Diving anxiety/panic attacks...help!!

[annlaur]

Thank you for bringing this up. It is a topic of interest to me as I have in the past suffered from anxiety attacks.

Like you, I had no issue and felt very relaxed when I first started diving.
Yet once, I overexerted myself during a dive and CO2 retention brought me on the verge of a panic attack. I really thought I was going to die.
Ever since that day, I feel some level of nervousness whenever I dive. It's hard to shake such a bad memory, it's like I've been sensitized and everytime I'm underwater I can't help thinking "What if I start freaking out again ?"… which obviously triggers anxiety and could even lead to a full-blown panic if I didn't take the appropriate measures.

These are the tricks that I use :

• I dive within my limits / comfort zone with equipment I trust. If those conditions are not met, I skip the dive. I always dive with a buddy but deep down I don't rely on them.

• I make sure I'm OK to dive (well-rested, hydrated&#8230. Only jump in the water once I'm fully relaxed. I suit up early so I don't feel rushed and breathless and I check my gear very carefully.

• I make as little effort as possible underwater (love drift diving for that), check my instruments often so I know I can safely return to the surface at any point should I have to.

• If I start feeling anxious (heart beating faster, shallow breathing&#8230, I immediately stop and focus on breathing slowly with full exhales. Then I check my air, look around (to avoid "tunnel vision"/perceptual narrowing) and start planning on surfacing.
Slow breathing and knowing I can safely bail out do the trick for me.
I have only aborted one dive in years but wouldn't hesitate to do so if I felt really nervous.

Finally, I think it's important for you to realize that you have been able to overcome your panic : no matter how anxious and distressed you felt, you didn't loose control, you didn't bolt to the surface, you asked your buddy for help and you survived.

That is something to remember if you ever again feel anxious underwater and that little creepy voice starts telling you horror stories about all the bad stuff that could happen : no matter how unsettling the situation, no matter how scared you feel, you have overcome this in the past, and you can do it again. Just stop whatever you're doing, breathe slowly with full exhales, then assess the situation for what it really is, not what the irrational unconscious part of you says.

You'll find a bunch of articles that might be of help if you google "panic cycle".

This anxiety issue is a pain in the a$$ but it gets better over time if you take baby steps and learn how to recognize your triggers. The "benefits" is that it makes you aware of the dangers so you're less likely to plan daredevil dives.

Be safe and don't let anyone (including yourself) talk you into doing dives that you feel uncomfortable with.

 

[boulderjohn]

I think the advice you got on dealing with a panic disorder as good, and you should look into it.

I will take issue, though, with Arkstorm's pretty harsh attack on you. Yes, it is not good to go OOA, but you handled it well and learned from it. I don't believe it in itself has anything to do with what is happening to you now unless you have a residual fear of it happening again--which is possible.

As for having some drinks the night before diving in a resort setting, I would bet that the number of divers who are not T-totalers who do that will be well over 90%. Moderation is the key there. You should, of course, not ever be still under the influence of alcohol when you dive, and you must recognize that alcohol dehydrates you and make sure that you have properly hydrated well before you dive. A number of people believe that the primary factor in DCS in resort areas is alcohol-related dehydration.

Unless you had drunk so much that you were still somewhat under the influence, I do not believe your drinks the night before had anything to do with your first experience. As several others have noted, it was most likely a combination of CO2 buildup and some anxiety about working hard against a current.

 

[NorCalDM]

You mentioned sick sickness with the first incident. Do you happen to use the Scopolamine patch? If you do read the side affects, my wife had similar issues after about 100 dives when she got a prescription for it before a live aboard trip. After she quit using it the panic attacks went away. She was ready to quit diving until we read the paperwork that came with it.

 

[PatW]

I think you have gotten quite a bit of good advice above.

As mentioned above, go over your dive routines (drinking before diving etc) and eliminate problematic behaviors.
Review your gear with an expert for any problems there.

Panic needs to be taken very seriously. Nothing kills you faster in the water than panic.

