Diving anxiety/panic attacks...help!!

[AlexM630]

Well, I'm not really sure where to start but here goes.

First off, I'm a first time poster but I've been reading ScubaBoard for years. I've been diving for five years this month. I logged around 20 dives in the first year or two before taking a one year break from diving before getting back into the sport heavier than before. Though I haven't logged my dives (bad habit, I know), I've done around 60-80 dives since August '09. I completed my advanced certification in October '09 and have since completed nitrox as well. I've done plenty of deep dives (deepest being 130', in Belize) and wreck dives in southeast Florida and the Keys with light penetration (swim throughs).

Anyway, I'll get to the point of the post....over the past few months I've developed a sort of anxiety that manifests into underwater panic attacks (or what I assume to be so...) This has essentially crippled me from any kind of diving like I used to do. I've never had any sort of fear about diving and like I mentioned before I've completed many successful dives. I've only had one out of air situation and didn't panic at all but air-shared slowly to the surface with my buddy. Aside from that I've always been a more than competent diver, in both my esteem and others'. Nothing has ever really fazed me, from sharks to night dives to cold conditions (though I definitely am more of a fair weather diver.)

That all changed sometime in early November on a 2-day diving trip to the Keys with a group of friends. We all went on a night dive the first night. The seas were rough and the dive was semi-challenging but all went fine and I had a great dive. After the dive we went out and had several drinks but nothing too excessive. I know drinking before a dive is technically a no-no but I've done it lots of times before and it tends to be the status quo at any dive resort I've been to. So anyhow, we all get to bed around 1 AM and wake up around 8. First dive is at the Duane wreck, which I've done before and not enjoyed because of the current, but on this dive it's great. I saw a massive Goliath grouper and some great micro stuff as well. Anyhow, so after the surface info and steaming to the next site, I drop down with my buddy to the next dive. I had felt slightly seasick on the way over but it calmed down when I got into the water. We dropped down to the point where the line to the wreck split and one part went to the bottom, the other to the wreck. For some reason, we took the wrong line, which I realized at about 80' when all I saw was sand and barracudas. At that moment I signalled to my buddy that we needed to swim towards the other line, which was against the current. We began to swim, and I looked over and saw that my buddy was about 30' away from me. At this point an absolute panic set in unlike anything I've ever felt before. I felt like I had to be at the surface instantly, and I couldn't breathe, just hyperventilating. I'm trained not to rocket to the surface so I was able to get my buddy's attention and make a slow ascent with her holding my hand as we rose slowly to the top.

I chalked that experience off to drinking the night before and did some more research that suggested possibly C02 retention. At the same time I was enrolled in a cavern diving class, and when we actually got up to the caverns in northern Florida, I choked and had to abort my dives up there as well.

Since then I completed one successful shore dive back in Florida before I flew to Asia (I'm currently on a three month backpacking trip.) The successful dive in FL gave me the confidence to try again in Indonesia (with my own mask and reg). The first dive I did, to around 35-45', went without issue. I felt a little anxiety since this was deeper than I had been since the incident in November but had no problems. The next day, on a dive to around 80', the same situation that happened to me in the Keys occured. We had been cruising along without incident, and I was enjoying and photographing the Indo-Pacific sealife that I'd never seen before, when about 15 minutes into the dive, BAM...the whole panic attack, "I need to be at the surface" scenario again, complete with perceptual narrowing and hyperventilation. Once I got up, I talked to the DM, who suggested that I give it a go the next day again to "get back on the horse" so to speak. When I tried to dive the next day, I started feeling the same feeling upon descent and aborted the dive early again.

That's pretty much the whole situation. I'm not sure exactly what question I'm asking here, but I guess I'm hoping to get some input from someone else who has been through the same thing, or someone who has experience treating this. I can't fathom (no pun intended) the idea of giving up diving. It's always been a means of relaxation for me. I'll be in Thailand the entire month of March and if there's any way I can successfully dive at all I'd do anything to know it.

Thanks and sorry about the length of the post, I just didn't want to leave anything out.

 

[VooDooGasMan]

Have you gained weight since first bought gear, If your gear is not fitting well can cause this instantly when you get in, Medication, Your regulator not performing, do ypou have an adjustment or have to switch from surface to dive mode.


