Mental Illness and Scuba

[ScubaDoo67]

Greetings, all. I'm not really sure where to start. I've been diving for 9 years, and have achieved certification through PADI Rescue Diver as well as several specialty certifications. I consider myself a competent diver.

I also happen to suffer from mental illness, specifically bipolar disorder and PTSD. While the diagnosis for BD and PTSD occurred after my initial certification, I have suffered from both disorders for decades.

In the past, I have not had issues with my illnesses - since my diagnosis, I have become quite aware of when I am symptomatic and know not to dive when my mental state is compromised. I find diving to be therapeutic, the tranquility of the underwater environment is quite soothing, and the training gives me something positive to focus my energy on.

While my PTSD does have mild dissociative features, I have very well-understood triggers, none of which could be encountered during diving. My bipolar disorder is fairly mild and is controlled with medication and therapy. I have been medically cleared to dive by both my physician and my mental health provider within the last month.

Last week, I had an event that has created a lot of self-doubt. I was on a dive vacation - I spent the first day shore diving (which was great), and the second day on a dive charter (which was also great). On the third day, I went on another charter (same operator and crew as the previous day) and had some issues. I was buddied with an insta-buddy, someone I was not very comfortable with - he spoke English poorly, was a recent OW certified diver, and admitted that his skills were not very good. He actually wanted to dive solo. I had a choice to buddy with him, or to not dive. I chose to dive.

Although we were diving off a boat, the site had a short surface swim against the current to reach the buoy and descent line. Ordinarily, such a swim would not pose any challenge, but when I reached the buoy, I found myself out of breath and under a fair amount of anxiety. At that point, I terminated my dive. Insta-buddy continued on without me (I did not think this was a good idea, but the operator allowed it, and it was not my place to stop him, of course).

Since that anxiety attack, I've had a lot of self-doubt. I ask myself whether it's safe for me to continue diving, whether there is a heightened risk for anxiety interfering with my ability to dive safely, and whether I am putting those I dive with at risk. I'm well aware that anyone can experience anxiety during a dive, even with hundreds or thousands of logged dives. However, I think that my condition demands a higher level of vigilance.

Am I making something out of nothing? Should I be as concerned as I am?

 

[iztok]

Did you change any time zones during this trip? Either traveling to or from etc?

 

[ScubaDoo67]

Did you change any time zones during this trip? Either traveling to or from etc?

No, it was a local trip.

 

[HBO MD]

Hi Scuba Doo,
Thanks for your courage in outlining what is clearly a challenging dilemma and one which no doubt impacts upon your entire life and not merely diving.
I would suspect that in the absence of excessive sedation produced by the drugs that are often used in this situation, diving probably would be quite therapeutic for you.
However I think one of the issues that you remark upon is your understanding of triggers. I suspect that the absence of a regular buddy ; someone who knows you well, your limitations and your strengths would really be very beneficial in this setting. They would also act as a "barometer" in terms of your overall well being. Some of us are fortunate enough to have a spouse, significant other, best friend etc that provides this added sense of security that we have each others back when diving. While easier said than done, it is something to consider depending on your own unique circumstances, and perhaps may be achieved by joining a local dive club.
Good luck.

 

[pasley]

I am not a physician or mental health profesionall or otherwise knowlagable in any manner on the following subject. The following does not constitute advice or recomendatoin. You and you alone are responsible for your dive decisions.The following is IMHO only

...certification through PADI Rescue Diver as well as several specialty certifications. I consider myself a competent diver.

I also happen to suffer from mental illness, specifically bipolar disorder and PTSD. ... I have become quite aware of when I am symptomatic and know not to dive when my mental state is compromised. I find diving to be therapeutic, the tranquility of the underwater environment is quite soothing, and the training gives me something positive to focus my energy on.

While my PTSD does have mild dissociative features, I have very well-understood triggers, none of which could be encountered during diving. ... I have been medically cleared to dive by both my physician and my mental health provider within the last month.

Thank you for sharing. I run a program teaching disabled veterans to scuba dive, mostly TBI with PTSD. As you have said (and from my own experience) diving is very therapeutic for PTSD. A local mental health professional at the Vets Center (caters only to combat vets) has requested I expand my program to include her clinic for PTSD due to the very reasons you mention.

So lets look at what happened. Two days of diving, no problem. Third day is the issue. Let's review. 1. Any diver can can any dive at any time. 2. Who called this dive? 3. When did they call this dive? 4. Why did they call the dive? 5. Should you continue to dive? Lets review the facts

...On the third day, I went on another charter (same operator and crew as the previous day) .... I was buddied with an insta-buddy, someone I was not very comfortable with - he spoke English poorly, was a recent OW certified diver, and admitted that his skills were not very good. He actually wanted to dive solo. I had a choice to buddy with him, or to not dive. I chose to dive.