One way to gain confidence is to acclimate yourself. Exposure like this is used to combat phobias. Phobias are irrational and so are panic attacks. Maybe using similar techniques will work.

To do this, I would suggest diving in a situation where it is not only safe but BORING. It is hard to panic when you are bored. If it is really bad, dive in the deep end of a pool. That way, if you absolutely panic, it won't matter if you bolt to the surface (assuming you don't hold your breath while doing so).

If you can handle that without incident, graduate to really easy dives: clear, warm, shallow water with no current.

You say that in your panic attacks, you feel as if you should be on the surface immediately. Panic can easily escallate into something that can not be controlled. Bolting to the surface on anything but the shallowest dives is a great way to be very seriously injured or even die. Panic attacks and diving are not a very good mix.

 

[divermike1011]

1. Don't look for medical advice on the internet.
2. Don't violate safety norms and expect everything to go well.
3. Go see an actual MD, DO, PA, NP or a ****ing witch doctor for all I care, preferably one with experience with both dive medicine and psychiatry.
4. Not sure how to proceed on an issue relating to your safety? See rules one through three.

***Edited to comply with the TOS of this particular forum.***

Michael

 

[arkstorm]

[...]I will take issue, though, with Arkstorm's pretty harsh attack on you.

I find it both disturbing and revealing that an experienced diver would characterize my comments to the OP as a "harsh attack".

Disturbing -- because of the lackadaisical attitude toward running OOA.

Revealing -- because I often wonder how the message regarding OOA has been so perverted?

This article sums it up pretty neatly: Featured Article - Out Of Air -- Simply Unacceptable!!

My post was not an attack on the OP. Part of being a responsible diver is to point out dangerous behavior to a fellow diver. I noticed that prior to my first post nobody did so, so I thought it my duty.

[...]Yes, it is not good to go OOA, but you handled it well and learned from it.

Wrong message. Should read: It is unacceptable to go OOA and you're lucky to be alive. The lesson you should take from this that if you cannot plan your dive/dive your plan in such a way as to avoid going OOA then you should not dive at all.

[...]I don't believe it in itself has anything to do with what is happening to you now unless you have a residual fear of it happening again--which is possible. [Emphasis added.]

This is the same point I made to the OP in my "attack" on him, is it not?

The larger context of my point here is that it is time for more members of the diving community to unabashedly champion safe diving and just how dangerous it is to go OOA rather than to suggest it is a good learning experience.

I realize this concept may may be a finger in the eye of the overly self-esteeming sentiment so prevalent in polite society but I would rather be accused of being gruff than hear of a tragedy that could have been avoided.

- Cheers

 

[TSandM]

Please note that we have NO information on the OOA experience that the OP had . . . we do not know if it was a clogged dip tube, or a freeflow, or a blown hose -- there are definitely situations where one could end up out of gas through no fault of one's own.

There have been a lot of things said about panic disorder here, but the first thing I would look at, if you are using your own equipment, is the cracking pressure on your regulator. I had a friend who got a brand new reg and started diving it, and couldn't figure out why she was anxious and unhappy at depth. It turned out the cracking pressure on the reg was set at three times normal, so she was CO2 retaining, and of course, it got worse with depth, as the gas became more dense.

The other possibility mentioned, that of "dark narc", or anxious narcosis, is also very possible. To this day, I find that often, in the 100 foot range (and especially if swimming) I feel just a bit edgy or uneasy, and this goes away at about 75 or 80 feet. If you are worrying about panic, and begin to feel this way, you could escalate it into a much more intense feeling.

I would think about those things before I thought about the new onset of true panic disorder in someone who had never experienced such symptoms in the past.

 

[AlexM630]

This has given me a lot to think about. I want to first of all thank all of you for responding. This is the first time I've brought up this situation in front of an open forum, and I expected to get some flack regarding the drinking the night before thing as well as the previous OOA situation but felt that it was more important to put all the facts out there.

