REGULAR COLD-WATER IMMERSION AND SYMPTOMS OF DEPRESSION, ANXIETY, AND STRESS IN ADULTS: A SYSTEMATIC REVIEW WITH MECHANISTIC INSIGHTS
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5537Keywords:
Cold-Water Immersion; Winter Swimming; Depression; Anxiety; Mental Health; Systematic ReviewAbstract
Cold-water immersion (CWI), including cold-water swimming and winter sea bathing, has become increasingly popular as a lifestyle practice that may influence mental well-being. Exposure to cold water induces physiological responses related to stress regulation, which may affect psychological functioning. Despite growing public interest, the available scientific evidence remains limited and methodologically diverse. This systematic review aimed to examine the relationship between regular CWI and symptoms of depression, anxiety, stress, and related indicators of mental health in adults.
A systematic search was conducted in PubMed on 21 February 2026 in accordance with PRISMA 2020 guidelines. Studies were eligible if they involved adults and assessed mental health outcomes associated with repeated cold-water exposure. Five studies met the inclusion criteria: one randomized controlled trial, one feasibility study, one case–control study, one cross-sectional study, and one case report. Data extraction included study design, participant characteristics, exposure protocols, and reported outcomes. Risk of bias was assessed using established tools appropriate to study design.
Across approximately 570 participants, regular CWI was associated with improvements in selected indicators of psychological well-being. Reported outcomes included improved quality of life, better self-reported well-being, improved sleep, and reductions in depressive and anxiety-related symptoms in some studies. However, results varied across study designs and were limited by small sample sizes, lack of control groups in several studies, and heterogeneity in exposure protocols.
Regular cold-water immersion may be associated with improvements in mental well-being and selected psychological outcomes. The current evidence base remains limited, and further controlled studies are required.
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Copyright (c) 2026 Kamil Szymczak, Małgorzata Ziółek, Magdalena Maroszek, Kornelia Domagała, Bartosz Janik, Ariadna Bakier, Albert Wiatr, Agata Olecka, Filip Gałązka, Jakub Cegielski
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