Question Panic in the experienced diver?

It would seem to me that, as we gain experience and go through some minor glitches on dives, we should increase our capacity to tolerate issues underwater. I'm wondering what could cause an experienced (say, more than 200 lifetime dives) diver to become distressed enough to lose rational thought. Has anyone here (who meets those criteria) been through a panic event? What caused it, and what did you do?

 

[Kingpatzer]

The problem, of course, is that more evolved animals can find themselves in circumstances where robust, yet ill considered responses to danger will kill them...

So can less evolved animals, for examples humans have this silly thought of going scuba diving when dolphins long ego figured out an evolutionary solution to that underwater problem

 

[SeaHorse81]

I think of it as the condition resulting from the release of large quantities of neurotransmiters resulting in bio-physical changes that overwhelm the individuals ability to think and act normally - either at all or without intense focus. For the individual the experience is emotional to the point of overwhelming normal cognition and accompanied by potentially intense physiological changes in things like heart rate and breathing. It is, I believe definitionally, the onset of intense fear and/or anxiety.

The neural activity is focused in the lower brain and it is a "lesser evolved" response to danger. Regardless of the fight or flight decision this biological phenonmenon ensures a robust, if ill considered, response.

I'm in the camp of panic being fight-or-flight in overdrive. The above is an accurate description, though perhaps a bit technical if one doesn't work with such information on a regular basis. The point is that in the rush of blind terror, the ability to think, to evaluate options, to recognize help, or to problem-solve are gone. Panic turns an intelligent human being into a primal animal willing to do anything (to anyone) in the next second to survive. Ironically, though the pure-instinct response in that moment is to survive, the strategies chosen most often assure destruction instead.

I've had some anxious moments, but nothing close to panic as yet. If/when I do, I'm going to try hard to remind myself that no matter what's going on in that moment, it can't be half as dangerous to my life as panic, and I hope I'll be able to push it back and get on with the issue at hand.

 

[lamont]

I was wondering about this thread today and if prior experience has a lot to do with someone's response to anxiety/fear leading into panic.

When I was 16, I learned how to drive in Alaska in a crappy RWD van, and learned to deal with that feeling in the pit of your stomach when you just hit black ice a bit too fast and you need to stay calm. I was wondering if success in those kinds of situations in life in general would build up healthier responses to that kind of fear, while inexperience with those kinds of situations or bad outcomes in those kinds of situations would lead to worse control over the panic response...

Kind of tangential, tho...

Also, I was thinking about the subject line and "experienced diver" should probably be qualified. I thought I was experienced around dive #60, and I'll probably be appalled by how inexperienced I am now after you tack another decade onto me...

 

[mdb]

"Also, I was thinking about the subject line and "experienced diver" should probably be qualified. I thought I was experienced around dive #60, and I'll probably be appalled by how inexperienced I am now after you tack another decade onto me..."

Good post Lamont.

 

[Thalassamania]

Re: Lamont's driving lesson.

I think that you can habituate to almost anything. The first time scares the bejesus out of you, the second time raises your heart rate and your breathing, the third time is mildly exciting, the fourth time on is kinda ho-hum and you deal with it as a matter of course.

 

[gcbryan]

I was wondering about this thread today and if prior experience has a lot to do with someone's response to anxiety/fear leading into panic.

When I was 16, I learned how to drive in Alaska in a crappy RWD van, and learned to deal with that feeling in the pit of your stomach when you just hit black ice a bit too fast and you need to stay calm. I was wondering if success in those kinds of situations in life in general would build up healthier responses to that kind of fear, while inexperience with those kinds of situations or bad outcomes in those kinds of situations would lead to worse control over the panic response...

I've wondered the same thing. I'm not sure if it's that people who handle stress better get involved in more of these situations or if it's just that getting into more of these situations promotes a better outcome next time.

I've been involved in enough different "keep your cool" situations that I sometimes feel that this helps me out the "next time". However if I would really think back to the first time I encountered a similar stressful situation I can't say that I reacted any differently the first time.

I do know that they say (not scientific I suppose) that some people just have less of a "fear" gene than others. I think that when something is completely new that it is more likely that anyone can panic to some degree but after that there does seem to be a large variability in how people react. Some people are just more excitable.

For some however, scuba is their first and only experience in putting themselves "out there".

I'm rambling but I think you are in the ballpark on this one.

Edit: One more thought. Can it be as simple as "survival of the fittest"? Some people just are more adapted than other in certain regards? I've seen a baby harbor seal on our coast that was dehydrated and obviously wasn't going to make it. I'm told it's not uncommon since once weened harbor seals are on their own. Some learn to hunt and therefore feed themselves and survive and some don't and die.

