Post-Traumatic Stress Disorder (PTSD) - which some people experience after a traumatic life-threatening event or serious injury - can be treated in many different ways and treatments can be successful many years after the actual event that triggered the condition.
There is, however, one treatment that might not be as well known as a form of managing PTSD symptoms which is that of wild swimming.
Taking the plunge in cold water has become a popular movement in the UK among those who love the adventure of swimming in the natural environment.
While treatments have to be suited to each individual under guidance from a medical practitioner, there are some in the mental health field who advocate wild swimming as one potential way of helping to cope with PTSD.
The PTSD UK charity, which is dedicated to raising awareness of PTSD – is among those in the sector that highlights swimming outdoors in nature as one possible treatment for symptoms of the condition.
PTSD might be known for often striking members of the Armed Forces, particularly those who face traumatic experiences in combat for example, but the condition can also affect anyone who has been exposed to a traumatic event.
The medical and mental health sectors have come a long way since the condition was referred to as ‘battle fatigue’ or ‘shell shock’ in the aftermath of the two World Wars.
However, advocates for a better understanding of mental health issues suggest there is still a long way to go to dispel the stigma in wider society surrounding mental illness and PTSD in particular.
During the global coronavirus pandemic, PTSD diagnosis in frontline workers has reportedly been on the rise.
In May of this year, Nadia Whittome, Labour MP and youngest member of parliament, was among many reported cases when she announced that she had to take several weeks off work following a diagnosis.
The main way to treat PTSD is psychological therapies and medicine.
However, there are many alternative options and activities that can help alleviate symptoms.
Now, wild swimming is among the many treatments that is being suggested as one possible way of easing the symptoms people face following a diagnosis of PTSD.
So, is it worth taking the plunge?
The Brain And PTSD
According to PTSD UK anyone can develop PTSD after being exposed to a traumatic event.
If the exposure happens over a prolonged period of time, a person can develop what is known as complex PTSD or C-PTSD which can cause flashbacks, nightmares, and insomnia.
A person diagnosed with PTSD often feels afraid, unsafe and generally useasy even in situations that pose no direct danger or threat.
To put it in crude terms the brain is stuck 'in danger mode'. It then sends signals to the rest of the body to remain in high alert, the person remains anxious for prolonged periods of time, unable to relax no matter the setting.
The part of the brain responsible for fear and anxiety is called the amygdala.
The amygdala is the archetypal limbic structure, sitting under the cotrex in the temporal lobe.
That may not mean much to a person who is not a neuroscientist, but what matters in this context is that it is an ancient part of the brain that is responsible for filing and preserving memories as well as regulating emotions.
Memories and emotions are highly interconnected which is why the aforementioned mental health charity describes PTSD as 'essentially a memory filing error'.
The memory of the traumatic event can causes the person to remain in a state of fear long after the event itself took place.
According to neuroscience Professor Asaf Gilboa, in PTSD sufferers, the amygdala is over-active in mildly fearful stimuli and is slow in calming down after being activated. Moreover, the amygdala expands in size with long-term PTSD.
The overstimulation and expansion of the amygdala does not have to be permanent. With appropriate treatment, due to the neuroplasticisty of the brain, many people suffering from PTSD can in time return to feeling secure and safe within their environment.
How Cold-Water Swimming Can Help
Regular exercise along with quality sleep and nutrition are the fundamental building blocks of good mental health.
It has been proven that exercise releases endorphins that help boost mood.
Exercise activates the frontal regions of the brain which helps to control the amygdala, the part of the brain that is directly involved in regulating PTSD symptoms.
Swimming is a fantastic form of exercise, but swimming in a crowded chlorinated pool may not be the best suggestion for someone suffering from PTSD, as it can generate anxiety, acting as an echo chamber for sounds that may be triggering.
Also, as Professor Gilboa points out, the amygdala is particularly sensitive to unsettling circumstances that are social.
