Understanding Diver Panic (.Pdf)

Understanding Diver PANIC By John R. Yarbrough, Ph.D Panic refers to a sudden and often unpredictable onset of intense, sometimes blinding, fearfulness or terror, usually associated with feelings of impending Photo William M. Mercadante doom. W e associate panic with a associated with a specific phobia, knowing when of if the symptoms number of physiological symptoms, such as a fear of sharks or a fear of will recur. such as shortness of breath, a feeling going too deep (called of not getting enough air, bathophobia). In these instances, Cognitive and Physiological palpitations, chest pain and fear of divers most likely avoid placing Symptoms of Panic losing control. Panic symptoms themselves in such situations so as At one time or another, everyone usually build to a crescendo in 10 to minimise the chances of an experiences mild symptoms of minutes or less. episode. anxiety. Perhaps the most common and familiar form is performance According to the DSM-IV (the Situationally predisposed panic anxiety or stage fright. People may American Psychiatric Associations attacks usually occur in the presence feel apprehensive or embarrassed Diagnostic and Statistical Manual of of a trigger: they do not always occur that all eyes are focused on them, Mental Illness, 4th edition), people in every situation, however, or they waiting for them to demonstrate a experience three major types of might not occur immediately. 0or particular skill. Often apparent in panic attack: example, an apprehensive novice dive training, this occurs when may make two successful dives to 10 students are observed practicing Situationally bound, or cued attacks; metes, but has an overwhelming skills such as clearing a flooded mask. Situationally predisposed attacks; & need to bolt to the surface on the Panic is at the far end of the anxiety third. Spontaneous attacks. continuum: it can be intense and overwhelming, overriding rational 0inally, a spontaneous panic attack Situationally bound (or cued panic thought. is not associated with any particular attacks) happen immediately after trigger and occurs out of the blue. exposure to, or in anticipation of, a Due to their unique environment, This is perhaps the most frightening situational cue or trigger such as divers may actually predispose type of attack and possibly one of seeing a shark or crossing the magical themselves to panic, especially in the more dangerous kinds. No one 18-metre mark into a deep dive. This emergency situations. The natural can predict the onset of panic form of panic is most often human responses to an symptoms, and there is no way of overwhelming sense of anxiety - the Alert Diver, SEAP 16 this time more deliberately, but without effect. You immediately feel that you are out of air, and the thought flashes through your mind that you are going to drown. Before your training kicks in and you reach for your octopus or back-up air supply, or before you signal to your buddy that you are out of air and take his or her octopus, your first impulse is to get out of the situation as quickly as possible. Your inclination is to hold your breath, believing you are conserving at least a partial lungful of air and kick for the surface. Unexpected is a significant factor here, for if you are expecting an emergency you can often look at it more clinically: i.e., responding to the situation rather than simply reacting. Note: this example of the malfunctioning regulator applies to any level of diver. It is merely an assumption that veteran divers do not experience any symptoms in similar situations. Practice and over- learning play important roles in how experienced divers respond in unexpected, emergency situations. This is one of the reasons that military divers train continuously and in various stressful situations. Photo William M. Mercadante Panic and perceives the threat and reacts by natural fight or flight responses to Personality actors which we are predisposed - are getting you ready for fight or flight. unsuited for coping with problems Your heartbeat accelerates and Several personality factors encountered in the marine perception narrows, blood is diverted contribute to a persons environment. from your internal organs to your predisposition to panic. Anxiety- limbs. Oxygen demand increases. prone individuals may set 0or example, your regulator This happens automatically and themselves up for panic by doing unexpectedly malfunctions at 20 involuntarily; you can do nothing to many things, including: metres. Your body immediately prevent it. You again try to inhale, 17 having the additional stress of Do you perceive an increase in your After this thought stopping, redirect diving in a new and unfamiliar place; heart rate? your mind to some other thought, trying to dive too deep; Do you suddenly feel tired, such as the head-to-toe equipment attempting to dive a profile to stressed, anxious? check. This technique serves two which they are