Panic - Split from overweight thread

[under water]

As happens here so often, a discussion ensues around something where there are many who agree that there are lots of shades of gray and then there are a few who somehow come across as implying that things are black & white.
I don't think there is really much disagreement here at all. Walter is probably never ever ever going to say he is wrong about something (watch him prove me wrong) and he often states things in a terse fashion that comes across that he is correct and others are wrong.

Hopefully nobody disagrees that more training will help prepare most people for most situations.

Hopefully nobody disagrees that all the training in the world will not insure proper response for everyone for every possible situation at every possible permutation of events.

Even with the best training, even the best of the best will find a limit.

 

[Puffer Fish]

What you have described is a normal physiological response to entering the water but this isn't necessarily a "negative" stressor. Yes, experience and training can increase one's threshold of panic. Stress is learned through an educative process and I feel that, in the same way, my tolerance to the stressors leading to panic is trainable.


I am NOT in control of everything that happens to me in life but I can be in control of how I respond to everything that happens to me.

The neat thing is that in many cases if breathing and heartrate are brought under control the other physiological stressors subside.

However, if you were trained to anticipate one of these occurring, don't you think you would respond differently?

You ever decide to take a trip over to Florida, I will be happy to show you that you are not in control of as much as you think.

Your pointing out that heart rate is also controlled by "normal physiological response" is a very good indicator of just how not in control someone is.

All one can do is increase your threshhold for panic.. not eliminate it. Increasing it is a very good thing to do, the right thing to do, but it does not help you in every situation.

We used to do a simple drill..

1. Shut someones air off.

2. Pull of their mask.

3. Inflate their vest (old days, this was a CO2 cartridge, so it was very fast)

You can be as calm as you want, but you have to know which to address first and do it quickly or you are in major trouble.

I've seen people that you could do this to, and not have the slightest issue... until it was done at night. I still don't have a clue why...but with some people it made a giant difference.

Note: This was military diving, not recreational)

Sadly, most of the people that are preaching their great ability to control themselves, that get to have a real test of that, are not around to tell us... which leaves the untested ones to continue to believe they are always in control.

My mentor told me his worst dive was in cold water, high current, low vis and someone shot him with a spear gun... had a permanent "reminder" of that dive. He lived, but told me he was out of control there for a while... wonder how well he controlled his heart rate?

 

[TSandM]

I think we can all agree that raging panic is probably unsalvageable, except by accident. If this woman was completely placid until she jumped in the water, and immediately suffered full intensity panic, there probably wasn't anything anyone could have done to save her, and therefore there's little point in discussing the issue.

On the other hand, I still think it was almost certain that there were stressors leading up to the panic. Let me share a story.

We did a trip to Nanaimo this January. I'd never been there, and I was excited about the trip. At the same time, I was apprehensive about it, because these were square profile dives to depths where I don't often go. They were dives off an anchored boat in potentially very limited viz, which I also don't often have to do. I was going to be diving with someone with less experience than I have, which made me the responsible person, which was also a concern. Some people might remember some threads I started at the time, talking about how to plan deco should we inadvertently enter it. I was trying to cover my bases and cope with my anxieties - IOW, I was trying to defuse that stress.

The night before the dives, I woke up in a cold sweat, worried I would have trouble getting back on the boat in my 85s. More stress.

We got on the boat and got geared up. Air temp was about 25 degrees. More stress.

We did giant strides off the back of the boat, which I hate. More stress.

Hit 43 degree water, and discovered it truly takes your breath away. Within a couple of minutes, I'm hanging on the granny line, breathing like gangbusters, and thinking, "Wow, I'm on the ragged edge of panicking, and I'm on the SURFACE, holding onto a LINE, looking up at the BOAT I can get back on any time I want." I stopped, held onto the line, slowed my breathing, told my buddy to wait a minute, and didn't go anywhere until my respiratory rate slowed and the panicky feeling went away. I was ready to call the dive if it didn't.

I subsequently figured out that jumping into that very cold water would give me a bit of this feeling every dive, and it was okay, because it would go away.

Stress started weeks before, built in the days before, augmented by poor sleep and concerns about competence, and brought to a head by sudden immersion in ice water, which I had never done before. A recipe for panic, but any one element would not have been enough.

 

[Cacia]

sleep deprivation gets me every time.

I've learned, it, for me is more dangerous than many widely recognized culprits.

I hope that you are allowed to go thru life, believing that you are in control of everything... because it means that you have never been in that situation to discover the nasty hard reality of this.

yea, I learned the day my son stopped breathing and turned the color of death.
your mind clouds over and short circuits. I had plenty of training resucitating children, and when it was mine, in a car....I was a madwoman. They still call me the "that lady with the football" in that little ER.

Don't ever think life cannot bring you to your knees....that is a real miscalculation. I agree, adding your children to the scenario takes it to another level.

