Could Taking Cold Showers Help You Battle Depression?

In the United States alone, depression is estimated to impact 21.0 million adults. According to the CDC’s WISQARS Cause of Death Reports, in 2019, sucidie was the 10th leading cause of death overall in the United States, claiming the lives of over 47,500 people that year. As we know, these reported cases were documented prior to our global pandemic and unfortunately, depression rates have tripled since then. Although the cause of depression can be complex, researchers do believe that changes in brain structure and function alongside lifestyle and genetic factors make certain people more susceptible to depression than others. Although current treatments including medication and psychotherapy interventions can be helpful for those suffering from depression, are there other ways we can help prevent  or reduce episodes of depression? In today’s blog post, I share an interesting new idea researchers have been investigating when it comes to the use of cold therapy exposure for depression. 

Symptoms of Depression 

Depression, otherwise known as major depressive disorder or clinical depression generally involves a persistent feeling of sadness, hopelessness and loss of interest in activities patients once enjoyed. Aside from the emotional symptoms caused by depression, many people will also experience physical symptoms including chronic pain or digestive issues. To be diagnosed with depression, the following symptoms must be present for at least two weeks. 

According to the DSM-5- Diagnostic Criteria, you must be experiencing five or more of the following symptoms during the same 2- week period and at least one of the symptoms should involve either 1) depressed mood, or 2) loss of interest or pleasure in activities previously enjoyed. 

1. Depressed mood most of the day, nearly every day. 

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. 

3. Significant weight loss when not dieting or weight gain, or decrease/increased in appetite nearly every day. 

4. A slowing down of thought and a reduction of physical movement (likely observed by others), or a feeling of restlessness

5. Fatigue or loss of energy nearly every day 

6. Feeling of worthlessness or excessive or inappropriate guilt nearly every day. 

7. Diminished ability to think or concentrate or indecisiveness, nearly every day. 

8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. 

Medications Associated with Depression 

When evaluating someone for depression, it is important to address the root cause of their particular depression and unfortunately reviewing the medications you are on are an extremely important part of this evaluation. Some of the most common medications associated with depression include acne medications (isotretinoin-accutane), thyroid medications (Levothyroxine), allergy medications (cetirizine- Zyrtec and montelukast- Singulair), corticosteroids, and birth control. 

Common Traditional Treatment for Depression 

Some of the most common types of antidepressants currently used in the treatment of depression include: 

1. Selective serotonin reuptake inhibitors (SSRIs)- Celexa, Lexopro, Prozac, Paxil, Zoloft

2. Serotonin and norepinephrine reuptake inhibitors (SNRIs)- Pristiq, Cymbalta, Fetzima, Effexor XR

3. Atypical antidepressants- Wellbutrin, Remeron, Trazodone, Trintellix

4. Tricyclic antidepressants- Anafranil, ASendin, Elavil, Norpramin, Pamelor

5. Monoamine oxidase inhibitors (MAOIs)- Nardil, Emsam, Parnate, Marplan

Although these treatments may be effective and necessary in certain patients, they often can come with a variety of side effects including: 

• Nausea, vomiting, diarrhea

• Headaches 

• Insomnia

• Dizziness

• Sexual problems, such as reduced sexual desire (low libido), difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction) 

Nutrient Deficiencies Associated with Antidepressants 

Nutrients deficiencies are also a common outcome of antidepressant use, which is unfortunately rarely recognized or listed as a possible side effect of their use, especially concerning for long-term users. 

Niacin (Vitamin B3) 

Many antidepressants inhibit the activity of an enzyme known as indoleamine 2,3-dioxygenase (IDO). Since IDO is required in the production of niacin, those on antidepressants are more at risk of developing a niacin deficiency. Since niacin is an important nutrient involves in more than 500 intracellular reactions in the body, including those involved in the brain, niacin deficiencies can often go unnoticed and instead cause your doctor to increase your antidepressant dose, which may other increase your niacin deficiency and make your depression associated symptoms worse. Having your doctor test your B3 levels can be extremely helpful. 

Folate

Various studies, including randomized controlled trials, have noted a clear association between low serum folate levels and depression. 

Coenzyme Q10 

CoQ10 production has been shown to be inhibited by tricyclic antidepressants and may be associated with impaired mitochondrial function and increased oxidative stress. 

Calcium and Vitamin D 

Although anti-depressant may be associated with specific micronutrient depletions, they may also be the cause of those side effects, likely treated by certain supplements. For example, a systematic review and meta-analysis published in 2018 found an association between risk of fracture and the use of SSRIs which was not accounted for by age since it affected all age groups and the risk increased with greater antidepressant use. And while the exact mechanism behind the link between Vitamin D and depression is not fully understood, researchers have found a link between low vitamin D status and depression. 

Adapted cold showers as a potential treatment for depression 

Although medications and psychotherapy have an important role in the treatment of depression, new therapies including cold exposure therapy have been of particular interest in the treatment of depression. The idea behind cold therapy was to evaluate how “thermal exercise” could impact brain function. To test the theory, researchers investigated the use of adapted cold showers (68 degree F for 2-3 minutes) performed once to twice a day. From the data collected, this type of adapted cold exposure was able to activate the sympathetic nervous system and increase the blood level of beta-endorphin and noradrenaline levels which was able to trigger the synaptic release of noradrenaline (Norepinephrine)  in the brain as well. Researchers also theories that due to this direct impact on the brain, the high density of cold receptors on the skin could cause an overwhelming amount of electrical impulses from the peripheral nerve endings to the brain resulting in an antidepressant effect. Although there is still more research needed, these initial findings were extremely insightful and a possible additional therapy that is readily available for those suffering from depression. 

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About the Author: Meet Dr. ZenAlissia Zenhausern- Pfeiffer, NMD, FABNE, (commonly known by her patients as Dr. Zen), is a licensed naturopathic doctor board certified in naturopathic endocrinology and the founder of NMD Wellness of Scottsdale, a premier naturopathic medical practice that focuses on helping women to take a proactive approach to their hormone and fertility health. Dr. Zen has been featured as a lead expert in Forbes, Shape Magazine, and Instyle and is deeply passionate about bridging the gap between traditional and natural medicine in the world of fertility. She works with a variety of hormone related issues including PCOS, endometriosis and unexplained infertility. Her goal is to help more women get back into the driver’s seat of their own health to make lasting transformational changes to their health to bring more cute and adorable babies into this world. Read More About Dr. Zen...