Panic - Split from overweight thread

[grazie42]

I too agree with the "once you panic all bets are off".

I believe basic personality and comfort can raise the "tolerance of stress".
An anecdote:
My brother has been freediving/snorcling for most of his life. He got certified this year. When we got back home I wanted to do OOA-drills etc to get him "comfortable". When I suggested we do this he looked at me funny but readily agreed. We ended doing all the drills I did for my cave course (following line blind witout air and begin airsharing after 15 mtrs etc) and he never twitched, afterwards he said it was kinda fun but wondered what the point was. Some of the other people in my recent DM-course lost control of their breathing the second their mask was removed.

I believe training can raise the threshold.
Even if you are uncomfortable at first you can be "desensitized" to some degree but I believe that anything that makes you uncomfortable "the first time" will always be more of a trigger than the things you "cruize thru"...
Also if you do something enough times (I´ve seen numbers of 3-10 thousand repetitions) it will be embedded in your muscle-memory and the correct "stimuli" will elicit the "correct" response. I experienced this during my DM course where I would still "duck" to clear my, in the pool, nonexistant longhose...

 

[tracydr]

Walter, I didn't miss the point. I just disagree with this statement. The only way to avoid all panic is to avoid all risk.

By it's very definition, panic is unreasonable. It's onset is equally as unreasonable. Once in a current that you possibly did not expect (elevated CO2) and being pulled into an orientation that you are not used to (disorientation), panic can surely set in. Panic does not respect training out the wazoo: even very trained and very experienced divers can and do panic and quite often this results in injury and death.

I completely agree with you. While plenty of training helps to eliminate some of the possibility of panic, nobody really knows what happens to a person's brain in a panic situation. Talk to someone who has "panic attacks" sometime and you'll realize that these odd attacks can hit anyone, anytime, any place. Man or woman, nobody is immune. In fact, I probably treat more men then women for panic attacks. Frequently, it has to do with the cumulative stress that the body has been going through over a period of weeks or months. Suddenly the circuits get overloaded and explode!

 

[tracydr]

My personal observations with regard to panic:

I have experienced a panic response that occured instantaneously and left me COMPLETELY paralyzed. Before this incident, I never really believed that people really can "freeze-up" when presented with a certain stimulus.

My terrifying incident occured when I lived alone and an intruder entered my house and ripped back the shower curtain while I was covered in soap and showering. I happened to see the hand enter the shower and watched as the hand pulled back the curtain. I was so terrified of the unexepected intruder (who I was sure was going to stab me with a large knife) that I completely froze and was too terrified to even look up into the face of my apparent attacker. I just stood there screaming hysterically while my girlfriend (who had driven 50 miles and wanted to surprise me) just kept screaming that "it's only me". I was completely frozen, totally defensless and unable to even look up and fully comprehend the demise that I was irrationally assuming would be occuring in seconds. I was completely incapacitated in a "life-or-death" situation for at least 10 or 12 seconds by my panic response.

I have been presented with other unexpected scary situations, like when a german shepard lunged at me from some hedges while I was jogging on a dark night. Under this stimulus, I was equally surprised of my response, when I leaped into the air, assumed an instinctive defensive posture when my feet hit the ground and then immediately proceeded to scream and attack the dog with kicks and punches before I even fully realized what was happening.

I am not prone to panic attacks, but from my personal experience it seems impossible to make someone completely immune to falling victim to a panic attack in all situations. Apparently panic can occur almost instantaneously in certain situations.

I think you need to spend more time training in the shower!! All panic can be easily avoided with proper training!!

 

[tracydr]

I wonder if, as with so many other things, the reactivity of the limbic system runs on a bell-shaped curve, from people who wouldn't turn a hair if the Martians landed to people who have "panic attacks" from triggers that are so minor they can't even identify them. The majority of us would fall in the middle ground, where enough stress can cause panic but it isn't an immediate reaction to anything startling, and people in that range can be taught to recognize anxiety and use coping strategies before it spirals out of control.

I would think, however, that if that is the case, people with a tendency to panic attacks would make very poor candidates for scuba diving. There is almost no stimulus you can provide a human body that gets a more immediate and vigorous response than stimulation of the airway (eg. aspirating seawater) and we're all likely to experience that to some degree from time to time.

Unfortunately, panic attacks give no warning. How is someone supposed to know if they are prone to panic attacks before they've had their first one?
I totally agree with you that there is probably a bell shaped curve of panic threshold. Very good description. I also believe that all stress is additive so that even if someone has been trained to handle a stressful situation, if there is too much exogenous stress in their life that might just be the straw that breaks the camel's back.

 

[tracydr]

I think it's great to identify those stressors, and learning how to handle more and more loads is also a good thing.

But, this does not appear to fall into that category. There is no reasoning with an unreasoning and fairly instantaneous panic. There is no way to learn how to recover from that.

I'm so with you on this topic. I've never completely panicked but I've been around people that have and it's fast and scary.
Also, as a survivor of PTSD I understand that a state of anxiety is often irrational. For instance, I have to close the door to the bedroom in order to sleep. No idea why, I guess I want to avoid someone attacking me in the night, although I have no reasonable experience in the past to make me think that is likely to happen. At least I can sleep now, for the most part. Before, I would jump at the slightest noise. PTSD causes you to be hypereactive to stimuli. The open/closed door has nothing to do with the traumas that I have experienced but for some reason seems to be one of the last remaining remnants of a very difficult to treat disease.
For those interested in treating anxiety states and PTSD, the most effective method out there is EMDR. I would expect this would be very effective on someone who is afraid of a certain situation in scuba diving as well. (you relive the experience over and over with a trained EMDR counselor while using a device that switches you back and forth from right to left brain) I can tell you it was really the only thing that helped me get through the bad times. When I become an assistant instructor, I will refer students who have irrational anxieties for this type of treatment, when and if it seems appropriate.

 

[tracydr]

TSandM:
I love your posts because you actually acknowledge that you have weaknesses. It is so rare for someone as experienced and educated as you is able to admit this in public. Your posts always make me feel good. They make me think "if you can do it, I can do it!!" Just wanted to let you know that I always look forward to reading your input.

 

[tracydr]

I read a divers post on the board the other day I have no reason to dispute. He said he felt somewhat conjested so he took a prescription decongestant. When he got to the bottom, for no apparent reason his pulse started racing, his breathing went shallow and quick and he was in a full blown panic. He said his mind was rational. He said his training kicked in and he steadied himself on the bottom and began focusing on taking long, deep breaths until he felt better. It is likely that training saved his life.

My wife and I are landlot. However, we make a point of doing some local diving and practice 1 emergency skill with each dive. We often make a game of it to do who responds/performs better. I'm hoping this practice will never be needed to save our lives but I'm more comfortable knowing we do this.

Read The Last Dive. Author wasn't feeling well, took sudafed and advil for what was a "routine, easy dive" for him. He made bad decisions and ended up seriously bent. In fact, he panicked. This, from a very experienced wreck diver. Just a few minor situations took him over the edge into a full-blown panic and a major dive incident.

 

[freediver]

Unfortunately, panic attacks give no warning. How is someone supposed to know if they are prone to panic attacks before they've had their first one?

Dr. Tracy, are you saying here that after birth certain person's are predisposed to panic attacks?