Whole Body Cryotherapy for Mood Disorders: Application, Effects, and Suggested Treatment Regimens
Table of Contents
INTRODUCTION: MEDICAL USE REQUIRES SUPERVISION BY A DOCTOR
Based on theoretical knowledge, clinical studies. and experience the indication list for whole body cryotherapy has been increasingly justified and expanded over the last years11 to include a variety of health disorders. The terminology has also been adjusted to distinguish between talking about healthy subjects (cryostimulation) versus patients (cryotherapy).
For some health. conditions, the benefits of whole body cryotherapy have been proven to the point that recommendations to incorporate it in the treatment regimen are given by medical professionals with confidence. These conditions include inflammatory rheumatic diseases(rheumatoid arthritis and ankylosing spondylitis), degenerative rheumatic diseases (osteoarthritis) and chronic pains of various causes. The most common expectations from incorporating cryotherapy in treating the named disorders are reduction in inflammatory activity and pain.
Based on diverse and well-founded clinical experience that whole body cryotherapy leads to an improvement in mood and a leveling of the state of agitation, studies have been carried out also on its potential impact on depressive, mood, and anxiety. disorders (1,3,4,5).
Most of the available studies to date have been performed by Joanna Rumaszewska and colleagues. The sample sizes and methodology limitations do not justify drawing far reaching general conclusions, but the observations allow to conclude that for the affective and depressive disorders whole body cryotherapy can be considered as a symptomatic, supplementary treatment option.
Improvements in sleep have been most noticeable where depressive symptoms were present. The improvement rate observed was 91% for difficulty falling asleep, 98% for sleep interruptions, and even 100% for early awakening.
The 80% improved state regarding depression and suicidal tendency also reached statistical significance (1,3).
It has been observed that, considering patients’ general condition and life satisfaction, reduction of symptoms by up to 50% could be achieved (4,5). In addition, there is evidence that vagus nerve stimulation is beneficial in reducing symptoms of mood disorders (9). The US Food and Drug Administration (FDA) has approved the method to treat epilepsy AND depression. Although the treatment endorsed by FDA requires an implant to stimulate. the nerve by controlled electrical pulses, cold is known as a powerful natural stimulator, and whole body exposure to cryo temperatures produces a similar effect. Recent publications (10) also show a relationship between inflammation and dopamine levels in the brain that contribute to motivational impairments, suggesting that inflammation reduction supported by whole body cryotherapy may result in depression reduction. Regardless of the available proof of WBC benefits, it must be noted that one needs a medical license to give any medical advice or, moreover, to prescribe a treatment. Consequently, all cryocenters that do not have the credentials to practice medicine must ALWAYS stress that whole body cryotherapy is an option that must be considered in every individual case by a doctor.
WHAT ARE AFFECTIVE (MOOD) AND ANXIETY DISORDERS
It is not unusual for a human being to experience brief periods of low mood or anxiety, particularly in response to certain life stressors. Most people do.
If the symptoms persist for a period of at least two weeks, it is considered a depressive episode. To meet the diagnostic threshold of a disorder, they must be lasting (often for several months) and impairing.
Affective (mood) disorders affect both men and women and change the way we think and feel. They are classified as mental illnesses. The symptoms may be quite severe, including but not limited to dramatic mood swings, difficulty falling or staying asleep, and suicidal thoughts. In most cases, they will not go away on their own.
The most common conditions in this category are depression and bipolar disorder. No one knows just what causes them. It is known they run in families. They can be a result of major life changes, stress, trauma, certain. physical illnesses, and medicines. It is now known that changes in certain chemicals in the brain also may play a. role.
DEPRESSION
Depression is more than just feeling sad. It is a mood disorder characterized by prolonged feelings of sadness and loss of interest in daily activities. It is an indicator of underlying disease when the feelings become excessive, all-consuming, and interfere with normal living, including sleeping, eating, or
working.
Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. A 2019 study (10) shows that chronic inflammation also contributes to lack of motivation and consecutive depression, due to interfering with dopamine release in the brain.
