Diving anxiety/panic attacks...help!!

[annlaur]

Annlaur,
I'm glad to hear that someone else has actually dealt with this with some degree of success.

It's an ongoing process for me and has lasted for over 4 years, but everyone is different. I have always been an anxious person, so maybe that's the reason why it's taking so long. The fact that I only get the chance to dive while on (long but infrequent) trips doesn't help either, since I almost have to start over the whole "getting my confidence back" process everytime.
Hopefully it will be easier and faster for you.
That being said, I still enjoy my dives immensely. Even if I feel edgy at times.

I went through something like this years ago during a very stressful period having nothing to do with diving. In the end, I came to kind of anthropomorphize the anxiety as an enemy that could not really harm me, so I could tell it, "Do your worst, and see what it gets you. Okay, I feel it. Is that all you got, because it's really uncomfortable, but it's not doing me any real harm, so go away." Then, "Oh look - it did it's worst, and it didn't kill me." I don't know just where this stuff comes from in the mind, but I found it gives up after a while when it can't win.

Well described ! I use a similar thought process to keep the panic at bay, but that is an acquired skill that first needs to be practiced in a safe environment (on land).

I might get flamed for giving advice to the OP without being a psychologist or doctor of any kind, but this is an exercize that has helped me (someone on the board had posted it years ago, don't remember who) :

Sitting in a place where you feel both safe and comfortable, close your eyes and visualize yourself on the dive that freaked you out.
You really need to live the experience to the fullest, see yourself gearing up, jumping in, descending, equalizing and so forth. Visualize yourself swimming against the current to reach the correct line and turning around to see your buddy is lagging behind.

If you do this correctly, you should by then relive the anxiety you felt on the dive.

Now observe what happens in your body : heart racing, shallow breathing, palms sweating, chest constricting… whatever. And listen to what your mind is saying, what it is afraid of.

Then take slow, deep breaths with full exhales, move your neck and shoulders which might have tightened, open your hands which might have turned into a fist and observe how you'll slowly relax and how the gloomy feelings will start vanishing.

Once you've calmed down, with your eyes still closed, assess the "real situation" : so you're 30 feet ahead of your buddy trying to reach a line in a current to reach a wreck. What should you do ?

You probably won't get that far the first times you try it. It doesn't matter, the idea is for you to learn to recognize the signs of anxiety and to learn to deal with it. So once you start freaking out, even if you haven't even "jumped in the water" in your mind, start observing how anxiety manifests itself, what it's telling you, and then do the deep breathing and observe how you can control it.

If you feel too uncomfortable at any time during the exercise, just open your eyes and try another day. Do not try to push yourself, the point of this is not to traumatise yourself even more.

Practicing this several times (but no more than once a day, as it's a stressful experience) will teach you how to deal with anxiety and gain confidence that you can overcome it.

Word of warning : many substances can increase anxiety (alcohol, some medication, marijuana and other drugs…). Since anyone on the Internet could read this tread, it's worth mentionning that the above exercise should not be attempted while intoxicated, as it could only make things worse.

As 2 Big 2 Fail wrote, anxiety won't kill you or harm you. It does, however, impair your judgment if you let it escalate, which is dangerous in certain situations such as diving or driving a vehicle.

 

[divermike1011]

DiverMike,
Your point is well taken, but again I'm really not looking for medical advice so much as shared experience. In addition, going to a doctor blindly without any a priori knowledge or understanding of what may be happening to you is (in my opinion) just as foolhardy as soliciting medical advice from strangers. A degree in medicine does not always make for correct diagnoses - if a doctor, for instance, is not exposed to the situations we face as scuba divers, he or she may search for a more blanket solution rather than one specific to the situation. I'm also in the middle of Asia right now and can't exactly find someone to help me work through this. When I do get back to the states, I'm fully determined to find someone who understands diving to help me try to figure this out, but as of right now this was just weighing on my head too much to not even put the question out there and see if anyone else was in the same boat.

The reason I suggested you see a doctor or other health care professional is that you may have a medical or psychological condition that needs treatment in order for you to dive safely. We can commiserate with you, and offer you advice based on our own experience, but we cannot order labs, perform a physical exam or take an in-depth face to face history. Generally speaking walking into a doctor's office and being able to describe your symptoms allows them to start the process of figuring out that is wrong with you. You don't, unless you are a medical professional yourself, add a whole lot to the process by trying to figure out what's wrong on your own, in fact if you think you have a particular condition you may, consciously or unconsciously, give a history that supports what you think is wrong and send the doctor down the wrong path.

