Panic for no reason

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InTheDrink

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Not sure what forum this should be in...

I recently had a trip to the Philippines to an Island called Malapascua. The operation is probably the best run op I've ever come across, Evolution divers. Their local guides look straight out of the GUE manual, having text book trim & propulsion, amazing situational awareness (I mean scary) and great at finding small stuff. The boat hands tended to every need (including washing your wet suit every day) without being intrusive. It really is a seriously good op.

Diving was lovely over the course of the week and I even managed not to have my normal slightly anxious first dive (which I typically get every first dive on a trip since my IPE incident nearly 2 years ago). So I was pleased and happy.

One the penultimate day on the second dive (a wreck) I was having a pleasant dive when I noticed a sense of anxiety, around 30m. It came from nowhere, started small but steadily rose over the next 2 or 3 minutes until I felt in an alarming state. My heart was thumping out of my chest. I've had anxiety on dives before but this was of a different order. Even tho I wasn't concerned that IPE might be recurring (which on my first dives on a trip is my usual concern) by the time my heart was thumping that hard I was concerned that over working my heart his much could potentially cause IPE again. Which of course creates more anxiety. Wonderful negative feedback cycle. I held on to the wreck to minimise any work to try to get my heart rate down. I was trying to control my breathing but it was essentially long hard draw down then rapid exhale. Then repeat.

I should mention at his point that there was no current, great viz, the water was 27C, and there were no obvious stressors. The dive couldn't have been simpler.

Because I thought this could be dark narks I ascended to around 25m. My buddy was around 30-33m and being a CCR diver looking more at his computers than me. At this point I was fairly concerned. I banged my camera against my tank to get my buddies attention and when he looked up did my wavering hand signal. He didn't seem to understand what I was indicating and went back to checking out the lobster under the wreck. I repeated several times (including shouting thru my reg) until he finally ascended and I told him I felt dodgy and that we should ascend a bit and pair up. We ascended to 20-23m and continued the dive - I felt ok by then and kept at this depth for the remainder of the dive. We talked about it afterwards and why my signals weren't getting their due attention and how we could improve this.

Next dive, same day was a shallow 17m hard bottom dive that l'd done several times before. There was a strongish current but we just drifted with it. And then it started happening again albeit to a much lesser extent. A rising sense of anxiety. On an even easier dive. This time I was just annoyed with myself that this was happening. The feeling persisted for maybe 5 or 10 mins and wasn't nice and I just couldn't understand why it was happening. I canned my 4th dive of the day.

The following day I did the thresher shark dive at the usual 5am. Most of the dive is around 23m and we get close to deco or slightly into it. I'd done the dive 4 times before and it's truly a doddle dive. No current. Sandy bottom. Just hover and watch the action. This time my buddy wasn't there and I was notionally buddied with two great Belgians but the buddying was loose at best. I also didn't have my stage (which I always carry these days) which made my weighting somewhat experimental (I took 2kg rather than the 1 or none I normally dive in my 5mm semi dry - I have heavy bones or something). All was fine and I was at near rest watching the sharks when suddenly I noticed this sense of anxiety. It steadily grew until I was in a state of heightened anxiety and again, in disbelief that this could be happening. I let all gas out of my wing to make myself negative so I could rest completely on the sandy floor (even tho I had been hitherto critical of other divers doing this because of the damage to what remains of the reef there). After 5 or so mins the feeling passed and I continued the dive as normal and we were even lucky enough to get a beautiful mobula ray circle us on our safety stop.

Soooooo..... WFT happened out there? Where has this level of anxiety come from on shallow hard bottom no current warm blue water dives???

In each instance I handled it fine I think and was able to complete the dives to 65-70 mins on a single tank. But in each instance I was quite glad when the dive finished. And when the anxiety (or on the wreck, panic) was happening it was seriously unpleasant.

I've had anxiety before but typically a bit deeper around the 40m+ zone. But at 17m??? On easy easy dives?

Any thoughts anyone? I imagine it won't persist but it is obviously a concern, mainly for my enjoyment of diving but also a concern safety wise in case my heart beat level getting so high in case it could possibly cause a recurrence of IPE.

