Mental Illness and Diving

[pasley]

...IF his PA comes back ...

Physicians Assistant aka PA's are fine for many things I suppose, but they are not doctors. This really should be done by a doctor (one who has done the full medical school and residency) and preferably one that is familiar with the demands and concerns of SCUBA Diving.

This is particularly true if the PA is military. When I was at Ft. Riley being seen for an injury my PA was under the supervision of....yes a PA. My PA was a Quartermaster Officer:shocked2: who wanted to go to PA school, but had not yet been. They let him see patients under the supervision of a real PA. Happy I was not.

 

[jsmart]

Estrela,

Not sure when your trip is but enjoy it!

Now my 2 cents...I don't know your condition nor do I want to come off as knowing it, but I have my own and the following is my personal experience and thoughts on the topic:

I did a Discovery Dive about 8 years ago knowing that I was a bit claustrophobic; I loved it! No problems, just didn't have time to get my OW.

Life happens -- flash forward a few years. I suffered my first panic attack after a close friend died from a heart attack. Next thing I knew I thought I was having one (a heart attack). Same symptoms (heart palpitations, sweats, dizzy, chest pains, numbness in my arm) but at 30 and in relatively good shape it turned out to be my first panic attack. Decided against medication and a few months later in an airport a lady collapses and dies from a heart attack, I get on my plane and I'm having another one (turns out to be my 2nd panic attack). Decided to see a doctor to get my issues under control.

Flash forward 3+ years -- I'm on Xanax XR (very low dose) and Effexor XR (very low dose) and have not had a major issue in that time. Last week my wife and I went to the Caribbean. Before we left we both agreed we wanted to dive again. Knowing what would be asked on the medical release I went to see my family doctor and psychiatrist to get their opinion on my ability to dive. Both agreed that my medication controls the attacks, but I (mywife and my instructor) need to be conscientious of the potential of an attack and end any activity and call it quits if there is a problem (hopefully at 3 ft. not 30 ft.).

I was upfront with the instructor and filled out the paperwork openly and honestly and gave him my release from both doctors. I could see he was a bit apprehensive (as I would be if a 6' 3" 275# guy told me he had a history of panic attacks) and he put me through the ringer at 3-5 ft. in the pool before we went to 10 ft in the pool. It took some time, but by the time we boarded the dive boat we were both comfortable that I could dive SAFELY (btw it was just the three of us in the class -- very helpful).

One side note here in an already long saga -- first drill, 4 ft in the pool -- instructor tells my wife to remove her reg and put it back in her mouth. She removes the reg takes a big gulp of pool water and in the process of bolting for the top kicks my reg out of my mouth. Instructor shows obvious concern as he sees my reg get kicked out of my mouth and assumes I'm bolting also...I lean over reach around find my reg and put back in my mouth, while staying under. He goes up to check on wife. Big relief for both of us, and set the stage for me getting my PADI Scuba Diver Certification. No issues, great instructor, great time! IT CAN BE DONE!

I'm looking to get my OW now and I think I may wait for a return trip with an instructor I already have rapport with, but I'm considering going to a local shop where a person I talked to before I took the trip seems like he could be a very good instructor (not sure I want to discuss the issues with him as I'm not sure what his reaction might be (see some of the above posts)).

Sorry for the rundown of the last 8 years of my life, but I've been through a similar situation and so far I've lived to tell about it. Will I have an episode one day -- maybe? I only hope if I do I don't hurt anyone else in the process, but until then I will pursue this great sport and look forward to my next time under the water. Take it slow, work with your doctors, your husband, and your instructor, and have fun -- 99.99% of the time this will reduce your anxiety.

 

[East West]

Dear Estrela and hubby. My name is Charles and new to the board with brain issues . I do have the ability to think out of the box with good advice sometimes. First of all I would urge anyone interested in scuba diving to learn to snorkle dive . You learn to be comfortable on top of the water which the industry seems not to stress. Second you can enjoy snorkle diving see the same fish and have no risk on the vacation. Still I would learn snorkle diving before the trip at home. First step first !

 

[SeaNSandScuba]

Hello,

As an instructor your situation may not be the reason not to dive.

In the US we must follow ADA. With documentation from your doctor, recreational scuba may be an approved activity.

The next step is to have the right instructor that will team with you to meet your learning style.

Good luck.

Steve

 

[mstevens]

I realize this is an old thread and that the OP's decision may be made. However, this thread may be useful to others with the same question.

I'm a psychiatrist who used to be a DM and assistant instructor. I've got patients I'd dive with (including people with panic or PTSD) and colleagues and family members I wouldn't (and vice-versa). I've worked with a number of patients with various conditions, particularly traumatic brain injuries, who've pursued scuba training.

