I was wondering if anyone has had a dive buddy that was taking meds for anxiety. I met a potential dive buddy that had several certs. AOW, Cave, Nitrox Etc. I was really impressed (as I'm a newbie with only a OWC). Found out in the conversation that its been over a year since her last dive and she is taking meds for anxiety and panic attacks problems. Seems dangerous. I never persued a dive with her.
A dive buddy on prozac?
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John Reinertson
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That's a good question.. one that has come up before.
First, while I have had patients that I thought were reasonable risks to dive while on Prozac or their related medications and I have endorsed their diving, these were carefully considered judgments in each case, sharing with them the small but real seizure risk and knowing their underlying reasons for taking the medication and their temperament.
The risk of having a panic attack while diving is real, and is more likely in someone with severe anxiety. Panic underwater is very dangerous.
There is a slight increase in seizure risk with these medications. Seizures underwater often spell death to the person having one.
Your friend needs to have a careful discussion with their physician and explore the risks for their particular set of circumstances.
I think your friend did the right thing in sharing the presence of the medication with you. I feel anyone buddying with another diver needs to share any unique concerns or special circumstances with the potential buddy, and this is something that should be brought up.
Follow the Golden Rule when buddying and treat your buddy as you would wish to be treated.
If I had a buddy that shared with me a history of Prozac use, but had discussed it with their physician and that physician were knowledgeable about the underwater environment and diving, I would probably buddy with that person.
The risks are somewhat higher, but probably no more so than a well controlled diabetic or well-controlled asthmatic, and they are often endorsed for diving.
This is neither a blanket endorsement or a blanket condemnation.
These diseases and the medicines pose a certain risk, but when well controlled the risks are felt by many to be acceptable.
What would not be acceptable would be to conceal either the illness or the medication.
Dive safe,
John
First, while I have had patients that I thought were reasonable risks to dive while on Prozac or their related medications and I have endorsed their diving, these were carefully considered judgments in each case, sharing with them the small but real seizure risk and knowing their underlying reasons for taking the medication and their temperament.
The risk of having a panic attack while diving is real, and is more likely in someone with severe anxiety. Panic underwater is very dangerous.
There is a slight increase in seizure risk with these medications. Seizures underwater often spell death to the person having one.
Your friend needs to have a careful discussion with their physician and explore the risks for their particular set of circumstances.
I think your friend did the right thing in sharing the presence of the medication with you. I feel anyone buddying with another diver needs to share any unique concerns or special circumstances with the potential buddy, and this is something that should be brought up.
Follow the Golden Rule when buddying and treat your buddy as you would wish to be treated.
If I had a buddy that shared with me a history of Prozac use, but had discussed it with their physician and that physician were knowledgeable about the underwater environment and diving, I would probably buddy with that person.
The risks are somewhat higher, but probably no more so than a well controlled diabetic or well-controlled asthmatic, and they are often endorsed for diving.
This is neither a blanket endorsement or a blanket condemnation.
These diseases and the medicines pose a certain risk, but when well controlled the risks are felt by many to be acceptable.
What would not be acceptable would be to conceal either the illness or the medication.
Dive safe,
John
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Hi Luv2Dive,
The issue of diving on Prozac & similar drugs, and with a psychiatric disorder, has been discussed on a number occasions on this board.
A search of the archives turns up a very extensive item by "scubadoc" within the following thread http://www.scubaboard.com/showthread.php?s=&threadid=7369&highlight=prozac.
Hope you find it helpful.
DocVikingo
The issue of diving on Prozac & similar drugs, and with a psychiatric disorder, has been discussed on a number occasions on this board.
A search of the archives turns up a very extensive item by "scubadoc" within the following thread http://www.scubaboard.com/showthread.php?s=&threadid=7369&highlight=prozac.
Hope you find it helpful.
DocVikingo
I am not an MD but I have had personal experience diving with someone on Prozac for depression problems. This individual had to repeatedly abort dives and be buddied to the boat because of the medications. The reaction was compounded by acholol consumption. She increasingly became a risk to herself and her sister who was her buddy during the seven day trip. I can definitly learn from observing other divers.
IMHO, this situation may be a bigger problem for incidents than is currently recognized.
DSAO,
Larry
IMHO, this situation may be a bigger problem for incidents than is currently recognized.
DSAO,
Larry
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Hi daylight,
I'm sure that was an unpleasant, if not harrowing week.