Once you have been diagnosed with something, by all means educate yourself as you can add to the process then, but even in SEA there are very competent (even excellent) doctors who can take a history, order tests, and try to determine what causes your symptoms, and from there develop a treatment plan.

Diving is great, but it's not worth dying to do and I recommend you stay out of the water until you know why you have panic attacks and a plan to counter act them because the law of averages means that eventually you'll have a panic attack and suffer trouble from it.

Michael

 

[2 Big 2 Fail]

Yes. Certainly nothing of what we relate of dealing with such things suggests you shouldn't see a physician. But know that most physicians have few therapies that don't involved medications. They're approach if often to prescribe something to relieve anxiety and hope it passes. The medications do exactly that, relieve the anxiety, and they do it very well, but you can be left dependent on a pill for the ability to live normally. For some, they are necessary, in order to get things under control so other work can begin, but the goal must always be to stop the medication. (Never suddenly. They can have very bad, even fatal, effect when suddenly withdrawn.) Plain anxiety disorder rarely has a physical cause, so the medication is merely a temporary tool. But make sure that's the case by letting the doctor check.

Other professionals, typically clinical psychologists, if they are legitimate, exist only to help you become your own therapist, and you end up doing that by discovering your own process. But no matter what flavor your process takes on, it will necessarily involved becoming aware of the nature of anxiety as a physical, not a mental, phenomenon. Enough said, but I will recommend this book as a minimally "Zeny" instruction in simply learning to be fully aware and alert without the busy little frontal lobes getting in the way.

 

[divermike1011]

2B2F:

Agree with you almost 100%. Last thing the OP needs is a PCM throwing some benzos at him with an injunction not to take too many. I also agree that since PD rarely has a physical basis he needs to get himself to a good psych. to see how he can deal with the problem. My concern comes from the fact that the OP can follow advice here (and on this thread much of it is good advice) but without an understanding of the why or the how of what sounds like panic attacks he may push himself too far too fast and run into significant problems underwater.

Also, from a more global perspective I'm not comfortable with the idea of a future reader looking through the Basic Scuba forum with a similar issue and just blindly following some stuff they read. I realize we can do nothing to prevent this, but I think strongly suggesting the OP or anyone else with an adverse physical or psychological response to diving see a health care professional is a good thing.

Michael

 

[bj139]

Get a pony bottle.

In re-reading your post I realized your OOA situation as well as not being able to get to your buddy (loss of control anxiety) on the other dive may be related. A pony bottle means you will have your own redundant air and will not need your buddies air. You must however consider you are your buddies redundant air, so can you leave him in a panic at 80 ft?. Maybe he should get a pony bottle too. I heard some NJ wreck dive boats require a pony bottle. I consider it to be cheap insurance and bought one myself as it eliminates worries about disappearing buddies.

You must work out your own reaction to anxiety.

I will relate my experiences with anxiety in case they might be helpful to others.

I first dove a Discover scuba in Bermuda at 30 ft. I started to experience mild panic on the surface before the dive. I remember not being sure I could keep my mouth above water (loss of control ) and asked the DM if I could just get back on the boat. He told me it would get much better under the surface. Boy was he right. The sense of wonder made me forget about any anxiety I might have had. Fish and coral were everywhere. This is why I wanted to dive. I am so glad he talked me out of aborting the dive. Try to think about the wonder of diving. Think about how cool it is being weightless and seeing all the great undersea life and not about OOA(check your gauge). I wasn't neutrally buoyant on this dive but knelt on the sand on the bottom. I remember how I had to swim down since I did not sink easily but was negative on the bottom. My weighting was probably just right on this, my first dive, although I did not know it at the time.

Years later I asked my doctor for something to take the edge off during stressful situations at work. He prescribed lorazapam. The label says take one three times a day. I never did that since I would be passed out. I break a pill in two and take half before a stressful situation. I have found this prevents mild panic attacks. I took a half before each of my scuba pool sessions and certification dives. I knew the effect on me of taking half a pill once every week or two had on me, so I did not think it would affect my diving. I have eight OW dives and all were great including my first drysuit dive on New Years eve at 58 ft.