Despite these issues I had a wonderful trip but I'm annoyed and perplexed that these anxiety attacks happened and for no obvious reason. The only possible reasons I might think of was same day same ocean diving, tiredness - we were getting up at 4am each day for the shark dive, and alcohol consumption of which there was a bit each evening (but tiredness and night before alcohol consumption are hardly new to my diving whereas this level of anxiety definitely is).

Very puzzling that the anxiety seemed to come out of now where. And quite embarrassing too.

Ordinarily I would have put the wreck dive down to shallow dark narks. But I struggle to believe that narcosis could be impacting at 17m. I've certainly never felt it before.
 
We sometimes think we know a lot about diving and the effects it has on our bodies. I often think we have no idea how little we know. Experiences like yours just reinforces that thought. Maybe you're getting to old to drink at night, get up at 4am and dive all day? I know those days ended for me long ago! These days early to bed and 2 dives per day are about enough for me. Hope it was a one time experience for you.
 
The lack of quality sleep and the lingering effects of alcoholic beverages could well be at issue. As you know the consumption of which contributes to dehydration. And of course lack of quality sleep doesn't help either. As you said you have anxiety on your first dive of the day due to a previous IPE and I'm sure that is just nagging at the back of your brain. Are any medications being used? Have you sought help for the anxiety? There are techniques which a person can use to help alleviate anxiety. It's also possible there are physiological issues at work. I would talk to a diving physician and possibly have a work-up done. B
 
The combination of physiological stresses such as travel, tropical environment, sleep, alcohol, age etc. is probably the underlying cause.

Bad gas may be another. Slight increases in contaminants accumulate during the diving week. Any other divers reporting the same?
 
I got this once and I couldn't believe it was happening--like you, it happened to me a number of times in a 24 hour period. Truly puzzling and very, very unpleasant. In my case I determined that it was an OTC medicine I had taken for menstrual cramps but had forgotten about. Now I'm extremely careful about what chemicals I put into my system before going to depth because even if a drug hasn't shown any side effects on land is no guarantee that there won't be some weird side affect under pressure.
 
Thanks for the responses. I turned 40 last month so perhaps this is a welcome to the club message :)

I'll make sure next trips not so early starts and no or less booze and see how it goes.

No-one else reported any issues so I don't think it was gas and the op is a tech shop and their 02 and Nitrox mixes were always spot on altho I didn't analyse for CO.

However something about the way these anxiety attacks took hold did feel more physiological causing psychological rather than vice versa but its rather hard to be sure about this.

I'll chalk it down to experience and do some build up dives prior to next trip.

Funny that diving used to be such a carefree activity for me. Now I seem to be just building up more baggage. Hopefully this was a one off. Thanks again for the responses.

John
 
We just need to make adjustment as we age. I'm 58 with 42 years of diving. As I said early I don't dive as much in a day as I used to and don't drink much when on a dive trip, 1 or 2 drinks at dinner maybe. I like diving and sleeping more than drinking anyway. Don't dwell on it, it'll just be worse.
 
Funny that diving used to be such a carefree activity for me. Now I seem to be just building up more baggage. Hopefully this was a one off.
Might be worth noting that even though your dives got easier your anxiety seemed to get worse. Is it possible you may have been focusing on your past dives and the anxiety you experienced bringing on anxiety in your current dives? If so, focus on your diving, go with a buddy you're familiar with and like and get back in that happy zone. I know when I start to become concerned with issues it will only become more frequent and pronounced unless I dissect what's up, the reasoning and if it's really worth worrying over based on the issue. Usually I get to calm down once things are figured out.
 
Yeah I'm keen to figure it out. The first dive when it happened was the worst by a long shot and I'd say I was fairly compromised. If my heart beat had elevated much further I think the situation could have become problematic.

Perhaps I took some of that anxiety into the next dives but if so it was certainly subliminal as I felt zero anxiety prior to and in the first part of the subsequent dives. To be honest when someone mentioned bad gas on this thread that made sense altho I don't believe it was that. The whole thing seemed so 'other' and I was amazed it was happening, it didn't make sense. Still doesn't really.

Any docs out there, can you advise whether elevated heart rate (from anxiety/panic) can cause medical issues and if so which ones? This should give me a firmer plan if it does happen again. On the dives when it happened I just soldiered thru it and on the wreck ascended a bit too.
 
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