In midlife or older adults, depression often co-occurs with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions may worsen when depression is present. Also, medications taken for these physical illnesses may cause side effects that contribute to depression.
The symptoms and the severity of them differ. They may include: - Persistent sad, anxious, or “empty” mood. - Feelings of hopelessness, helplessness, guilt, worthlessness, or pessimism. - Irritability. - Loss of interest or pleasure in hobbies and activities. - Decreased energy or fatigue. - Moving or talking more slowly. - Feeling restless or having trouble sitting still. - Difficulty concentrating, remembering, or making decisions. - Difficulty sleeping, early-morning awakening, or oversleeping. - Appetite and/or weight changes. - Thoughts of death or suicide, or suicide attempts. - Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment.
BIPOLAR DISORDER Bipolar disorder is sometimes called manic-depressive illness because it causes extreme mood swings, from feeling intensely happy and full of energy to episodes of great despair. In some cases, both extremes occur at once. Without treatment, it is likely that relapses will keep happening throughout one’s life.
ANXIETY Anxiety and depression share a biological basis. Both involve changes in neurotransmitter function. Low serotonin levels are thought to play a role, as do other brain chemicals like dopamine and epinephrine. At the same time, anxiety and depression are consciously experienced differently.
Those with anxiety are mentally preoccupied with worries to a degree that is disproportionate with actual risks or in situations where there is nothing wrong. Studies have shown that up to 70% of people with depressive disorders also have anxiety symptoms.
Anxiety and depression can occur sequentially — one in reaction to the other, or they can co-occur. When anxiety and mood problems reach the threshold for clinical diagnosis simultaneously, they are called comorbid conditions.
Mental markers of anxiety may include: - Worry about the immediate or long-term future. - Uncontrollable, sometimes racing, thoughts about something going wrong. - Fearing death due to perceived danger of physical symptoms or anticipated dangerous outcomes. Depending on the nature of the anxiety problem, the mental markers can vary slightly. For example, someone with generalized anxiety disorder may worry about a variety of topics, events, or activities, while an individual with social anxiety disorder is more apt to fear negative evaluation or rejection by others and to be apprehensive about meeting new people or other socially challenging situations.
THE SIZE OF THE PROBLEM Mental disorders. have been stigmatized (and, consequently, leading to discrimination) for centuries. Only recently the focus has shifted from denial and isolation to acceptance and treatment, and the actual size of the mental health problem has been admitted.
Nearly 1 in 25 adults in America live with a serious mental illness. 1 in 5 experience symptoms. Depression in the adolescent population (ages 12 to 17) is also on a rise. An estimated 3.2 million teenagers have had at least one major depressive episode. This number represents 13.3% of the respective age group. According to the NationalInstitute of MentalHealth (NIMH), major depression is one of the most common mental disorders in the UnitedStates, and suicide is the 3rd leading cause of death. In people with a mood disorder, their general emotional state is distorted or inconsistent with the circumstances and interferes with their ability to function.
THE RISK FACTORS AND THEIR MANAGEMENT There are no known ways to prevent or reduce the incidence of mood disorders. They are likely caused by an imbalance of brain chemicals, and many intrinsic and extrinsic (genetic and environmental) factors can contribute. Among the many risk factors to develop a mental illness, experts mention: - A history of mental illness in a blood relative. - Childhood abuse or neglect. - Previous mental illness. - Personality traits and social encounters that may lead to few friends or unhealthy relationships. - Stressful life situations. - Traumatic experiences, such as military combat or assault. - An ongoing (chronic) medical condition, such as diabetes. - Brain damage resulting from traumatic brain injury. - Use of alcohol or drugs. While many of these factors are outside our control, the best way to manage the risk of developing ANY health condition is to remain as healthy as possible and to engage in enjoyable activities. Paying attention to even subtle symptoms in others can help prevent development of a mental disorder in a family member, friend, or coworker.
Whole body cryotherapy positively impacts mood, ability to relax, and sleep. For these reasons, it is a good practice to incorporate into one’s health supporting lifestyle.