Sometimes, the best thing to do is to immerse yourself in nature, and what better way to do it than to immerse yourself fully in cold water? And yes, it does help that the water is cold, apparently.
In September 2018, the British Medical Journal published a report on the benefits of cold water therapy. It stated: “The theory is around our stress response and inflammation.
"Immersing yourself in cold water puts your body into fight or flight mode. Starting with the cold-water shock response, dipping into cold water puts your body under stress. As you repeat this experience, you diminish this stress response.”
Having control over stressful stimuli can be beneficial for people with PTSD. In time, the body is able to relax faster after a stressful situation.
Plunging into cold water can stimulate the nerves that relate to mental health, and improve the ability to relax faster after stress.
This has shown to help a range of mental health conditions including depression and chronic fatigue.
Spending time outdoors in nature can have an overall beneficial effect on well-being. There may not always be a lifeguard on duty like in your local pool, but with the right safety precautions considered, there can be a sense of adventure with wild swimming that advocates suggest makes swimmers feel truly alive.
Ready To Dive In - Where To Start?
Wild water swimming can be exhilarating but that does not mean that anyone can just jump into any body of water. There are different regulations around swimming in Scotland’s lochs and the lakes in the rest of the UK.
The legal situation for swimming in inland waters in Scotland is very different to that of England, Wales and Northern Ireland.
The public in Scotland have the right to swim in many more rivers, lakes or pond at any time of the day or night.
This was one of the first pieces of legislation enacted by the Scottish Parliament, the Land Reform (Scotland) Act 2003, and came into effect in 2005. The right does come with responsibilities.
People are responsible for their own safety, must respect the privacy of others and keep their dogs under control. Other than that, people are welcome to dip into any one of Scotland's 30,000 freshwater lochs.
Unfortunately, the rules and regulations around freshwater swimming are very different in the rest of the UK and swimmers must always do their research before taking the plunge.
Apart from the legal aspects, there are other safety measures to consider beforehand.
Those lucky enough to be able to get to the coast for a regular dip should first check the times of the tide.
Be aware of rip tides and fast-moving currents.
Reservoirs are usually off limits and can be dangerous so it's best to stay away from them altogether unless the right checks have been made to ensure it is legal and safe.
ACTIO is among apps that can help to find freshwater ready to dip into in a local area.
It does, however, come with costs at £12 a year subscription fee and some locations charge a booking fee for each swim.
However, it is one safe way to get started and can get users connected with like-minded outside goggle-wearers in their area.
So, once a location has been found, and perhaps even some wetsuit-clad buddies, there are some other important points to bear in mind:
- Get in the water in a controlled manner. It takes around two minutes for the initial cold-water shock to wear off. It is ok to let a swear word slip at this point, just make sure there are no kids around.
- Do not jump in if it is cold or you are unsure of the depth. You don’t want to start hyperventilating underwater or injure yourself before you’ve had the chance to take your first stroke.
- Gently exhale as you enter the water. Being cognizant of your own breathing is good advice in any situation, especially if you are putting your body through stress, even if it is intentional stress.
- Listen to your body – if you hear your teeth chattering its time to get out. Even if it happens after five minutes. You will be able to adjust over time and practice your breaststroke for longer. Even if you only do five minutes, that’s still an accomplishment. But it’s best to leave the chattering for the post-swim hot brew.
- Bring something to wrap up warm in afterwards. A thick hoodie will do. A hug is a bonus.
Although there is considerable evidence that suggests that coldwater swimming can help cope with a variety of mental illnesses, this is not medical advice.
Always be sure to seek professional medical help before making any decisions about this, or any other treatment.
Medical professionals can help devise a personalised healing path that will work for you specifically and that could mean other treatments are better suited to some.
In Need Of More Urgent Help?
If you feel like you cannot cope, emergency NHS services are there for you, not just for physical ailments. Dial 111 for advice or 999 if you need urgent support. There should never be any stigma or shame in seeking help when you need it.