Solution go rent gear in thialand and dive there and see how you feel.



Happy Diving

 

[The Chairman]

I am not a medical doctor, but I encountered this once with a friend. He had been working hard on his air consumption and had essentially over done it. I feel he was was suffering from hypercapnia, or an excess of CO₂ from skip breathing. You can read more about it HERE!

 

[arkstorm]

I've only had one out of air situation

I know drinking before a dive is technically a no-no but I've done it lots of times before and it tends to be the status quo at any dive resort I've been to.

...With a track record like yours I'd be having panic attacks too.

You "only had one out of air situation"?!? Do you realize that going OOA is completely unacceptable?

You know that "drinking before a dive is technically a no-no but [you've] done it lots of times before"?!? "t tends to be the status quo at any dive resort"?!? Where in bloody hell are you diving?

I think your panic attacks are your subconscious telling you that you need to closely re-evaluate your diving mentality. You are taking very serious risks. You should never run out of air. You should never drink before diving. Period.

Its easy to panic when you know you're on the wrong end of the risk curve before you even get in the water.

 

[dmoore19]

By no means an expert here but is it possible that you have become more sensitive to Narcosis for some reason? I only ask because it seem to be related to deeper dives. From what I have read, mostly here on Scubaboard that everyone is narced to some degree when diving and depths and reactions are not the same for everyone everyday, each of us change from day to day and some are more suseptable than others.

 

[ItsBruce]

I concur with Arkstorm and even wrote up a similar reply before reading the Arkstorm's post.

I'll add: Just because you’ve dived deep before does not mean you are qualified to dive deep. It just means you have not had something come up during one of them that has killed you. It does not mean that this happy state of affairs will continue.

Your panic may be your subconscious telling you that you've used up too much luck.

Other than re-examining your attitude towards diving, the only other thing I might suggest is that you avoid any unnecessary tasks, such as photography, pass-throughs or anything but just swimming around at a nice slow pace.

 

[scubajim 1]

If we rule out ill fitting gear (bcd too tight or a poorly serviced reg) and medical problems (which I'm assuming you have looked into) then it is the mind set we need to consider...
It does seem like you are getting a mild panic attack. There are a number of ways you can over come this.
Just jumping back in won't really help, but if you look at the dives you can get clues to what triggers these events and try to break the problem down into easily treatable events.
Ask yourself three things:
1. What started the event? (Seems in the cases you mentioned your workload was above normal and drinking which is a huge no no)
2. How did I act? (Again it seems you were reactive instead of proactive)
3. What can I do differently? (and there-in lie the rub)

Try to understand the causes of the attack so you can be aware of the types of things that might bring it on...why you feel this happening it is very important to remember to STA (pronounced: stay) Stop, Think, Act!
Stop...take 6 or 7 very slow deep breaths, and I do mean stop. Hold the line if possible but concentrate only on slow deep breaths. Do nothing else.
After your breathing is under control start to
Think....what is wrong....how can I solve this problem, or is it really a problem....come up with a couple of different solutions to the problem and start to
Act..go slowly and put your solutions into effect. If they don't seem to solve the problem that is causing the panic start over...
You might also like to visualise your dives and set up "what if" scenarios...I do this for every dive but every so often the unexpected happens and that's when I fall back on my training and STA

 

[2 Big 2 Fail]

Okay, here's the doom and gloom reply. I'm going to answer this as if I'm correct in judging that you had a experience that has triggered a panic disorder and that it's not necessarily "mild" just because you did not lose all control of your actions. You'll know soon if I'm right, because simply understanding the mechanism of the first incident and trying to act to control panic won't work. If I'm wrong and you get past this quickly, you can ignore this.

First, questions like yours tend to get a lot of replies with advice about easing back into diving or attending to breathing more or any other thing that is generally good advice for everyone but demonstrates no familiarity with panic disorders and anxiety. Things like "get back on the horse." "Get back on the horse" is for people who were thrown and are anxious about being thrown again. It does not work for people for whom getting on a horse induces panic. You'll see this right away, that they're thinking of it in terms of worrying that something that happened will happen again, while you know, I think, that it's a great deal more. And you may also resist the notion that you have a problem that's not going to be easy to fix, and you may well try to dive again. If it works, fine. If not, the rest of this is for you.