THE IMPORTANCE OF TREATMENT Talking about mood disorders, experts stress the importance of early detection and intervention. Depending on the underlying conditions and severity of symptoms, treatment may involve: - Medication. - Various medical therapies like psychotherapy, hypnosis, or brain stimulation. - Various non-medical therapies, such as whole body cryotherapy, light therapy, chromotherapy, music, art, or interaction with animals, like horses. - Exercise or spending time outdoors (being in nature has proven benefits). - Supplements. - Support groups and engaging in the community activities. A combination of several of the above often produces the best results. Your cryocenter may be able to help, for as long as the importance of an oversight by a health professional is understood and stressed and no medical advice or a recovery promise is given.
THE ROLE OF CRYOTHERAPY
When the body experiences extreme cold, even for a short period of time, “fight or flight” response is initiated to activate all functions essential for survival and to prevent the core temperature from dropping. It enhances blood circulation and boosts energy, but also involves release of endorphins.
Endorphins are the body’s natural pain killers and mood lifters. A whole-body cryotherapy treatment jump-starts the production of endorphins, even in people who traditionally have mood issues.
Cryotherapy is also helpful in easing depression caused by chronic pain. Since the treatment not only acts as an immediate analgesic but also lessens inflammation, the underlying cause of many aches and pains, regular treatments ease symptoms and help people feel better both mentally and physically.
Numerous studies have looked at effects of cryotherapy on anxiety and depression, and the results have been promising.
One study concluded that whole-body cryotherapy has a significant influence on improving the well-being and mood of patients (in terms of both psychological and somatic aspects) and consequently leads to an improvement in their quality of life.
The worse the mental state of the patients is prior to the cryotherapy, the stronger its effect. The observed effectiveness of cryotherapy was the strongest in women, patients with spinal pains and in patients with severe depressive symptoms. Across the board, the registered improvement has been statistically significant. The Hamilton’s depression rating scale (HDRS) and Hamilton’s anxiety rating scale (HARS) were used as the outcome measures. After three weeks, a decrease of at least 50% from the baseline HDRS-17 scores in 34.6% of the study group and a decrease of at least 50% from the baseline HARS score in 46.2%of the study group were noted. A better mean state after 3 weeks of cryotherapy was observed with respect to 11 of the 14 components of the anxiety scale (except the gastrointestinal and genitourinary symptoms) and 12 of the 16 components of the depression scale, in line with 6 components of the life satisfaction scale, such as physical well-being, physical condition, domestic activity, professional activity, personal interests and general satisfaction from life. An 80% reduction of suicidal thoughts was also reported.
The research outcomes could be summarized, as follows: - Short exposition to extreme cold has a doubtless profitable influence on man's frame of mind. - Immediately after passing the cryogenic chamber there are detectable changes in patients' mental state such as improvement of mood, deep relaxation, freshening up, consolation, and even euphoria. - The improvement lasts for a long time after ending the cycle of cryotherapy. - Whole-body cryotherapy may be recommended as an auxiliary treatment in depression.
CRYOTHERAPY PROTOCOLS FOR MOOD DISORDERS Even one cold exposure can produce improvement in mood that may last for several hours and better sleep, but isolated or random treatments will not result in any significant change.
Like in most other studied health conditions, the cryotherapy protocol to achieve a noticeable and lasting improvement should involve once daily (or as frequent as possible) treatments for at least 2 to 4 consecutive weeks. The more pronounced the symptoms, the more treatments should be suggested. OTHER CONSIDERATIONS FOR MORE NOTICEABLE RESULTS It is important that the client talks to their doctor about the treatment options and lifestyle changes that shall best suit their specific needs. Your cryocenter may raise the awareness of possible strategies without giving any advice or promise. Several types of supplements are thought to have some positive impact on depression symptoms, yet none of them should be taken without consulting with the doctor. The supplement field is very little regulated, and many herbs and vitamins marketed for mood disorders haven’t demonstrated effectiveness in clinical research. A potentially good resource to look up trustworthy brands and more information about each natural remedy is: https://www.healthline.com/health/depression/herbs-vitamins-supplements Examples of supplements to ask the doctor about: - St. John’s wort (more popular in Europe than in the US). - S-adenosyl-L-methionine (SAMe). - 5-hydroxytryptophan (5-HTP). - Omega-3 fatty acids. - Essential oils, such as wild ginger, bergamot, chamomile, or rose. - Vitamin B (B-12 and B-6 are vital to brain health). - Vitamin D: (people who are depressed are more likely to have low levels of this “sunshine vitamin” essential for healthy brain function).
