Does the Wim Hof Method help women with depression?
Both the Wim Hof Method and slow-paced breathing produced equivalent improvements, with a 24% reduction in depressive symptoms and a 27% reduction in anxiety symptoms after three weeks. A randomized controlled trial of 84 healthy midlife women with high stress and high depressive symptoms found that improvements were maintained at 3-month follow-up, with 46% of the sample reporting mild or no depressive symptoms.
The Wim Hof Method condition combined a breathing technique designed to induce intermittent hypoxia with cold showers, an approach the researchers framed as hormetic stress. The comparison condition used slow-paced breathing and warm showers.
What the data show:
- Equivalent improvements: Both groups showed a 24% reduction in depressive symptoms, a 27% reduction in anxiety symptoms, and a 20% reduction in perceived stress after the intervention
- Sustained benefits: Improvements maintained at 3-month follow-up, with 46% of the sample reporting mild or no depressive symptoms
- Rumination reduction: The Wim Hof Method group had significant reductions in rumination after daily stressful events compared with the slow breathing control
- Study scope: 84 women randomized (41 Wim Hof Method, 43 slow breathing), with six participants (7%) dropping out, all from the Wim Hof Method condition
A randomized controlled clinical trial published in Comprehensive Psychoneuroendocrinology found that both the high-arousal Wim Hof Method and the low-arousal slow breathing comparison reduced depressive symptoms in women with high stress and high depressive symptoms, with benefits sustained at 3-month follow-up.
Dr. Kumar’s Take
The Wim Hof Method is interesting because it stacks modalities: controlled breathing, cold exposure, and the training of a person’s own response to a stressor. This trial tested that stack against something deliberately unglamorous, slow-paced breathing with warm showers, and the two came out even on depressive symptoms, anxiety, and perceived stress. That is the honest result, and it runs counter to what the investigators had preregistered.
I want to be careful about who was studied. These were 84 medically healthy midlife women screened into the trial for high stress and high depressive symptoms, not patients carrying a clinical diagnosis of major depressive disorder. That distinction matters when someone asks whether breathwork treats depression. What this trial shows is that a structured daily practice moved symptoms in women who were struggling, and that the fancier protocol was not the reason.
The one place the Wim Hof condition separated itself was rumination after daily stressful events, which was significantly lower than in the control group. I find that plausible as a mechanism worth chasing, since rumination is one of the more tractable levers in depression. But the authors themselves call for replication in larger and more diverse samples, and the attrition pattern is worth noting: all six dropouts came from the Wim Hof arm, and the control participants rated their assigned intervention as more credible going in.
Study Snapshot
This randomized controlled clinical trial compared a Wim Hof Method intervention against an active control condition in women with high stress and high depressive symptoms. Participants were randomized to either the Wim Hof Method condition, involving a breathing technique designed to induce intermittent hypoxia plus cold showers, or an active comparison condition involving slow-paced breathing and warm showers. Primary outcomes were depressive symptoms, anxiety symptoms, and perceived stress, collected before the intervention, after the intervention, and three months later. Daily stress rumination and affect were captured with daily diaries during the intervention, and participants completed the Trier Social Stress Test before and after the intervention with salivary cortisol reactivity sampling.
Results in Real Numbers
The trial randomized 84 healthy midlife women with high stress and high depressive symptoms to either the Wim Hof Method condition (41 participants) or the active comparison condition of slow-paced breathing and warm showers (43 participants). Participants received daily audio instructions lasting 15 minutes for three weeks during the COVID-19 pandemic (2020-2021).
Participants in the active control condition perceived the intervention to be more credible and expected greater mental wellbeing benefits than those assigned to the Wim Hof Method. Differential attrition followed: six participants (7%) dropped out, all of them from the Wim Hof Method condition.
Among participants who completed the intervention, both groups improved on mental health outcomes immediately afterward, with a 24% reduction in depressive symptoms, a 27% reduction in anxiety symptoms, and a 20% reduction in perceived stress. Improvements were maintained at the 3-month follow-up, with 46% of the sample reporting mild or no depressive symptoms.
Participants in the Wim Hof Method condition had significant reductions in rumination after daily stressful events compared with those in the active control group. Both conditions had reduced daily negative affect across the intervention and lower peak cortisol reactivity to the laboratory stressor after the intervention.
