your hands, or having your shoulders tense and coming out your ears, you give your power and control away to the ice. You resist your body’s natural stress response of adapting to your environment.
Instead, relax every cell of who you are and surrender to the stressful environment around you. By surrendering, you allow the stress to travel right through you. When you do this, the environment has no power over you. You are in charge. You are in control. We are basically training your nervous system to respond more mindfully in stressful situations instead of reacting by just pushing through, trying to get through the event or white-knuckling our way through it.

Lastly, one of my favorite aspects of the ice is simply from a thought perspective. Most of us walk around having conversations in our heads at a terrifying pace. Most of what we are thinking about is linked to something that has either already happened in the past or what might happen in the future. Those are two things we have absolutely no control over. This “monkey mind” is dangerous if left untrained and can drive anyone to the brink of disaster.

Cold has a powerful way of bringing a person’s focus to the present. What are you thinking about when you get into icy water? You’re thinking, “Holy crap, this is cold!” Guess what you are not thinking about? Everything else that is going on in your life. The difficult call you just ran. The fact that you only got two hours of sleep. There is a lot of power to the cold. This practice can show you, in real-time, what it’s like to be in the present moment. Focusing on the only moment we have control over right now. How do you want to respond? How do you want to be?

Science
Let’s get into the science of the ice and the available physiological benefits. The autonomic nervous system consists of two parts, the sympathetic (fight or flight) and the parasympathetic (rest and digest). As humans, we are supposed to be in the parasympathetic 99.9% of our lives unless we are actively facing a threatening moment.

We first need to understand how our stress response works. When a stressful event is about to happen, the amygdala (in your brain) sends an alarm to activate the HPA axis and initiates our hormonal response. The HPA axis stands for Hypothalamus, Pituitary, and Adrenal axis. Once those signals have been sent, the result is a release of your primary stress hormones or catecholamines. They are adrenaline, noradrenaline, and cortisol. Adrenaline and noradrenaline increase blood flow, and cortisol releases sugar to give your muscles the energy to “fight or flight” during the situation.

Here is an example of how our stress response is supposed to work. Imagine you are a caveman or cavewoman who has to wander out of the safety of your cave home to gather food for your family. As you’re plucking that delicious apple off the tree, you notice a saber tooth tiger eyeballing you. Before you know it, the tiger begins to run towards you. Your amygdala perceives the immediate threat and sends the alarm to your HPA axis - releasing the hormones you need to survive in the moment. Let’s say you were able to run as fast as you could (because we are not going to fight a tiger), and you made it back to your safe cave and shut the cave door. There is no way that tiger can get in. Since there is no more threat, cortisol returns to the brain through negative feedback and tells the system that we can switch from sympathetic (fight or flight) to parasympathetic (repair and digest). Now you can enjoy your family time and eat some apples. There is no more threat and no more stress. This is how the system is supposed to work. So what’s the problem?

The big issue is that our physiology cannot differentiate between a real threat and a perceived threat. A real threat is a real-life stressful situation, and a perceived threat is a stressful situation we think about in our head. For example, if I think about a stressful call I had ten years ago, my physiology begins to react as if it were presently happening. The amygdala sends an alarm activating the HPA axis, releasing the stress hormones. Physically, I may start to breathe faster or sweat and panic thinking about this call. Once the thought has passed, cortisol goes back up to the brain, telling it that there is no more stress, and we can now turn off our stress response and switch from sympathetic (fight/flight) to parasympathetic (rest/repair/digest).

Have you ever sat down and observed your stress? How many real-life stressful situations are you actually facing in the present moment vs. how many exist primarily between your ears? Most of us have a nonstop internal dialogue going on all day, every day. Most of those thoughts are about something that has happened in the past, which tends to bring up depression, or something that might occur in the future, which tends to bring up anxiety. Whether work-related, family or relationships, financial challenges or grief, any time we entertain stressful thoughts, our physiology immediately reacts as if it were physically occurring in the present moment.
The body will take the path of least resistance, instead of continuously reactivating our stress response because of the constant influx of thoughts, we, as humans, will remain in constant fight or flight basically waiting for that next shoe to drop. It then makes way more sense, from an energy perspective, why we are stuck in “chronic stress” that so many people talk about. Even more, continuously dumping stress hormones into the body can result in feeling chronically exhausted, high-strung, foggy, short-tempered, angry, anxious, and depressed, to name a few.