... short surface swim against the current to reach the buoy and descent line. Ordinarily, such a swim would not pose any challenge, but when I reached the buoy, I found myself out of breath and under a fair amount of anxiety. At that point, I terminated my dive. Insta-buddy continued on without me (I did not think this was a good idea,...

OK, You terminated the dive. When? You terminated the dive in your own mind before you ever hit the water. Why? Insta buddy with whom you were very uncomfortable due to A: Poor English skills, aka your communication between diver was not all you would like it to be. B: New diver with self admitted poor skills. C: Insta Buddy "wanted to dive solo" which given his new certification and admission of poor skills would indicate poor judgment (not slamming solo diving in general, just this particular instance).

Since that anxiety attack, I've had a lot of self-doubt. I ask myself whether it's safe for me to continue diving, whether there is a heightened risk for anxiety interfering with my ability to dive safely, and whether I am putting those I dive with at risk. ...?

You terminated a dive you did not feel comfortable making. That is what you are suppose to do. Your PTSD and/or Bipolar would appear to have had nothing to do with this situation. Your good judgment had everything to do with it. You were not comfortable diving with this diver in this situation and talked yourself into making the dive anyway. This contributed to anxiety and that caused you to hyperventilate (be out of breath) and physically terminate the dive in water just as you had mentaly on the deck.

 

[Jax]

I am not a physician or mental health profesionall or otherwise knowlagable in any manner on the following subject. The following does not constitute advice or recomendatoin. You and you alone are responsible for your dive decisions.

You terminated a dive you did not feel comfortable making. That is what you are suppose to do. Your PTSD and/or Bipolar would appear to have had nothing to do with this situation. Your good judgment had everything to do with it. You were no comfortable diving with this diver in this situation and talked yourself into making the dive anyway. This contributed to anxiety and that caused you to hyperventilate (be out of breath) and physically terminate the dive in water just as you had mentaly on the deck.

Ditto the above -- I was in your same exact scenario (not with your challenges )and I called the dive. Good decision.

 

[annlaur]

As someone also suffering from mild bipolar disorder (but who is not as confident as you seem to be underwater), I know how excruciating these moments of self doubt can be. I tend to spend way too much time second guessing my decisions and capacities, which oftentimes leads to anxiety.

As others above, I too think you made the right call by calling the dive. Don't beat yourself up about letting that instabuddy on his own : it was his choice to go solo in the first place and, ultimately, everyone is responsible for their own safety.

The one place where I'd slightly disagree from the above comments is this :

(…) You were not comfortable diving with this diver in this situation and talked yourself into making the dive anyway. This contributed to anxiety and that caused you to hyperventilate (be out of breath) and physically terminate the dive in water just as you had mentaly on the deck.

You mentionned having to swim against the courant to reach the buoy. You probably overexerted yourself doing so and had excess CO2 in your system. That alone will make anyone, bipolar or not, feel some level of anxiety, regardless of any other factor.

The one thing I've found the most useful so far to keep anxiety at bay is stopping and working on my breathing (long exhales, emptying all of my lungs and "stomach"), whenever anything feels not right. Works like a charm.

You say you have good diving skills and you showed good judgment not doing that dive. No reason to second-guess yourself IMO.

 

[idocsteve]

As others have suggested, over exertion can lead to anxiety.

It might have had nothing to do with your condition and even if it did, so what? You called the dive and nothing happened of any consequence other than your buddy was placed at some additional risk (by his own choice) due to the need to dive solo.

One suggestion. Next time don't be so quick to call the dive. Sit and relax at the surface for a good five minutes to give yourself a chance to calm down and get a handle on it.

 

[ScubaDoo67]

I run a program teaching disabled veterans to scuba dive, mostly TBI with PTSD.

At the risk of threadjacking my own thread...

As a veteran (US Army, 1987-1993), I want to thank you for what you're doing for disabled veterans. What you're doing is important and meaningful work, and I am sure is assisting those you work with to live full and satisfying lives.

 

[ScubaDoo67]

As others have suggested, over exertion can lead to anxiety.

It might have had nothing to do with your condition and even if it did, so what? You called the dive and nothing happened of any consequence other than your buddy was placed at some additional risk (by his own choice) due to the need to dive solo.

One suggestion. Next time don't be so quick to call the dive. Sit and relax at the surface for a good five minutes to give yourself a chance to calm down and get a handle on it.

Others have said both here and in PM that overexertion / excess CO2 retention may have been a contributing factor. In hindsight, this is probably true.

I failed to mention it, but I did rest at the surface for a short while to try and get a handle on things. I'm not sure how long it was. I do know that I was feeling "closed in" (claustrophobic?) - I ripped my mask off and felt like my wetsuit was constricting me. I felt an overwhelming urge to get out of the water right ******* now. I was in control enough to realize that my anxiety could easily give way to panic if the situation wasn't remedied quickly.