Three reasons for anxiety.
1. Loss of control leading to death. ( Heavy gear dragging you underwater to your death, Not being able to clear mask leading to inhaling water through nose and death)
2. General life task overloading leading to loss of control. ( Mask clearing, financial problems, stock market losses, stressful spouse problems, etc., etc., etc.)
3. Fear of death itself. ( If you live it is a certainty you will die, so to feel anxiety about it is stupid. It took me a while to re-learn this and I am sure I must re-learn it later.)

Once I realized these, I learned to trust my gear will not drag me under. IF I CAN BREATHE THROUGH THE REGULATOR I AM OK. IT IS NOT AN EMERGENCY YET. EVEN THOUGH MY BUDDY IS FAR AWAY I AM OK. I practiced mask clearing through a snorkel in the pool until I can do it easily.

I REALIZED MOST STRESS I CAUSE ON MYSELF AS A REACTION TO A SITUATION.
THE SITUATION IS ONLY AS STRESSFUL AS I MAKE IT. IF I CHOOSE TO I CAN
DE-STRESS IT.

 

[jwllorens]

I know this thread is old, but I wanted to chime in and say that I had a very similar experience without the experience, so to speak. Unlike you, I was on my 6th dive ever. I had never been below 60ft. I didn't even have my OW cert card yet, though I had completed certification and training. We were headed to the Eagle off Key Largo or something or other.

I was also seasick. I always get seasick. I had also been having a good ol' time the night before and was dehydrated (Stupid decision #1). I was also incredibly excited to see a shipwreck, and to go deeper than I had before, but was also a bit anxious about it. The dive master on the boat (not our instructors going with us) walked us through it. He told us everything, but I of course did not pick up on how important the current that he was talking about was because I had never dove in a current before. I went down with three very young, equally inexperienced girls. We were in a group, but paired off into twos as buddies.

We get in the water and head off to the line. When everyone is ready to descend, we start down. None of us holds onto the line (Stupid decision #2). I don't remember the boat captain mentioning that we should hold onto it and I don't remember seeing anyone hold onto it on the descent, but he definitely said to keep it in sight and stay close to it. We should have paid more attention. The other buddy pair is dropping faster than me and my buddy is having ear clearing issues, and I end up being very focused on that situation and don't seem to notice that all the other divers from the boat and the descent line itself have vanished from view. I motion for them to slow their descent, and get really close to by buddy to make sure she was ok. She said she was fine after a bit. I noticed that it was only us four with nothing in sight at about 40ft. I figured we were a bit lost, but we would continue to 90ft and at some point see the wreck, swim around it and then locate the other divers and the ascent line. We continue down (Stupid decision #3).

At 90ft, we see the bottom, but no wreck. There is nothing but a car garage sized concrete cinder block. I look around, still no wreck, and I realize I have absolutely no peripheral vision. All the sudden my breathing gets pretty deep, I am heaving a lot. I start to feel slightly dizzy. The effects are not intense at all, but I feel a bit like the dentist is preparing me for a root canal. My brain seems to be ever so gently suggesting that I take a nap, which freaked me right the hell out. I do a bit of finning and hover at 95-100 ft just over the big concrete object, and I get fixated on the idea that something is physiologically going on and I must not go any deeper. All I could think of was "I DO NOT WANT TO BE HERE!"

My first reaction is to get neutrally buoyant so that I am not exerting myself (I guess I was imagining my gas getting used quickly and wanted to stop breathing so hard). I take my reg out and exhale into my BC and I am neutral. I stay put for a few seconds and focus on breathing slowly and relaxing my legs, and I quickly get it under control. I am still very uncomfortable, but I think to myself, "Ok, I am fine, but we need to get out of here because I feel weird, we are lost, and none of us knows what we are doing." This whole process took about 20 seconds. I signal to my buddy that there is a problem, then that I am dizzy by doing a loopy motion at the side of my head with my finger, and that we should ascend. She gives me the OK. I look for the other two divers, who were likely near us, but again I had tunnel vision and did not see them. We did not swim around to look for them, and we start up slowly. Everything is fine and we are ascending nice and slow. After we go up about 10-20ft, all the symptoms are gone, I feel normal, in fact I start to feel good, and I like being in the water, but I feel worried for the other buddy pair.

