Here in the digital age, we know all too well that there are trends that go around on social media that catch fire and die out in the blink of an eye. Some of these trends are health-related, and unfortunately, many can be unsubstantiated.
For example, TikTok users are starting to pick up health-related tips and tricks on the social media platform. One such video, posted in late 2020 by psychologist Dr. Julie Smith, claims that ice cubes can halt a panic attack.
Her five “hacks” include holding ice in your hands and focusing on the temperature and texture, moving ice along the arm, noticing the sensation, holding the ice in your mouth, being sure to push it to the roof of your mouth, rubbing ice on your face, which can reduce the temperature of your skin and lower one’s heart rate, and something called “ice diving,” a not-for-the-faint-of-heart trick in which you’ll dunk your face in a bowl of ice water.
Although all of this may sound a bit off-the-wall and unfounded like so many other social-media hacks out there, here’s something that will likely surprise you: ice cubes work.
More studies need to be done, but it’s a trick that many mental health professionals recommend. One 2018 study that centered on harm-reduction for people prone to self-cutting listed ice cubes as an “active distraction,” something that also proves helpful during a panic attack.
Two mental health experts are here to peel apart this TikTok phenomenon and explain why ice cubes and panic attacks can go hand-in-hand.
What is a panic attack?
Before diving into the ice-cube debate, let’s start with this question: What exactly is a panic attack?
Psychotherapist Kaylee Friedman, LAC says that a panic attack begins with a real or imagined threat. It can happen consciously, starting with a troubling thought, or unconsciously, such as reacting to loud noise.
“Our sympathetic nervous system is then triggered, and this moves us into the fight or flight response,” she explains. “Our body primes us, biologically, to fight or run from the perceived threat. Our heartbeat quickens, blood pressure elevates, eyes dilate, digestion stops, and our prefrontal cortex, the part of our brain in charge of logic, communication, and reason, goes ‘offline’ to free us up to run from the lion, so to speak. This is a normal and healthy reaction to a perceived threat.”
Normal fight-or-flight turns into a panic attack “when we stay stuck in this response,” as Friedman says, “either because we are stuck in a thought loop that maintains the danger, we cannot physically escape the danger, or we are having a trauma response.”
The uncomfortable, incapacitating feeling of panic can be experienced by anyone, anywhere, at any time, according to Susan Albers, PsyD, a psychologist at Cleveland Clinic. She says that approximately six million Americans experience panic attacks each year, however, it is more likely if you’ve been diagnosed with a panic disorder or generalized anxiety disorder.
How do ice cubes help?
Making contact with ice cubes during a panic attack is considered what’s called a “grounding exercise.” A grounding exercise is something that “changes your sensations” and “brings a new sense of mindfulness,” as Dr. Albers says, adding that ice triggers a reaction through the body.
“This is like a jolt to the system to steer it away from the panic response and release chemicals into the body that counter a panic attack by slowing down the release of cortisol and adrenaline,” she says.
And since the shocking cold temperature of ice can feel painful, this also can prove helpful.
“Instead of these panic-induced neurotransmitters, pain receptors are stimulated and sometimes the endorphins that help us cope with pain are released,” Dr. Albers notes. “Thus, the body is coping now with pain, not panic.”
If ice just isn’t your thing, Friedman says that biting a lemon, sticking your face in cold water, or smelling strong peppermint can bring you back to the present.
Is using an ice cube to stop a panic attack safe?
When asked if using ice cubes during a panic attack is safe, Friedman affirms: “Yes, it is safe. Short of giving yourself hypothermia or possibly choking, using ice to ground yourself during a panic attack is low risk.”
Are ice cubes as effective as other mental health treatments?
“The ice method is one small tool that’s part of a larger treatment modality, mindfulness-based cognitive behavioral therapy. It is not a treatment on its own,” Friedman says.
While using ice during a panic attack can be an effective coping mechanism, it’s not a be-all, end-all treatment for anxiety. This is when therapy and medication can be particularly beneficial.
“For some people, ice cubes just aren’t a powerful enough intervention,” Dr. Albers says. “They are wired in a way that they need drug therapy to help regulate the neurotransmitters in their body in a stable, routine way.”
Dr. Albers also asserts that comparing medication and ice “is like comparing apples and oranges,” saying, “Medication is prescribed and taken in consistent doses. Ice has an immediate and intense effect. Ice might be more helpful in acute situations.”
The bottom line
If you’re experiencing severe anxiety and panic attacks, you should speak with your primary care doctor and/or a mental health professional. Although ice can absolutely be helpful in a moment of panic, a therapy regimen and potentially medication should be considered long-term, scientifically proven aids.
- Journal of Psychiatric and Mental Health Nursing: “Harm‐reduction approaches for self‐cutting in inpatient mental health settings: Development and preliminary validation of the Attitudes to Self‐cutting Management (ASc‐Me) Scale”