What is hydrotherapy?

Hydrotherapy, meaning ‘water cure’, is an ancient technique that has had a modern revival due to its plethora of health benefits. The unique properties of water such as buoyancy, hydrostatic pressure and surface tension provide an environment that is able to improve both physical and mental health conditions. Varying the temperature, pressure and movements within water can have profound effects on many different systems in the body.¹ 

You will have definitely been told that a cold shower is great for energising and a hot shower will relax our muscles and mind, but what is the science behind it and how does it improve our mental health and wellbeing? In this article, we will investigate recent studies and publications that show the positive benefits of hydrotherapy and how we can use it in mental health treatment today. 

Benefits of hydrotherapy for mental health 

Stress reduction

Stress is widely experienced due to the demands of work and general life. Having effective coping and relieving mechanisms is essential when managing this. Hydrotherapy treatment has been shown to significantly reduce our body’s stress hormone cortisol.² A prolonged build-up of cortisol can have negative effects on our mental health leading to conditions such as anxiety and depression, whilst reducing sleep quality. Immersing the body in hot water allows muscles to relax, relieving pain and stress. 

Anxiety relief

Mixed anxiety and depression disorder is the most common mental disorder in the UK with 8% of the population experiencing the condition.³ Anxiety disorder has profound effects on an individual's life leading to excessive worry, difficulty focusing, and avoidance of situations. These psychological effects can further manifest into physical symptoms such as cardiovascular disease, gastrointestinal disorders, and a weakened immune system.⁴ Management of anxiety is essential to prevent the onset of long-term psychological and physical effects whilst improving the individual's overall mental health and well-being. 

A study led by R. D Benfield at the Department of Obstetrics and Gynaecology at East Carolina University researched the effects of warm water hydrotherapy for one hour in women during labour. Anxiety was measured before and during labour using a visual analogue scale for anxiety. Results showed that hydrotherapy was effective in reducing maternal anxiety and leading to a more positive birthing experience.⁵

Improvement in mood

A study conducted by D. Wahyuningsih in Indonesia looked at the effects of hydrotherapy treatment on 30 patients with depression.⁶ They found that following the investigation, those patients in the intervention group showed a significant difference in depression scores. The intervention group underwent regular water therapy sessions starting with a whole-body warm water flush and then submersion into cold water for 2-3 minutes. On average, before treatment, the patient’s depression score was moderate-severe and this was reduced to light-moderate post-treatment. The researchers propose this method as an effective therapy for the treatment of mental disorders including depression in clinics and communities, however, they did conclude that further research on long-term effectiveness is needed. 

Furthermore, relaxing in a hot tub for prolonged periods has been shown to increase our bodies' levels of endorphins through increased blood flow and deep breathing. Endorphins naturally relieve pain in the body and their release also contributes to improved mental health and well-being. 

Types of hydrotherapy 

Hot water hydrotherapy 

Experiencing the benefits of hydrotherapy can be as simple as enjoying a hot bath or relaxing in a hot tub and sauna. The increased temperature of the surrounding water raises our body’s core temperature and relaxes blood vessels, increasing blood flow and temporarily reducing blood pressure.⁷ High blood pressure has been linked to depression and poorer mental health, further supporting the mental and physical benefits that hydrotherapy can have.⁸

Cold water hydrotherapy

On the other hand, cold water hydrotherapy has also been shown to improve mental health by immersing the body in water below 15℃. This method of hydrotherapy can be accessible to all by taking cold showers or immersing yourself in ice baths. This cryotherapy method causes blood vessels to constrict and reduces blood flow to the body’s peripheries during submersion. When you leave the cold water, your blood vessels dilate to supply oxygen and nutrients to the tissues which boosts circulation and helps reduce inflammation.⁹

Additionally, cold water exposure stimulates the vagus nerve which regulates our breathing and heart rate. This forces the individual to bring focus to their breathing to help regulate it within the intensely cold environment. Brief and regular stimulation of the body’s stress response in this way can overall improve our response to encountering stressful situations by building physical and mental resilience.¹⁰

Contrast hydrotherapy 

Contrast hydrotherapy is one way of harnessing the benefits from both hot and cold water immersion. By rapidly changing the body’s internal temperature, our blood vessels are forced to alternate between vasodilation and vasoconstriction, creating a pumping action within the vasculature. This can support the reduction in blood pressure which has many important physical and mental health benefits. 

Here is a suggested method for contrast hydrotherapy:¹¹

• Three minutes submerged in hot water (37℃)
• One minute submerged in cold water (15℃)
• Repeat 4-5 times

Considerations and precautions

The natural treatment of immersion into water is generally safe when done properly, however, it is important to consult a healthcare professional prior to starting treatment. Individuals with additional physical health conditions must consider the potential adversities which may arise as a result of hydrotherapy. In particular, those with heart, circulatory or blood pressure issues should take particular care before beginning treatment. 

Whilst there are many studies supporting the great benefits of hydrotherapy for mental health, the researchers all disclaim the method should complement and not be used as a substitute for other treatments and medications.  

In order to maintain safe practice during hydrotherapy before submersion, the temperature of the water must be measured to ensure it is in the safe range between 15-40 ℃. In addition, the length of time in cold water hydrotherapy should not exceed 10 minutes to avoid hypothermia. 

Summary 

The wealth of health benefits and accessibility of hydrotherapy proves it to be an excellent tool for boosting well-being and mental health. Using contrast hydrotherapy provides an excellent way of utilising the advantages of both cold and hot water immersion. Despite the positive reports from emerging research, hydrotherapy should not replace other mental health treatments and is best used in combination with other medications or therapies. 

FAQs

How often should you do hydrotherapy?

The frequency of hydrotherapy sessions varies based on individual needs and health conditions. It is best to consult with a healthcare professional or physiotherapist who can assess your specific situation and recommend an appropriate schedule. They will consider factors such as the nature of your condition, treatment goals, and your overall progress. Regular communication with your healthcare provider will ensure that the hydrotherapy sessions are tailored to your needs, promoting effective rehabilitation or management of health issues.

What types of patients could find hydrotherapy useful for other conditions?

Hydrotherapy can be beneficial for a range of patients, including those recovering from injuries, individuals with musculoskeletal conditions, and those with chronic pain or arthritis. It is often recommended for rehabilitation after surgeries, such as joint replacements, as the buoyancy of water reduces impact on joints while providing resistance for strength building. Additionally, hydrotherapy may aid individuals with neurological conditions, promoting mobility and balance. Consultation with a healthcare professional is crucial to determine the suitability of hydrotherapy for specific health concerns.

Other than mental health, what are the benefits of hydrotherapy?

Beyond mental health, hydrotherapy offers various physical benefits. It can aid in improving joint mobility, reducing muscle tension, and enhancing overall flexibility. The buoyancy of water reduces the impact on joints, making hydrotherapy beneficial for individuals with arthritis, musculoskeletal conditions, or those recovering from injuries or surgeries. The water resistance also facilitates strength training and rehabilitation. Additionally, hydrotherapy may contribute to better circulation, increased cardiovascular fitness, and improved balance. It is important to consult with healthcare professionals to determine the suitability of hydrotherapy for specific physical health needs.