I strongly recommend anyone with questions about diving with psychiatric conditions track down a board-certified psychiatrist who is familiar with dive medicine. Not all doctors who dive are especially knowledgeable about dive medicine, but doctors who are divers are likely to know more than non-divers. DAN should be able to help with a referral, which might well involve travel and will likely involve expense.

When it comes to details about "trait vs. state," non of that matters so much as the specific person's actual symptoms. The devil is in the details: How big an issue is dissociation? How often does panic occur and what are the symptoms for that person? What are the triggers? Is medication being used, and if so what medication? You get the drift.

I would absolutely ensure that your instructor know about this. If they get spooked, look until you find one who doesn't freak out. Avoid "quickie" courses. One option to consider is that many colleges offer scuba. Those courses tend to be a full semester and are not at all superficial. jsmart's comments are highly pertinent here - the time to work out any issues or concerns is in the pool. Becoming completely comfortable with each skill before moving on is key.

There can sometimes be unanticipated equipment issues. For example, wetsuits can get pretty claustrophobic for some people, especially if they feel "stuck" trying to get one off or on. Some masks restrict vision more than others. Some people find wrap-around BCD's more confining than back-flotation styles while others find them comforting and have trouble trusting back-flotation. These issues can be worked through and different gear can be tried out, but only if the instructor knows it may be necessary.

Some closing thoughts:

Some people get into scuba because of pressure from someone else. That's a terrible reason and can lead to unhappy, anxious divers. On the other hand, those who overcome obstacles in order to dive because they're personally motivated often turn out to be wonderful divers.

Some people get panicky underwater. Others find it's the calmest they've ever been. It doesn't take long to figure out which group you're in.

 

[bobh_60435]

...
There can sometimes be unanticipated equipment issues. For example, wetsuits can get pretty claustrophobic for some people, especially if they feel "stuck" trying to get one off or on.
...

Excellent point. Sometimes this will happen to me when I'm starting to overheat on the surface and I have to work to keep that anxiety under control until I'm in the water or removed the upper half of my farmer john.

The point I would like to add is that this also leads to considerations for the training vs. the diving environments. I had a student that is a paraplegic, was excellent in the pool, could perform every skill I threw at him, but ultimately was never comfortable in a thick wetsuit on his checkout dives and did not finish his certification. If you're training in a pool, but you're going to dive cold, then train in cold gear. The fewer surprises during the checkout dives, the better. If the diver is going to dive warm, but you typically do checkout dives in a cold environment, dive the pool in cold gear for the experience, even if it's a brief experience, but give the diver a referral to complete the checkout dives in a warm climate.

 

[pasley]

Bobh_60435 is IMHO right. We train in an 80-82F pool. We did the first 7 sessions in what they felt comfortable in, but for the remaining 5 sessions it is 7mm as that is was we wear in Southern California. No new anything for first tiime in the ocean. I would not want one of my students to be "surprized" by the restrictions of a 7mm suit be they able bodies or adaptive and since all my students are adaptive (HSA Paralysis to TBI/PTSD) mostly TBI&PTSD, I don't want any surprizes. We are trying to do a beach snorkeling dive before we go out on our SCUBA to make sure everyone is comfortable.

 

[KrisB]

Don't forget SNUBA

Actually, DO forget snuba!!!

Snuba is far more dangerous to all participants than a discover scuba dive, for a multitude of reasons, not limited to the following:
1. Underqualified instructors. No professional-level training is required of a snuba guide.
2. No redundant air supply. Period. Even an "unreliable" buddy is better than none.
3. Panic is more likely given constraints by hose, difficulty breathing (snuba regs rarely breathe as easily as scuba) and the fact that you have no idea how much air is left.
4. Bolting from 20' is likely just as dangerous as bolting from 40'. In fact, you can embolize from as shallow as 3'.
5. Anybody that will let you breathe compressed air underwater without a physician's autograph, given your disclosed condition, doesn't have your best interests in mind.

In short, snuba is a big accident waiting to happen. Please don't be the one involved in that!

 

[PullmanSCUBA]

So I don't know what your disorder is but it sound a little like D.I.D. Please forgive me if I am wrong on that. Not the point. One of my regular dive buddy's has D.I.D. and operates just fine. I don't see why you would have any problems, and it sounds like your disorder actually will be helpful.

 

[PullmanSCUBA]

DID is Dissociative identity disorder. It is a psychiatric diagnosis that describes a condition in which a person displays multiple distinct personalities, each with its own pattern of perceiving and interacting with the environment. It is an interesting disorder to deal with first hand.