Who Benefits Most
Women with high stress and high depressive symptoms who are willing to commit to a short daily practice are the population this trial actually speaks to. Both the Wim Hof Method and slow-paced breathing produced the same symptom improvements, so the choice between them can come down to preference and tolerance rather than expected benefit.
People drawn to a high-arousal practice may find the Wim Hof approach engaging, and it was the condition associated with lower rumination after daily stressors. People who would rather not take cold showers have a comparable option in slow-paced breathing with warm showers, which in this trial delivered equivalent reductions in depressive symptoms, anxiety, and perceived stress, and which participants rated as more credible.
Safety, Limits, and Caveats
The population here was medically healthy midlife women screened for high stress and high depressive symptoms, not a clinically diagnosed depressed sample, so these results should not be read as evidence for treating major depressive disorder.
All six dropouts came from the Wim Hof Method condition. That differential attrition, combined with the control group’s higher expectations going in, complicates any straight comparison between arms.
Because both conditions improved by similar amounts and the trial had no inactive control group, the results cannot separate the specific effect of either practice from the effect of engaging in a structured daily routine over three weeks.
The rumination finding, the one place the two conditions diverged, is a single result from a small sample, and the authors state that it needs replication with larger and more diverse samples.
Cold exposure and intensive breathing techniques carry their own practical cautions. Anyone with cardiovascular or other significant medical conditions should speak with a clinician before starting cold showers or a hypoxia-inducing breathing practice, and neither practice should be attempted in or near water.
Practical Takeaways
- A short daily practice, roughly 15 minutes over three weeks, was enough to move depressive symptoms, anxiety, and perceived stress in this trial
- Slow-paced breathing with warm showers performed as well as the Wim Hof Method on every primary outcome, so pick the one you will actually keep doing
- The gains held at three months, with 46% of the sample reporting mild or no depressive symptoms at follow-up
- If reducing rumination after stressful days is the goal, the Wim Hof condition is the one that showed that advantage, though the finding awaits replication
- Get proper instruction before starting the breathing technique or cold exposure, and clear it with a clinician if you have a medical condition
- Treat either practice as a complement to conventional care for depression, not a substitute for it
What This Means for Depression Treatment
The headline from this trial is not that the Wim Hof Method works better. It is that a low-cost, low-intensity breathing practice matched it on depressive symptoms, anxiety, and perceived stress, and both held at three months. Both conditions also produced comparable reductions in cortisol reactivity and daily negative affect.
For clinical practice, that argues for prescribing whichever structured daily practice a person will sustain, in women with elevated symptoms, alongside conventional treatment. The rumination difference favoring the Wim Hof condition is the open question, and it is the one the authors themselves flag as needing replication before anyone builds a recommendation on it.
Related Studies and Research
Cold-Water Immersion: Neurohormesis and Clinical Applications
Episode 31: Depression Explained, The Biology Behind the Darkness
Episode 32: Depression Recovery Roadmap: A Step-by-Step, Evidence-Based Plan
Episode 34: The Natural Depression Treatment Doctors Don’t Tell You About
FAQs
What exactly is the Wim Hof Method as tested here?
In this trial, the Wim Hof Method condition combined a breathing technique designed to induce intermittent hypoxia with cold showers, delivered through daily audio instructions lasting 15 minutes for three weeks. The researchers framed it as a hormetic stress intervention.
Did the Wim Hof Method beat the comparison condition?
Not on the primary outcomes. Counter to the preregistered predictions, both conditions produced equivalent reductions in depressive symptoms, anxiety symptoms, and perceived stress, sustained at three months, along with comparable reductions in cortisol reactivity and daily negative affect. The Wim Hof condition did show greater reductions in rumination after daily stressful events.
Who was studied?
84 healthy midlife women with high stress and high depressive symptoms, randomized during the COVID-19 pandemic in 2020 and 2021. They were screened for elevated symptoms rather than recruited as a clinically diagnosed depressed sample.
How long did the benefits last?
Improvements were maintained at the 3-month follow-up, with 46% of the sample reporting mild or no depressive symptoms.
Bottom Line
In 84 healthy midlife women with high stress and high depressive symptoms, three weeks of daily Wim Hof Method practice and three weeks of daily slow-paced breathing produced the same reductions in depressive symptoms, anxiety, and perceived stress, and those gains held at three months. The Wim Hof condition reduced rumination after daily stressors more than the control, a single finding that the authors say needs replication.