I watch my depth gauge closely. At 15ft, I motion to level off for a safety stop. My buddy does not see me, and goes right past me. I reach for her fin but miss it. I decide to come up slowly after her. A good thing too, we were at depth maybe for a minute at most. At the surface, I do a 360 and do not see the boat. There is probably 1 inch of chop, the water is smooth and calm. I do another 360 and see the boat, it was so far away it had been hiding behind a 1 inch wave the first turn around. A safety stop would have put us at the mercy of the current for far longer. We swim back against the current for a good long time and get a bit of a workout, and finally get in range of the rescue line to pull ourselves in. The other two divers make it to the boat as well, but are pretty shaken up about behind so far from the boat. The boat crew is pissed at us, I am embarrassed. We then do a night dive which I feel absolutely no anxiety on, and have a blast. Afterwards I go home and analyze what went wrong.

Since then I have noticed the following: I feel that same anxiety on the first descent of the day, at the start of a dive, to a lesser degree. "Panic" has never caused me to flail around or anything as I am always able to think straight and over come it and then enjoy the dive, but it does mess with my breathing a bit on the descent. Also, I find that task loading helps and eliminates the anxiety immediately and more effectively than anything else, as my mind goes into problem solving mode and isn't left to wander. I found this to be true when I started diving down with an objective other than staring at fish and rocks, such as "find and rescue this unconscious guy at 30ft for stress and rescue cert" or "take a picture inside this sunken truck." And of course, there are tons of other factors that I have learned will contribute to or trigger my anxiety such as a tight wetsuit, an overtuned regulator that shoves air down my throat, not seeing any solid surface in any direction, cold water, murky water, water that is too clear and appears vast and empty, narcosis, seasickness right before the dive, and strong currents. So when I know these things will happen, I know I anticipate the anxiety which both brings it on quickly but also allows me to rid myself of it quickly.




I think most people will feel this at one point or another while diving, either due to an event or external stimuli or for no apparent reason at all, and some more than others. The difference is how people react to it. Some people react to panic by going berserk and running without a clear thought in their head which is the point at which the panic becomes dangerous under water. Obviously, it would be best to just be more comfortable in the water altogether and I am finding that I am much less anxious now as I get more experience (I am still very green), but at least I am not bolting for the surface (seen a lot of divers do this) when I am really damned scared (which I was on that wreck dive, feeling narced for the first time when I knew it was already a bad situation was probably the most scared I have ever been in my life).

If I feel it, it is always on the descent now. There is no way I would let this "descent anxiety" stop me from diving though, I am just way too addicted to it already. I do let other divers know that I will be "freaking out on the inside" on the descent, but I am always good to go once we are at depth.

 

[TMHeimer]

jwllorens, You didn't HAVE your OW card, which only recommends 60' depth? Did I misread?

 

[jwllorens]

jwllorens, You didn't HAVE your OW card, which only recommends 60' depth? Did I misread?

We were "certified" at that point, but only just so, so I did not have the physical card yet. We were also taught "deep diving" in OW class (I have since taken the specialty course and did not learn a single thing that I wasn't already taught in OW, my OW was through my university for academic credit and was actually quite extensive with LOTS of pool dives and we went into great depth). Otherwise, this particular dive was not a training dive and therefore not restricted to any "limit" other than that which is dictated by common sense, which apparently I did not have when I decided to continue descending even when I realized no other divers were near us.

Also we were with instructors on that dive, plenty of them. Every trip I have been on with this dive shop has been great, they have tons of instructors that come along to monitor everyone. We just lost them because we weren't paying attention. So at the start of the dive, we we all thought and intended to be diving with plenty of individuals that are instructor-level certified and had previously dove with to learn that they are very capable. At 40ft, I wrongly assumed the instructors and everyone else was "just beyond the veil" and we would see them at the wreck that I believed to be below us. Once I was at 90-100ft I realized this was not the case, we were in the middle of nowhere and none of us knew what we were doing, I felt an overwhelming sense of impending doom. So we didn't splash thinking we would hit 100ft on our own with only 5 previous dives under our belt, it just ended up that way because we were stupid novice divers.

Nobody got hurt, and we learned some valuable lessons so honestly I am glad it happened. Had it not, I might still not have a proper respect for currents and depth and could end up with this happening down the road with a sense of complacency about deeper dives in currents and let things get way more out of control, and I learned that my reaction to that type of panic is to instinctively try to calm myself down which I believe is good even if panicking in the first place is bad.

 

[scottwilson1]

never mind didn't notice old post

 

[Tarynitup]

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.