Of course, alcohol consumption adds a whole new dimension to the discussion of diving while on psychiatric medications. Even in the absence of such medication, alcohol use while actively diving can pose significant problems, especially if it is at all excessive. And, taking two drugs that act on the central nervous system, as do both alcohol & Prozac, is often an unwise idea.
The interaction of alcohol with medications that depress central nervous function, and many of those prescribed for the control of anxiety & panic attacks do have this action, can be fatal.
The research literature shows that the combination of alcohol & Prozac is very rarely fatal and has variable effects. Prozac sometimes enhances, sometimes counteracts & sometimes has no effect on alcohol.
It sounds to me like the young lady you mention had psychiatric problems that extended beyond uncomplicated depression.
Best regards.
DocVikingo
I'm sure that was an unpleasant, if not harrowing week.
Of course, alcohol consumption adds a whole new dimension to the discussion of diving while on psychiatric medications. Even in the absence of such medication, alcohol use while actively diving can pose significant problems, especially if it is at all excessive. And, taking two drugs that act on the central nervous system, as do both alcohol & Prozac, is often an unwise idea.
The interaction of alcohol with medications that depress central nervous function, and many of those prescribed for the control of anxiety & panic attacks do have this action, can be fatal.
The research literature shows that the combination of alcohol & Prozac is very rarely fatal and has variable effects. Prozac sometimes enhances, sometimes counteracts & sometimes has no effect on alcohol.
It sounds to me like the young lady you mention had psychiatric problems that extended beyond uncomplicated depression.
Best regards.
DocVikingo
Doc,
The symptoms you described were very evident. Her Manic-Depressive swings were frequent and obivious. They did seem to be magnified when under pressure and on compressed air. Needless to say, within our group of 16 divers, she wasn't Miss Popularity by the end of the week.
Regards,
Larry
The symptoms you described were very evident. Her Manic-Depressive swings were frequent and obivious. They did seem to be magnified when under pressure and on compressed air. Needless to say, within our group of 16 divers, she wasn't Miss Popularity by the end of the week.
Regards,
Larry
brizzolatti
Contributor
I don't think there's ever a blanket rule for these things. Presumably, you can come across potential buddies who you're wary of and they aren't taking Prozac!
When i first joined this board I asked a similar question because I was taking a drug in the same family as Prozac. I wanted to know whether I'd be allowed to dive or not. Then I discovered it was self certification in any case and up to the individual diver whether or not to disclose. I think the buddy you were talking to was up front with you and that's commendable.
I learned to dive when on the drug. But in many ways, it was irrelevant because I was feeling well and confident that I was well. If I hadn't felt like that I wouldn't have dived. But then, that should be the same whether you're taking a prescription drug or not.
And there are some people who are better on prescription drugs than off them - so the fact of the drug itself only tells you a part of the story.
From my own experience, taking a drug helped me keep well and didn't affect my judgement in diving. But that may not be the case for everyone. It all depends.
So no easy answer, I guess. But this board was really helpful for me when I was exploring the possibility of diving so check out the old threads.
When i first joined this board I asked a similar question because I was taking a drug in the same family as Prozac. I wanted to know whether I'd be allowed to dive or not. Then I discovered it was self certification in any case and up to the individual diver whether or not to disclose. I think the buddy you were talking to was up front with you and that's commendable.
I learned to dive when on the drug. But in many ways, it was irrelevant because I was feeling well and confident that I was well. If I hadn't felt like that I wouldn't have dived. But then, that should be the same whether you're taking a prescription drug or not.
And there are some people who are better on prescription drugs than off them - so the fact of the drug itself only tells you a part of the story.
From my own experience, taking a drug helped me keep well and didn't affect my judgement in diving. But that may not be the case for everyone. It all depends.
So no easy answer, I guess. But this board was really helpful for me when I was exploring the possibility of diving so check out the old threads.
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Hi brizzolatti,
I'm not sure that I can agree with the statement, "Then I discovered it was self certification in any case and up to the individual diver whether or not to disclose."
I don't know about Scotland, but most major training agencies in the US & greater Caribbean will query the applicant about medical history before accepting them. Additionally, many dive ops around the world will ask one to sign a medical release form prior to taking them out. In both instances, these often ask questions about medications & psychiatric illness.
One's failure to disclose under these circumstances is not only untruthful, but could have more than trivial implications for any liability litigation brought either by you or against you.
Additionally, failure to disclose to a potential/actual buddy is again less than fully honest, and deprives that person of information he rightfully deserves to have in making a decision about buddying.