 

[freediver]

As happens here so often, a discussion ensues around something where there are many who agree that there are lots of shades of gray and then there are a few who somehow come across as implying that things are black & white.

Sadly, most of the people that are preaching their great ability to control themselves, that get to have a real test of that, are not around to tell us... which leaves the untested ones to continue to believe they are always in control.

What also happens here on the board quite often and is equally as sad is that those who voice their convictions about a topic are quickly labeled as "elitest". Trust me, I am by no means extraordinary nor do I consider myself as such. I have simply become a student of my own human nature and the human nature of everyone else around me. What I have discovered is that by telling yourself you cannot control the stressors in your life, then you are undoubtedly correct. However, a bit of encouragement, some mental and physical training thrown in and I think you would be amazed at what barriers can be overcome. Please understand that I am not saying this because I want you to know what I can do, instead, I would prefer you look into this from the perspective of what YOU can achieve or control. Be careful though because introspective analysis can reveal some pretty awesome discoveries!

 

[Tigerman]

I know very well that the stress factors can be coped with, regardless of area they occurr in, if you know how to recognize and defuse stress before it becomes panic. However, under certain circumstances, your mental capabilities is already weakend and it might be harder to do what you know is the thing to do or even recognize a problem. Alcohol, narcosis and sleep deprevation is some of those circumstances.
Also, sometimes things happens in a matter of milliseconds and your response ARE at first primal, regardless of training. Mike Tysons first response to a punch out of the blue wont be to take a guard stance, it would be a flinch reaction.
If things build up too quickly while youre still in a primal reaction, you wont have the time to "go to training mode" and you have a panic that you didnt foresee.
Training might slow the time it takes to go from primal to training modes, but it will never remove that time completely.
Acknowleging that and realizing that practicing whatever skill will in general help you ONLY with the performance of that particular skill, I think holds great importance.
It dont help me if I have all the training in the world taking my mask off and putting it back on or swimming without it if what happens is that im attacked by a shark and I have no clue what youre supposed to do about it (No, not very likely AT ALL to be attacked, I know). If youre also NOT trained in handling stress on top of that, you have no "basic training" to fall back on and youre in, as Gomer Pyle would say, a world of ****.

 

[Marvel]

Gentle people, many of us are aware of the panic cycle & the steps that we can often take to stop it. Note the use of the word often. It is not always possible, IMHO to stop it. Witness the panic that was captured on video of the rebreather diver (I forget his name) who was attempting to recover a body at extreme depth. This was a highly trained individual & yet he panicked & died. An extreme example, I know, but one that proves that no one is totally immune to entering into a full blown panic that can possibly result in a tragic outcome. We can only train to mitigate the possibility.

Because we are lacking the details that will be available when the investigation is complete, the thread has moved from discussing the specifics of this accident to discussion of generalities that MIGHT have contributed to her death. Both discussions can be learning opportunities for all of us & make us safer divers. Isn't that our ultimate goal here?

After reading this thread, I honestly think that y'all are closer in opinion to one another than you think. I see many of you posting that the training that occurs in various classes can, & should, be continued beyond the class itself- no matter how thorough that initial training is. Even if, for example, mask removal is mastered in a class by an individual who has a problem with it that does not mean that the skill should never be practiced again. I have seen Walter & CoolTech routinely take their masks off & continue to dive for 5 minutes or so that way. They are, in effect, practicing that skill so that if they ever lose their masks they will STILL be able to manage themselves & complete the dive safely. I often suffer from an itchy nose underwater & do not hesitate to take my mask off to scratch it- at 10 feet or 100 feet- it makes no difference to me. I always use it to practice my buoyancy control in an adverse situation to build my confidence in my ability to be able to successfully manage the real deal. Those are just a couple of simple examples of how we can all work to improve our ability to manage an adverse situations.

Ongoing & additional training are other examples that were cited, as well as visualization techniques, such as other athletes use. When I played professional pool I had a coach that I worked with once a week & I spent countless hours practicing. I used a hypnotherapist twice & almost never went into a match without using visualization as part of my pre-match preparation. Even so, there were times that I was shaking so hard that it was visible from the stands. But, I had a high degree of success anyway BECAUSE I had taken the time to practice & prepare. How much more important is that when our very lives are at stake rather than our egos or a few dollars?

We are always going to run into unexpected stresses both over & under water when we are diving- as well as stresses that we are aware of before the dive & need to take into consideration when planning the dive. Last weekend on the Duane (different dive), we got to the site & there was no current. By the time the first team entered the water, the current was picking up considerably & when we got to the bottom of the line, it was pretty darned strong. Our dive plan had to change to accommodate it but we all recognized the need to stop & get our breathing under control & reassess before we proceeded. We went from a dive plan that included a trip to the front & some penetration to a shorter, safer trip halfway the length of the wreck. If we had not, one or more of us would have possibly entered panic mode- most probably me because of CO2 build up caused by fighting current.