Arkstorm,
Basically, I didn't describe the OOA situation in full detail since I didn't feel that it was completely relevant to the situation at hand. It also was not a situation in which I suddenly looked at my gauge and realized I was at zero, but rather realizing at depth that I didn't have enough air to make a safe ascent, and choosing that moment to abort the dive and make a safe ascent with my buddy, during which I air-shared at our safety stop. I realize that running out of air is a grave error and unacceptable, but I learned from it (this was almost two years ago). What was I supposed to do, punish myself and never dive again? I took it for what it was and learned from the experience. I thought it was important to mention that I had the experience to better explain that I've dealt with issues while diving and not responded with panic and anxiety.

2 Big 2 Fail,
I really appreciate your response. Doom and gloom though it may be, it gives me some hope that I can get over this and makes me feel like I'm not just weak because "manning up" isn't working. As much as it sucks, I feel like now I recognize that I have to deal with this slowly and deliberately as it's a very real problem. I had trouble explaining the situation to my other diver friends but I think you hit the nail on the head, as did a couple other posters.

Annlaur,
I'm glad to hear that someone else has actually dealt with this with some degree of success. That was more or less my main reason for posting. I'm not looking for medical advice to replace that of a doctor per se, but rather some actual input from real people who have experienced a similar feeling while diving.

DiverMike,
Your point is well taken, but again I'm really not looking for medical advice so much as shared experience. In addition, going to a doctor blindly without any a priori knowledge or understanding of what may be happening to you is (in my opinion) just as foolhardy as soliciting medical advice from strangers. A degree in medicine does not always make for correct diagnoses - if a doctor, for instance, is not exposed to the situations we face as scuba divers, he or she may search for a more blanket solution rather than one specific to the situation. I'm also in the middle of Asia right now and can't exactly find someone to help me work through this. When I do get back to the states, I'm fully determined to find someone who understands diving to help me try to figure this out, but as of right now this was just weighing on my head too much to not even put the question out there and see if anyone else was in the same boat.

Again, thanks for all of the responses. I have a lot to think over, but if anyone else has more to offer feel free. Thanks!

 

[AlexM630]

One more thing (@TSandM),

Yes, I am using my own regulator. After the first incident and the aborted spring dives, I began to think that the regulator may have been the problem so I took it in for a complete servicing and overhaul in December prior to coming to Indonesia. I still had the same problem here. Is it possible that the dive shop would do an overhaul and not check the cracking pressure? How do I check this?

 

[2 Big 2 Fail]

2 Big 2 Fail,
I really appreciate your response. Doom and gloom though it may be, it gives me some hope that I can get over this and makes me feel like I'm not just weak because "manning up" isn't working. As much as it sucks, I feel like now I recognize that I have to deal with this slowly and deliberately as it's a very real problem. I had trouble explaining the situation to my other diver friends but I think you hit the nail on the head, as did a couple other posters.

I think nearly everyone who goes through this with the intention of getting past it experiences two things. One is that you eventually work out your own personal and unique path through it. (Nevertheless, you're gonna suffer some. Nietzsche's principle applies here.) The other is that you really do tend to come out better than before. (Of course, not everyone even attempts it. Some never muster the will or ability or maybe the determination to tackle it, and they become to one degree or another crippled by it.)

I went through something like this years ago during a very stressful period having nothing to do with diving. In the end, I came to kind of anthropomorphize the anxiety as an enemy that could not really harm me, so I could tell it, "Do your worst, and see what it gets you. Okay, I feel it. Is that all you got, because it's really uncomfortable, but it's not doing me any real harm, so go away." Then, "Oh look - it did it's worst, and it didn't kill me." I don't know just where this stuff comes from in the mind, but I found it gives up after a while when it can't win.

The "better than before" part is that it led me to discover Zen practice, and I now become immediately aware of impending anxiety in any situation, which is really a physical phenomenon rather than mental, and can dissipate it by correcting, out of habit, the posture and breathing responses. I'm a whole lot better able to automatically think without being distracted by threats. (And as a bonus, the practiced ability to shut down the jabbering little monkey mind conscious puts you in a great state to take in the world underwater.) If you're interested, ask one of the guys in the saffron robes. They're probably not Zen in SEA, but their meditation is pretty much toward the same end.