This sort of thing tends to focus on particular situations. It's sometimes hard to know just why the focus is where it is, but those situations become anything from very uncomfortable to intolerable. It is not logical. That's an important thing to note. Diving has risks, but anxieties don't have to focus on situations with obvious risks. For some, walking down the aisles of a store induces a powerful urge to flee. No real apparent danger there. For others, it's heights, even modest and safe heights. The fear is primitive and abstract. I think your problem is now not some sort of "fear of diving." Fear is something we can deal with and overcome. Clinical anxiety and panic is not something we can make go away by an act of will. And knowing what might have caused the first panic is not automatically going to resolve the problem. The second and third times had no such physiological cause.

It is not a trivial thing. And it may well not be and often is not something you can just "man up" and press on through. It can, though, be addressed and treated. And it may well be that if you want to dive again, you need to get on with the job. Your experience of progression from panic in a rationally anxious situation, to panic in situation with no rational anxiety but in a similar place, to intense anxiety with even trying to dive, is not unusual. At this point, it's not unreasonable to consider that it's now a recognized panic disorder that has rendered you a non-diver until it's healed.

Prepare for the resort of seeking out a good clinical psychologist. Perhaps you can discover one with diving experience, which may make progress more easy to come by. I wouldn't hesitate to see if a dive physician in your area knows of one. You may have medication suggested, Xanax, for instance. While they can be effective aids and normally do not make you dopey, the danger is they often do too good a job. They can work so well, that you don't do the intensive work to deal with it without medication. And all the effective meds are addictive, and the problem is that the withdrawal effects are pretty much exactly those of the anxiety disorder. Getting off them can be a bear.

The good news is that you very likely can get past this and that you will eventually actually be better able to handle stressful situations of other kinds and will be less likely that before to panic in any situation. Good luck. But get on it right away, if you find the "man up" or "stop and think" don't work, and be prepared for the long haul, if it takes that. Attend to this, because, while no matter how much someone in a panic attack feels they will die, it won't kill them, but underwater is might cause them act in a lethal way.

 

[dwhthediver]

I would have to think along the lines of CO2 retention, or narcosis, as you don't seem to have the problems on shallow reef dives.

 

[Bubbletrubble]

It's pretty clear that your first anxiety-ridden incident at depth was caused by CO2 retention ± narcosis due to being at a sufficiently deep depth (approx. 80 fsw), kicking hard against a current, breathing changes upon strenuous exertion, concern about being separated from your buddy, and concern about finding the wreck (maybe).

It's unclear whether CO2 retention ± narcosis played a role in subsequent incidents.
Based on your recent diving experiences, it's entirely possible that you are now associating diving with a feeling of being "uncomfortable." It doesn't take much to initiate a cycle of increasing anxiety.

If you want to try out diving in the future (and that's a decision entirely up to you), I'd recommend taking the following steps:

1. Gear - Make sure that your reg is functioning properly and has a reasonable cracking pressure (1.0-1.5 inches of water). If you don't know how to check this on your own, take it to a competent reg tech for the job.
2. Medical - Get a physical check-up from your primary care doc. Pay particular attention to your cardiovascular health. Although your panicky symptoms appear to be tied strongly to diving (and exertion at depth, in particular), an underlying medical condition might be a contributing factor. On another note, work on your aerobic fitness. If diving is the most physically demanding activity in your life, you're doing something wrong.
3. Dive planning - For your next dive, find a site devoid of any current. Finning against a current or simply working too hard underwater increases the likelihood of CO2 retention. Limit your depth to a relatively shallow 30-40 fsw. This should mitigate the possibility of narcosis. The aim here is to successfully complete a series of dives without experiencing panicky feelings. Doing so should build your confidence. Gradually extend your comfort zone to dive sites that are slightly deeper. Always take full breaths while diving and limit how hard you are working at depth.

Assuming that you don't have some sort of underlying medical condition, I think you'll be surprised how well this approach works.
Good luck and keep us posted on your progress.