unaccustomed; or purposes: it defuses the anxiety, and Do you have a bad feeling about task-loading themselves to the it reassures you that all equipment is the situation or dive? point that they are accounted for and thoroughly overwhelmed. checked and now re- checked. This affords you an Persons already suffering extra margin of safety and from an anxiety disorder, confidence to continue. It such as obsessive- also simply helps you to slow compulsive disorder, post- down and to concentrate on traumatic stress disorder something other than your (especially if the initial anxiety. trauma was marine-related) or a specific phobia, such as If this does not work nyctophobia (a fear of quickly, make a controlled darkness) or pnigophobia ascent toward the surface. (fear of not being able to Sometimes just moving up breathe) may be even more into shallower water can prone to full-blown panic help. If you do feel the need attacks. to surface, however, donÕt forget to make a safety stop. Note also that some medical There have been stories of conditions may predispose divers who have panicked certain individuals to panic. once at the surface, suddenly It has been suggested that believing that they would asthma, mitral valve immediately get decom- prolapse and thyroid disease pression illness by missing or may be contributing factors. cutting short their safety Use of cocaine, stops. Some, hoping to amphetamines or caffeine, Photo William M. Mercadante recompress, have even and withdrawal from alcohol compounded the problem by or other central nervous trying to descend while in a system depressants can precipitatePhoto a William M. Mercadante near-panic state. In his book The Gift of 0ear, Gavin panic attack as well. DeBecker discusses why we may feel Some individuals believe that in apprehensive, adding that too often order to understand panic you must Managing Panic In Yourself we cognitively override these experience it firsthand. Recall the One of the most important things feelings, ignoring the warnings our scene from Ridley Scotts 1997 film you can do toward managing anxiety bodies give us until we reach the G.I. Jane, when Navy S.E.A.L. is being aware of your internal state. point where irrationality and panic trainees were blindfolded and water Occasionally, run through a mental is imminent. Remember, it is never poured into their faces. The checklist: too late to abort a dive. command master chief instructed his crew: You need to know what it If you feel anxious, actively and feels like to drown in order to avoid forcefully tell yourself to STOP! Alert Diver, SEAP 18 panic and perhaps gain those few a situation only takes a few seconds, increased degree of comfort and seconds that just may save your life. but it could actually provide you with more freedom to enjoy the dive. that moment or two it takes to avoid While some extremists may embrace full-blown panic. Are you in adequate physical and this concept of fear management, it mental condition for diving? Have is not practical in you been out too late conventional dive training. partying and now have a Instead, one might consider hangover? Do you feel a technique called cognitive drowsy from the rehearsal, which consists of antihistamine you just playing What if? took for sinus problems or seasickness? Do you feel Ask Yourself Hard queasy from the boat ride Questions through unexpectedly What would I do if _____ rough seas? happens? 0or example: What would I do if my Is your training adequate buddy suddenly snatched my for the situation? How regulator from my mouth and experienced are you at began fighting toward the making night dives, dives surface? What would I do below 18 metres, or in if my weight belt caught on overhead environments? a piece of wreckage? Or my Have you acquired - and panicked buddy grabbed the do you practice - the inflator on my BC and I skills for self-aid or the suddenly found myself in an skills to assist or rescue uncontrolled ascent? or another diver? What would I do if I became entangled in kelp? What is your task load? Are you attempting to Photo William M. Mercadante Mentally walk yourself take photographs, count through an emergency. fish, stay off the reef, Rehearse a mnemonic for an watch your less- action: e.g., SA0E: Slow Ascent 0or Ask yourself whether you are experienced dive partner and keep an Exit. This is especially effective if prepared for the dive. Is your eye on your gauges all at the same you are already in a similar, but equipment serviced and operating time? presently non-threatening situation. correctly? Do you have a redundant Think about how to respond to a air supply, such as a pony bottle or What about environmental factors? diving emergency while you are Spare Airª system? Do you carry a What about currents, visibility and making a pool dive or hanging at your knife or shears to free yourself from temperature? Are you wearing safety stop.

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