SOURCES 1. H Podbielska et al. Whole body cryotherapy and depressive symptoms.Kriotechnika Medyczna 2006 2. J Rymaszewska, D Biały, Z Zagrobelny, A Kiejna. The influence of whole body cryotherapy on mental health. Psychiatria Polska 2000 https://www.ncbi.nlm.nih.gov/pubmed/11059263
3. Joanna Rymaszewska, Adam Tulczynski, Zdzislaw Zagrobelny, Andrzej Kiejna, Tomasz Hadrys. Influence of whole-body cryotherapy on depressive symptoms - preliminary report. Acta Neuropsychiatrica 2003 https://www.ncbi.nlm.nih.gov/pubmed/26983354 4. Joanna Rymaszewska, David Ramsey, Sylwia Chładzińska-Kiejna, Andrzej Kiejna. Can short-term exposure to extremely low temperatures be used as an adjuvant therapy in the treatment of affective and anxiety disorders? Psychiatria Polska 2007 https://www.ncbi.nlm.nih.gov/pubmed/18421919 5. Joanna Rymaszewska, David Ramsey, Sylwia Chładzińska-Kiejna. Whole-body cryotherapy as adjunct treatment of depressive and anxiety disorders. Archivum Immunologiae et Therapiae Experimentalis 2008 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734249/ 6. Joanna Rymaszewska, Katarzyna M Lion, Lilla Pawlik-Sobecka, Tomasz Pawłowski, Dorota Szcześniak, Elżbieta Trypka, Julia E Rymaszewska, AgnieszkaZabłocka, Bartlomiej Stanczykiewicz. Efficacy of the Whole-Body Cryotherapy as Add-on Therapy to Pharmacological Treatment of Depression - A Randomized Controlled Trial. Frontiers in Psychiatry 2020 https://pubmed.ncbi.nlm.nih.gov/32581890/ 7. Joanna Rymaszewska, David Ramsey. Whole body cryotherapy as a novel adjuvant therapy for depression and anxiety. Psychiatry and Psychotherapy 2008 https://www.researchgate.net/publication/230601186 8. Joanna Szczepańska-Gieracha, PaulinaBorsuk, Malwina Pawik,Joanna Rymaszewska. Mental state and quality of life after 10 session whole-body cryotherapy. Psychology, health, and medicine 2014 https://www.ncbi.nlm.nih.gov/pubmed/23535078 9. Rush AJ, GeorgeMS, Sackeim HA, Marangell LB, Husain MM, Giller C, Nahas Z, Haines S, Simpson RK, Goodman R. Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study. Biological Psychiatry 2000 https://pubmed.ncbi.nlm.nih.gov/10686262/ 10. Michael T. Treadway, Jessica A. Cooper,Andrew H. Miller.Can’t or Won’t?Immuno-metabolic Constraints on Dopaminergic Drive. Trends in Cognitive Sciences 2019 https://doi.org/10.1016/j.tics.2019.03.003
11. Prof. Dr. Sc. Med. Winfried Papenfuß. Power from the Cold. Whole body cryotherapy at -110° C, a short-lasting physical therapy with a long-lasting effect. 5th, revised and expanded edition January 2016, ISBN 978-3-938912- 08-9
Disclaimer: This article is a summary of available publications and some. well-known practices that have proven to be effective in managing symptoms of affective and anxiety disorders. At the same time, every condition is different, and the result depends on many factors. By no means should this document serve as a success guarantee or as a replacement for medical advice.