Pause for a moment and put yourself in your clients’ shoes—those who might be struggling with mental health issues. Now, take a look at the picture below. Imagine that you are dipping into icy water in the middle of winter in Finland. The cold bites your skin like a thousand tiny needles—but after a moment, your body fills with refreshing warmth, and a peaceful euphoria takes over your mind. Your breathing slows. A quiet, almost magical winter calm surrounds you.
What if ice swimming could be one way to support clients facing mental health challenges or dealing with various levels of stress—as a complementary treatment?
Ice swimming is becoming more and more popular as part of Nordic culture and health promotion. An ice swimming referral, or the idea of integrating ice swimming and cold therapy as an official part of healthcare practices, may seem futuristic – even utopian – at first. But what if the therapeutic benefits of cold water, especially in supporting mental health, could be part of the future of healthcare? Is an ice swimming referral just a dream, or could it be an important part of modern healthcare in future?
Entering the cold – A Wake-Up for the Body and Mind
Ice swimming triggers neurochemical and hormonal changes that affect mood. The process begins in the synapses of nerve cells, where stimuli are transmitted through connections with other cells. This releases neurotransmitters like noradrenaline, dopamine and serotonin, which regulate mood and emotional well-being. (Torppa 2021, 26.) There’s evidence suggesting that environmental stress that challenges our thermal equilibrium is beneficial. (Kelly & Bird 2021, 1.) Adaptation to thermal stress seems to cause an increase in tolerance to other stressful situations and diseases (Huttunen, Rintamäki & Hirvonen 2001).
Many Finnish ice swimmers report an improvement in their mood and a boost in their mental resilience during the winter swimming season. Numerous participants shared how ice swimming helped them manage stress, insomnia, depression, and even symptoms of ADHD. For some, the benefits have been so profound that they were able to discontinue their antidepressant medication. (Torppa 2021, 33.)
Would you rather visit a cold chamber or enjoy cold therapy outdoors?
Athletes might prefer cryotherapy, which is therapy given in a cold chamber that provides physiological benefits. Ice swimming outdoors provides cold therapy but also natural green and blue therapy, thus offering more holistic benefits to health and wellbeing. A stronger bond with nature is associated with better mental health and lower levels of anxiety and depression. One effective way to enhance this connectedness is through our senses, perceptions, and experiences. (Mental health foundation, 2021, 4-5.)
The positive effects of nature and also culture on health and well-being have already been recognized. Nature-based interventions as complementary care, along with cultural referrals, have been tested in social and healthcare services in Finland (Tyrväinen, L., Savonen, E-M. & Simkin, J. 2017, 18 & Innokylä, 2023). Traditionally, ice swimming also serves as a social gathering and is part of Finnish cultural heritage.
Is cold the new miracle treatment?
Ice swimming could be part of a self-care program. For example, a person suffering from depression and anxiety symptoms could be given a referral for ice swimming and a payment commitment for a winter swimming facility. In this way, ice swimming would serve as a complementary treatment in traditional mental health services.
“Ice swimming is seriously underused as a therapy!” (Torppa, 2021,30).
Torppa (2021,30) in her book Kylmä kutsuu interviews the psychotherapist Riikka Airo. She nicely highlights the advantages of ice swimming as a treatment: “In Finland, we have plenty of free opportunities to take advantage of this powerful treatment. We really should make use of them. Cold water swimming could totally be paired with psychotherapy—after all, the cold has a huge impact, and the effects kick in fast!”. Airo is also part of a research group in co-project together with University of Jyväskylä, Department of Psychology. The aim of the project is to develop a treatment model for anxiety and depression. The model combines a brief psychotherapy group and a communal winter swimming session. We will be anxiously waiting for the data analysis and reporting of the study in 2025 autumn. (University of Jyväskylä 2025.)
Although an ice swimming referral could be the future in the field of mental well-being, it is good to remember that it is not suitable for everyone and has not yet been thoroughly researched. As a health care professional, it is important to interview clients and assess their overall health and present circumstances before prescribing them to ice swimming to ensure their safety. Existing studies show promising evidence of the effectiveness of ice swimming on people’s mental well-being but more evidence is still needed. However, it’s hard to see why referrals for ice swimming shouldn’t be considered the future in the treatment of improving mental health rather than just a utopian idea. Maybe the future isn’t in a pill bottle or therapy room alone, maybe it’s waiting out on the frozen lake.
Writers
Marita Eskola, Mette Hämäläinen and Niina Kankainen, Students of Welfare and Health Coordinator Master’s Degree Programme at Savonia University of Applied Sciences
Pirjo Pehkonen, Juha Peteri and Sanna Savela, Lecturers at Savonia University of Applied Sciences
Sources
ChatGPT 2024. OpenAI. GPT-4.0. Used for language checking, April 2025. https://chatgpt.com/.
Huttunen, P., Rintamäki, H. & Hirvonen, J. 2001. Effect of regular winter swimming on the activity of the sympathoadrenal system before and after a single cold water immersion. https://doi.org/10.1080/22423982.2001.12113043. Accessed 7.2.2025.
Innokylä. Kulttuurihyvinvoinnin palveluohjauksen reseptikirja, 2023. https://innokyla.fi/sites/default/files/2023-10/231027_kuppi_palveluohjauksen_reseptikirja_FINAL.pdf Accessed 15.4.2025.
Kelly, J.S. & Bird, E. 2021. Improved mood following after a single immersion in cold water. DOI:10.1002/lim2.53. Accessed 11.1.2025
Mental Health Foundation. 2021. Nature. How connecting with nature benefits our mental health. https://www.mentalhealth.org.uk/sites/default/files/2022-06/MHAW21-Nature-research-report.pdf. Accessed 22.3.2025.
Toivanen, P. 2023. Kylmäterapiaa: Talviuintia mielenterveyden haasteisiin. Latu & Polku 12.1.2023, uutinen. Verkkojulkaisu. https://www.latujapolku.fi/uutiset/kylmaterapiaa-talviuintia-mielenterveyden-haasteisiin.html. Accessed 29.3.2025.
Torppa, T. 2021. Kylmä kutsuu – hyvinvointia talvesta. Helsinki: Gummerus.
Tyrväinen, L., Savonen, E-M. & Simkin, J. 2017. Kohti suomalaista terveysmetsän mallia. Luonnonvara- ja biotalouden tutkimus 11/2017. Luonnonvarakeskus. http://urn.fi/URN:ISBN:978-952-326-366-6. Accessed 22.3.2025. University of Jyväskylä 2025. List of projects. From cold to mental well-being : Effects of combining brief group psychotherapy and winter swimming. https://converis.jyu.fi/converis/portal/detail/Project/194297205;jsessionid=lyHBZiag4gtN8_VdzGZWlHGpzUSHTpyZsllXd199.cnvr6rh8?lang=en_GB. Accessed 1.3.2025