I think it's safe to say that that's probably how the majority of people would experience that.

You do write about a fellow in your book who maybe took the cold in his context, it might've been the lesser of two evils, right?

Because ultimately this became, I think, a more well-adapted coping mechanism to an otherwise maladaptive addiction.

Would you say that's fair?

I do.

I agree with you.

This was an individual addicted to alcohol and cocaine who got into recovery, experienced a lot of dysphoria, and discovered that taking an ice by a trainer or a coach actually made him high.

It gave him the kind of response that he often got from drugs.

So he began doing daily ice-cold showers and then over time got himself a cooler and would submerse himself in ever-colder temperatures and then got a motor to circulate the water.

So he was breaking the ice off in the morning.

At some point, kind of realized, oh, wait a minute, I think my tendency to take things to extreme may be operating here.

But yes, absolutely, I agree with you.

Ultimately, this was a healthy coping strategy.

And ultimately, which really speaks to what is a healthy coping strategy, it's something that we also do with other people.

So he started doing it with his family, with social groups.

People would come over for ice-cold water bath parties.

Much better than having people over to snort some lines or whatever the case may be.

So yes, and we have lots of patients who, when they get into recovery from drugs and alcohol, will often discover sports and endurance athletes in order so that they can still have that striving and that goal and the endorphins.

We just have to make sure they don't continue to do it to the point of personal injury.

I discovered something several years ago, which was if I took an ice-cold shower when I was very upset, angry, the mood would reverse quite quickly.

And I kind of attributed that to stimulation of the vagus nerve.

Again, my head had to be immersed in cold water.

It could have even presumably been dipping my head in a cold water, sort of stimulating the dive reflex.

But like others who enjoy cold plunging, which I do very, very much, I would completely share that experience.

It is a absolutely mood-lifting experience.

And when people ask me, which I get all the time, is cold plunging kind of an elixir of longevity?

Having looked at the data very carefully, I can say that the answer appears unlikely.

I see no evidence that cold immersion alters any of the hallmarks of aging, with the one possible exception being a reduction in inflammation.

But that's never translated to a clinical benefit vis-a-vis disease in the way that I do think that there is benefit to sauna, right?

So I do think if you look at the sauna literature and run that same Bradford Hill criteria, along with the experimental data which are included, that there really is probably causality between the benefits of sauna and disease prevention.

So again, I don't see that with cold, but my use of it personally just stems from the mood elevation.

So believing that it has no benefit on my ability to reduce the risk of cancer, heart disease, or dementia, just the mood elevation alone for me seems to be reason enough.

So I enjoyed the story of that gentleman.

Yeah, yeah.

Yeah, that's interesting.

I didn't know that about the data with sauna or even longevity relationship with ice-cold water plunges.

But in terms of a mood modulator and a replacement behavior, because I do think that ultimately we are strivers, right?

We want to experience intense emotions, and it's not that we can just sort of not have goals and not have emotions.

We want that kind of intensity.

And certainly many of my patients have reported similar types of positive responses to ice-cold water plunges.

Which by the way, I don't notice with sauna.

So with extreme heat, which I also enjoy greatly, it's a different sensation.

And I'm curious, do you think that there's something about cold that produces more pain?

I mean, I guess it does feel much more painful.

Is it simply come down to the pain?

I don't think we know.

I do think that the immediate response is going to be some kind of hormetic response, hormesis being this Greek term that means to set in motion or setting into motion our own regulatory healing response in response to injury.

And the branch of science called hormesis is looking at the ways in which toxic or noxious stimuli actually makes us more resilient over the long run.

So yes, I think that it's an immediate hormetic response.

And let me just say, we see this being beneficial not just in people struggling with addiction or looking for alternative sources of dopamine, but also when people get immediately dysregulated.

So you noted that when you get angry, it's helpful.

So when we have patients who are very dysregulated, overwhelmed by their emotions, can't re-regulate, we say stick your face in a nice cold water bath, plunge your hands in a nice cold water bath.

And it really, really works for some people.

There's also interesting work looking at cold more broadly and what it does to neurons.

And it turns out that cold is one of the most potent stimuli for neurogenesis.

So very interesting looking at, like, mice brains after exposing the mouse to extreme cold or the effect of hibernation in extreme cold.

And finding that cold initially causes a sort of, like, not neuronal death, but if you look at the brain slices, it looks almost like these dendritic, you know, tree-like neuronal structures sort of die out, you know, in response to cold.

But then very quickly afterwards, you get a spring-like regrowth, an amazing neurogenesis.

So who knows?

Maybe the repetitive use of cold on some level is causing or facilitating human neurogenesis as well.

I don't know.

I would love, though, to see more broadly in the field of neuroscience, people look at this concept of drug of choice because it's so interesting.

Cold, for example, does absolutely nothing for me.

I don't enjoy the experience, but I also don't get benefit afterward.

I sure wish I did because it's a nice, easily accessible kind of a tool.

But for many people, including you, it's very potent and that's great.