 

[TSandM]

I have read some stuff in the past about anxiety trait . . . and the idea that there are people with high levels of underlying anxiety, and some temperaments that are truly phlegmatic. A study of cave divers, for example, showed that we generally score very low on trait anxiety, which makes sense -- somebody who is chronically worried isn't going to be very happy about being 1000 feet from the nearest source of air

I think that you can habituate to almost anything. The first time scares the bejesus out of you, the second time raises your heart rate and your breathing, the third time is mildly exciting, the fourth time on is kinda ho-hum and you deal with it as a matter of course.

We used to say, during my residency, that by the end of the 2nd year, which was spent in the ER at the major trauma center and the various ICUs in the system, your panic button had been pushed so often it didn't work any more. I think there is more than a little truth to that!

 

[peterbj7]

I don't think I've ever felt seriously out of control when diving, but I have done twice whilst driving. The first was the day after i passed my driving test when I "borrowed" my father's E-type Jaguar and went for a spin. Almost literally. I found myself approaching a roundabout at 80mph and left it too late to slow down. I got the car round but the rear end clouted the kerb of the roundabout pretty hard, but amazingly did no damage. I drove the 5 miles home at about 25mph.

The other occasion was on a bike, a 1000cc BMW. I was on a motorway (like an interstate) leaving London at around 3am in the middle of winter, a totally empty road, cruising at around 130mph with 90 miles to go. Suddenly I became intensely aware that something didn't feel right, though I couldn't work out what it was. I eased off slightly on the throttle and I felt the back end slide slightly from wherever it had been. I slowed down on the throttle to a halt, then put my foot down as I came to a halt. My foot just slid away from me and I and the bike went down - I had been riding at 130mph on black ice! I walked the bike to the hard shoulder, which was surfaced with loose rough pebbles, and rode the rest of the way just fast enough to balance.

Actually I have just thought of a diving incident. Shortly after I qualified as an air/nitrox tech diver I went down the Blue Hole in Dahab with a couple of guys on trimix. I intended stopping at the arch, and they were going to the bottom. They hurtled down and foolishly I tried to stay with them. At around 40mtr I started to put the brakes on but didn't stop until I had passed 60mtr. I felt so incredibly narced that there was nothing for it but to go back up the way I'd come, and I started to feel OK when I got to around 40mtr. Going under the arch had to wait until another occasion.

 

[Farback]

We used to say, during my residency, that by the end of the 2nd year, which was spent in the ER at the major trauma center and the various ICUs in the system, your panic button had been pushed so often it didn't work any more. I think there is more than a little truth to that!

I agree that exposure to this sort of thing desensitizes and better prepares you to react in a more appropriate manner. I remember once after an industrial accident at my former workplace where the person involved had had the skin on his arm ripped and pulled down from the elbow to the wrist. I was discussing it in matter of fact terms with a fellow long-time firefighter. A couple of people who overheard us were looking at us like we were monsters. We all live in the same world, but within different realities I guess. We explained to these guys we weren't being callous, just that our experiences made this less shocking than I'm sure it was for them.

Life experiences, your hard-wired responses to stress, and time spent in the activity all make you better able to handle panic in my largely unprofessional opinion. (I'm not a doctor, but I'm willing to take a look at that)

Kirk

Kirk

 

[Bubbletrubble]

I have read some stuff in the past about anxiety trait . . . and the idea that there are people with high levels of underlying anxiety, and some temperaments that are truly phlegmatic. A study of cave divers, for example, showed that we generally score very low on trait anxiety, which makes sense -- somebody who is chronically worried isn't going to be very happy about being 1000 feet from the nearest source of air

I've always thought that questionnaire-based testing revealed more about the kind of person that a subject wanted to be...rather than who the subject actually is.

Dealing with stress has a lot to do with concentration and focus. If loud noise, loss of control of a car, gunfire, blood, or a lack of air to breathe can get you to lose concentration and focus, you won't be able to mount an appropriate response to that stress. At that point, you're one step away from not being able to think rationally. Lack of rational thought = panic. A reasonable approach to managing stress better is to simulate it (in real life or through visualization exercises) and gradually turn up the amplitude of the stress, with the aim of desensitizing the loss-of-concentration/focus response. I've read about certain cases in which patients found psychotherapy and self-hypnosis helpful.

FYI, in recent years, scientists have identified a gene called stathmin which is highly expressed in the amygdala and associated thalamic and cortical structures in the brain. On a cellular level, knocking out the gene disrupts long-term potentiation (process thought to be involved in learning/memory) in amygdala neurons. On an organismic level, stathmin knockout mice are "less fearful" mice with regard to social interaction, nest-building, and pup-rearing. Humans who have certain genetic polymorphisms in the transcriptional control region of the stathmin gene (STMN1) show measurable deficits in acoustic startle and cortisol stress response. I haven't cited any of the literature here, but if you do a PubMed search for "stathmin," you'll get lots of hits. It's a very interesting topic in neurobiology.

On a related note, I'm certain that more than one pharmaceutical company is working on a "drug" that modifies stathmin expression, function, or breakdown. Imagine all the different kinds of people who might be able to benefit from such a drug.