A doctor who has conducted numerous studies into the effects of cold water swimming has called on the Scottish government to adopt outdoor swimming as a “public health measure”.

Dr Mark Harper made the call during a presentation to MSPs at the Scottish parliament last week. He said, not only should wild swimming be supported by creating easier access and better infrastructure, but it could also be socially prescribed as an alternative option for depression instead of medication.

An introductory course to outdoor swimming, he said, would cost just around £100, and, since his research has shown most swimmers tend to stick with the habit, could potentially save the NHS millions in reduced costs associated with the treatament of mental health conditions.

Dr Harper said: “We need more emphasis on public health and preventing disease. What we need is a national health service, not a national disease service.”

He explained the benefits of cold water swimming: “First of all it gets you out and gives you exercise. It gives you green therapy, being out in the open air, and we know that’s good for you. It delivers blue therapy. We know doing things on, in or around water is good for you. It also brings a sense of community, because often you’re doing it with other people.”

“But there are also the unique effects of the cold which is predominantly through reducing inflammation: so many current illnesses like diabetes and arthritis are due to inflammation. It’s one complete package which is also lots of fun.”

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He had been invited to the Scottish Parliament by MSP Fulton MacGregor who is backing the idea of wild swimming being promoted as a public health measure.

Mr MacGregor said: “Wild swimming was something I hadn’t really engaged with until last year. Since then, I have been on numerous swims and have been introduced to the wonderful community of wild swimmers which is growing every year.

“This week in Parliament we heard how investing in wild swimming could act as a preventative measure to save the NHS millions of pounds in the future. There are numerous health related benefits to wild swimming, both physical and mental.".

Dr Harper is the author of the book Chill: The Cold Water Swim Cure and an anaesthetist who became interested in how to reduce the stress response around surgery, which led him to investigating the way cold water immersion, because of the way it exercises the stress response, can reduce it.

Swimming, he said, does two things. The cold water shock activates the sympathetic, fight or flight response and the dive response triggers the parasympathetic “rest and digest” response. “It’s about,” he said, “created a toned system, in balance. You are making the reaction to stress less strong. You make the brake, the parasympathetic response stronger, and the accelerator, the sympathetic response, not so strong.”

The Herald:

Dr Mark Harper, swimming at Wardie Bay, Edinburgh

A keen outdoor swimmer himself – who took a dip in Edinburgh’s Wardie bay whilst in the capital – he developed the theory that the benefits of wild swimming would be seen in those with conditions characterised by an over-active inflammatory response. These, he said, include diabetes, depression, rheumatoid arthritis, migraines.

Most of his research, so far, has looked into its impact on depression and his first case study, which saw a 24-year-old woman, who had been on and off antidepressants since she was 16 years old, do a series of weekly cold water swims, appeared on the BBC show The Doctor Who Gave Up Drugs, hosted by Chris Van Tulleken.

The woman saw sustained and gradual reduction in the symptoms of depression – and after swimming for a few months come off her medication. Since then he has conducted numerous studies, including a small-scale trial, which found “significant reductions in the severity of depression and anxiety” following a course of outdoor swimming sessions. The trial found that, even 3 three months after it had finished, over 50% felt recovered.

Another study took 133 NHS staff, emerging from the stress of the pandemic, and found that well-being scores rose and burnout reduced.

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His studies have been rolled out by Chill Therapy, a Devon-based not-for-profit organisation that delivers cold water swimming courses for people with mental health issues and other long-term conditions, and has created a model they believe can be delivered throughout the UK.

Anti-depressant use has been rising steadily in Scotland. In the decade between 2008 and 2018, anti-depressant prescription rose by 3 million items, around 73 percent - and during the pandemic, use rose further. But, a paper published in 2021 in the Drugs and Therapeutics  Bulletin stated that there was “considerable uncertainty about the benefits of antidepressant use in the short- and long-term" and advocated re-visiting “the widespread—and growing—prescription of antidepressants.”