So, I would ask that y'all be gentler & more thoughtful in your responses to this thread. All of us care passionately about diving & we care passionately about our fellow divers & their safety. We may come at it from different approaches but I believe that we all share the same ultimate goal. I would urge you all to bear in mind that diving has an amazingly safe record given the sheer number of divers & dives in any given year. We are all standing on the shoulders of the giants who preceded us & the dive community has gained from the lessons that they have given us.

 

[Thalassamania]

Good post Marvel.

For those of you who don't think that general panic avoidance can be trained in:

[FONT=verdana, arial, helvetica, sans-serif]Abelson et al (SEE ARTICLE) examined the impact of a brief cognitive intervention on subjective and hypothalamic-pituitary-adrenal axis responses to pentagastrin, a cholecystokinin-B agonist that releases cortisol and triggers panic attacks. The intervention attempted to reduce "stress" by enhancing familiarity, coping, and sense of control. It significantly reduced cortisol responses in healthy subjects and in patients with panic disorder and attenuated exaggerated anxiety responses in patients. Familiarity, control, and/or coping can modulate biological stress systems in healthy people, and sensitivity to such factors may shape laboratory abnormalities in psychiatric patients.[/FONT]

 

[dave4868]

Don't ever think life cannot bring you to your knees....that is a real miscalculation.

Great point! You've made a humble and pithy statement that distills this discussion of panic quite nicely.

(Forgive me if I've taken your words out of context and mis-applied them.)

While the discussion here has gravitated to the various surefire ways one can stay below their panic threshold, this person's unfortunate demise may have been a simple tragic combination of events, not necessarily foreseeable or avoidable.

One simple possibility is that the event began with a major aspiration of water, perhaps followed by laryngospasm or followed by another unfortunately timed gasp that drew in water, not air.

It wouldn't be at all surprising if that alone caused her to experience full-blown panic.

Certainly, there may be other factors we're unaware of, such as an underlying apprehension of being overweighted, or being stressed by needing to oversee her children, or other factors that may have heightened her general anxiety.

Even in the first scenario, panic could have easily taken over and prevented her or others from getting her airway clear of the water at the time of her next gasps.

I greatly respect how quickly panic might overwhelm myself or others.

All I need to do is remember an incident of choking on water and not being able to breathe....panic can begin in a split second.

I'll bet many people here have experienced something similar in their life, if only for a few white-knuckle seconds.

Sometimes, we can't control everything, and events can suddenly turn life-threatening despite our best preparations.... or we perceive them to be life-threatening....

A humble respect for the power of panic is always in my calculations. I won't ever try to convince myself that my experience or my preparations will allow me to completely avoid the possibility of panic.

Dave C

 

[Thalassamania]

The point is: "Familiarity, control, and/or coping can modulate biological stress systems in healthy people." This flies in the face of what some seem to be advocating. We do not yet know what the lesson here is, so I remain open to all possibilities, but I know from both experience and training that while there are situations and conditions that can overwhelm anyone, the point at which the onset of panic occurs is strongly influenced by a diver's level of training and experience.

People have taught that you can manage narcosis too... and we have since seen how foolish that was. I just don't feel that THIS panic is a training issue. ...

And with respect to your beliefs concerning nitrogen narcosis:

I would submit that it is rather strange to argue that nitrogen narcosis can not be reduced and managed. It is well know that nitrogen narcosis is influenced by many things, including mood, Body Mass Index, dive fitness, frequency of diving, workload, anxiety, cold, rate of compression, elevated CO₂ level, darkness, and diver confidence, to mention just a few factors that to one degree or another are amenable to diver mediated changes. Change those factors and you reduce narcosis.

With respect to individual diver suceptability, Abraini and Joulia (Psycho-sensorimotor performance in divers exposed to six and seven atmospheres absolute of compressed air. Eur. J. Appl. Physiol. 65: 84-87, 1992) demonstrated that, "for divers exposed to 50 msw (167 ft) that changes of performance in visual choice reaction time, manual dexterity, and number ordination might range from +5 to -21 %, +5 to -8 %, and +6 to -22 % respectively. Similar results were obtained at 60 msw (200 ft), showing changes of performance in visual choice reaction time, manual dexterity, and number ordination that ranged from +3 to -11 %, +2 to -9 %, and +3 to -26 % respectively."

They go on to state that, "... emotionally stable subjects seem to be affected to a lesser extent than less stable individuals. Furthermore, both qualitative observations and quantitative studies supported that experienced divers and subjects of high intelligence are less affected by nitrogen narcosis."

Bethan Thiviergey in the Gale Encyclopedia of Medicine, Dec. 2002 states: "Some evidence exists that certain divers may become partially acclimated to the effects of nitrogen narcosis with frequency-the more often they dive, the less the increased nitrogen seems to affect them."

Bottom line: bright, well adjusted, well trained, experienced divers who know how to titrate the factors that influence narcosis against the task at hand, are able to do so.