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Intern@tion@l Dre@m.net |
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Intern@tion@l Dre@m.net |
By Samuel Shelanski, M.D.
Avoiding
Panic
Have you
ever panicked under water? Has your heart ever pounded so hard that you felt
like you couldn't get enough air? Have you been so disoriented that you didn't
know which way was up? Because of some stress-you were low on air, a great
white was staring you down-have you ever lost control and acted irrationally?
If so, then you're not alone. According to a recent study out of the Sport
Psychology Lab at the University of Wisconsin, more than half of experienced
divers surveyed said that they had experienced panic or near-panic while
diving.
Dr. William Morgan's study, published in the December 1995 issue of Sports
Medicine, suggests that for divers, mental fitness may be at least as
important as physical fitness. The study also raises some serious questions: Do
certifying agencies adequately address the dangers of diver panic? Can divers
and potential divers who are prone to panic be indentified and treated?
There is
little question that panic strikes divers, occasionally with catastrophic
effects. Many experts, including Dr. Carl Edmonds, author of Diving and
Subaquatic Medicine, believe that panic is the leading cause of diving
fatalities.
The National Underwater Accident Data Center (NUADC) attributes 19 percent of
the scuba deaths from 1976 to 1988 to panic, with another 22 percent resulting
from unknown causes. Many divers whose deaths have been attributed to drowning
are found with adequate air in their tanks and no obvious problem with their
equipment. It is thought that a large number of these fatalities are the result
of panic attacks.
Panic is also implicated in many cases of arterial gas embolism (AGE). AGE
results almost exclusively from rapid, often uncontrolled ascents. While a
small number of these cases are the product of inadequate training or equipment
malfunction, the vast majority are divers who make panicked beelines for the
surface.
With panic
being of such concern to divers, it seems natural that it would be covered
in-depth during certification courses. Morgan, however, says that's not the
case. He contends that the major certifying agencies have downplayed the risks
associated with diving as part of the growing commercialization of the sport.
As a result, Morgan says, many people who never would have taken up diving 20
years ago--when it was still considered something of an extreme sport--have
flocked to their local dive shops.
Both PADI and NAUI refute Morgan's claims that they ignore the issue of panic
in their training. PADI issued a two-and-a-half page response to the study,
which questions many of the points raised by Morgan and points out that PADI's Open
Water Diver Manual and Rescue Diver Manual, as well as their
accompanying videos, specifically discuss panic and its associated hazards.
While
diving is significantly safer now than it was at its inception, there are still
some very real risks every time someone enters the marine environment. It's
only realistic to assume that some of the vast number of divers who have
entered the sport over the past several years are mentally less well-equipped
to cope with potential problems under water, and therefore may be more prone to
panic than their predecessors.
Is there any way to identify which divers are at higher risk of panic attacks?
According to Morgan, there is. He claims that divers who score significantly
higher than other divers on a test that measures "trait anxiety" are
potentially at greater risk of panic attacks while diving. Trait anxiety is
regarded as an enduring feature of an individual's personality, whereas
"state anxiety" is situational. Tests that measure anxiety, Morgan
says, make it possible to predict panic behavior in beginning divers with 88 percent
accuracy.
Should we be screening for these traits in divers? Most certifying agencies
require medical clearance prior to allowing an individual to start a
certification course. Should this now include a psychological profile?
Probably not. Divers in the study who were identified as being at higher risk
of panic attacks were not people with clinical mental illnesses, they simply
had a higher anxiety level than other divers. Excluding them from diving on
this ground would be extraordinarily difficult, if not illegal.
So what can be done to address the issues that Morgan raises? At the
professional level, instructors must be trained to recognize divers who exhibit
high levels of anxiety, and to recommend further training or deny certification
to these divers. On an individual level, divers must be aware of the risks
associated with diving and be able to make an honest assessment of their
personal anxiety level and how it might change in case of a high-stress
situation under water. Research such as Morgan's may eventually provide a tool
for divers to be able to assess their own risk for panic and for instructors to
know more about their students in relation to this often undiagnosed and
unrecognized problem.
There are
some under water situations that would cause any diver to panic. Turning around
to find yourself face-to-face with a great white springs to mind. However,
there are ways to minimize the risk of ending up in a situation that might
result in a panicked response.