I'd also like to explore the comment that, "I learned to dive when on the drug. But in many ways, it was irrelevant because I was feeling well and confident that I was well," could be problematic.
Persons with affective/mood disorder, e.g., psychiatric conditions with depressive or manic features, or both, can in the manic spectrum feel supremely well & confident, yet have compromises of judgment & impulse control that pose significant threats to safe scuba. While it is not a common side-effect, the research literature does report the apparent triggering of mild manic states by Prozac & other SSRIs, and the manufacturers of drugs in this class in fact warn of this possibility.
As such, under the condition of treatment of SSRIs I wonder about the appropriateness "feeling well & confident" as an index of fitness to dive.
What think?
DocVikingo
I'm not sure that I can agree with the statement, "Then I discovered it was self certification in any case and up to the individual diver whether or not to disclose."
I don't know about Scotland, but most major training agencies in the US & greater Caribbean will query the applicant about medical history before accepting them. Additionally, many dive ops around the world will ask one to sign a medical release form prior to taking them out. In both instances, these often ask questions about medications & psychiatric illness.
One's failure to disclose under these circumstances is not only untruthful, but could have more than trivial implications for any liability litigation brought either by you or against you.
Additionally, failure to disclose to a potential/actual buddy is again less than fully honest, and deprives that person of information he rightfully deserves to have in making a decision about buddying.
I'd also like to explore the comment that, "I learned to dive when on the drug. But in many ways, it was irrelevant because I was feeling well and confident that I was well," could be problematic.
Persons with affective/mood disorder, e.g., psychiatric conditions with depressive or manic features, or both, can in the manic spectrum feel supremely well & confident, yet have compromises of judgment & impulse control that pose significant threats to safe scuba. While it is not a common side-effect, the research literature does report the apparent triggering of mild manic states by Prozac & other SSRIs, and the manufacturers of drugs in this class in fact warn of this possibility.
As such, under the condition of treatment of SSRIs I wonder about the appropriateness "feeling well & confident" as an index of fitness to dive.
What think?
DocVikingo
brizzolatti
Contributor
Hey, Doc. Yes, divers are queried but my point was that people can choose to disclose or not and there isn't anyone checking up on them (that's what I meant by self certify). I agree with you that it's untruthful and wreckless not to disclose but it is possible within the system to do so because there is no check. I also agree with you that it's not right not to disclose to a buddy that sort of information.
But if you take the psychiatric medication bit out of the equation and put it in the context of hangovers, feeling under the weather having an infection, feeling sick etc etc, it's the same principle just a different place on the spectrum.
There have been discussions on this board about diving when not feeling well. Everyone agrees that it is a dumb and wrong thing to do. But how many of you have done it?
I'm not condoning this, all I'm flagging is that it's not always black and white. Just because someone's on Prozac doesn;t mean they are a risk to themselves or others if they dive. Just because someone isn;t taking prescription drugs doesn't meant that they aren't a risk to themselves or others if they dive. Maybe because of the connotations of psychiatric meds, though, people think of things differently.
But if you take the psychiatric medication bit out of the equation and put it in the context of hangovers, feeling under the weather having an infection, feeling sick etc etc, it's the same principle just a different place on the spectrum.
There have been discussions on this board about diving when not feeling well. Everyone agrees that it is a dumb and wrong thing to do. But how many of you have done it?
I'm not condoning this, all I'm flagging is that it's not always black and white. Just because someone's on Prozac doesn;t mean they are a risk to themselves or others if they dive. Just because someone isn;t taking prescription drugs doesn't meant that they aren't a risk to themselves or others if they dive. Maybe because of the connotations of psychiatric meds, though, people think of things differently.
I am on a SSRI (zoloft, like prozac) for mild depression and social anxiety. I have been cleared by a psychiatrist and family practice physician to become a divemaster. I believe that immediately after a traumatic event or begining drug therapy one should not dive, but I have been stable for a long time now. I feel no side effects. Usually, I won't tell dive buddies about this because it usually doesn't come into my mind, but other than that most people don't understand the purpose of these drugs to realize that most people taking them are normal, productive, safe members of society. Knowing that I am taking an SSRI, most people become nervous which makes them a burden on me and others. It is not as if I am going to slip over the wall and see how deep I can go. In any case, in my experience, most people on the verge of suicide feel guilty about their situation and realize that rash decisions while diving will hurt people other than themselves.
brandon.
brandon.
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