This brings up another benefit of the ice. The ice is a real-time stress. The fight-or-flight will be activated because the cold has an inherently universal sense of danger. The premise behind why this works is a term called hormesis. Hormesis means exposing your body (or physiology) to the right amount of stress for the right amount of time to adapt and become stronger. However, exposing yourself to that same amount of stress for too long would be detrimental and even dangerous. Think about this: we are not going into a weight room and choosing to bench press for six hours straight. More is not better. More is actually very dangerous. We are approaching our workout with very specific sets, reps, time under tension, etc., to keep the training safe and allow our muscles to adapt. This is the same exact concept with the cold.

So, how does the cold impact all the chronic stress we are putting ourselves through? As we discussed earlier, most of us live in a constant state of “fight or flight” because our thoughts are going haywire throughout the day. Since we now know that our stress response works through negative feedback to turn off, we can use this to our advantage. Ice-cold water is stressful. Once you get out, the stress or threat has been removed from the equation. Cortisol goes back up the brain, telling it to switch from sympathetic to parasympathetic because there is no more threat to the system. Many of us have no idea what it feels like to be in this state of mind - who we are supposed to be. I’ve worked with some individuals who have shared that they hadn’t experienced being parasympathetic in over 20 years.

Imagine going home to your family after a tough, sleep-deprived shift in the “fight or flight” part of your nervous system. You will probably be more irritable, frustrated, and exhausted, leading to a challenging day with your spouse and kids. Now, imagine going home after resetting your stress response with an ice bath and with your nervous system right where it should be. We are more engaged, happy, and relaxed, allowing us to have an enjoyable day with the reason we do this job - family. Our family must sacrifice so much already for the career that we love. My goal is when I am home, I am home with 100% of who I am because that is what they deserve. It is what we all deserve.

Now, I get asked all of the time about a protocol for the ice bath. There is no one way to practice with the cold. Specifically, when it comes to allowing our members to practice on duty, safety is the most important part. Like the bench press example earlier of lifting for six hours straight, more is not better. Staying longer in the ice does not benefit us at all from a nervous system perspective. Staying in too long changes the intent and game entirely.

First, the temperature is going to be different for everybody. The ideal temperature is when someone gets in; their first thought is, “I want to get out.” Everyone will be different, which is why it's so crucial that no competition or ego ever exists with the ice bath. This is an individual practice based solely on where you are in life. The way we keep it safe and effective from a physiological perspective is to limit the ice bath to no longer than two minutes. There is a particular reason why two minutes is all you need, and it's extremely important to understand.

A neuroscientist out of Harvard coined the term “The 90-second rule.” This rule states that when you are in a “fight or flight” environment, the hormones released (adrenaline, noradrenaline, cortisol) are flushed away after 90 seconds. This means that the hormonal response is now over. Our primary goal in the ice is learning how to handle this influx of hormones. Not allowing them to control how we think, act, and feel. By not responding to the hormones and maintaining control, we are teaching ourselves how to handle, process, and let go of stress. We go for an extra 30 seconds to make sure we have control, and then we get out.
As you can see, longer is not better as those hormones are no longer produced in that environment. If you want to do more, think about doing intervals. Get in for two minutes, out for 5 minutes, and then back in for two. We are only looking to train that initial response to stress. This process allows us to minimize the risk and gain the benefits we are specifically targeting.

That is it for now. I hope you found this helpful and informative. This article is lengthy for a reason. This is important work. It is even more vital that we are all on the same page to keep the practice safe and effective for all our brothers and sisters out there.