ADD/ADHD is a brain disorder that results in the inability of a person to maintain attention to a task and in some cases individuals are also hyperactive and impulsive. Those who have ADD/ADHD are usually diagnosed in childhood and the disorder often becomes milder as a person ages. While many believe this disorder is over-diagnosed these days, ADD/ADHD is a condition that is common enough to warrant a discussion for divers as the symptoms of the disease and the possible side effects of medications can pose potential risks for the diver and for the diver's buddy and anyone else with whom the ADD/ADHD diver is diving with.
First let us discuss diving as it relates to ADD/ADHD itself. Anyone who has trouble focusing or paying attention to detail for any length of time should not be allowed to dive regardless of whether or not they have ADD/ADHD. Those divers in training who make careless mistakes, who do not sustain their attention when it comes to completing tasks, and those who do not follow through with the instructions they have been given should be closely monitored because this inability to focus and function can be fatal on a dive. Any individual who has these issues and who chooses to dive is at risk of endangering their own life as well as the lives of his or her buddy and anyone who must help in a rescue attempt. Unfortunately, any individual who wishes to become a certified scuba diver must be turned away if they have moderate and or untreated ADD/ADHD, which sadly includes many teenagers who want to learn to dive.
Now let's discuss the medications that are generally prescribed to people who have ADD/ADHD. The most common medications used to treat this disorder are Ritalin and Adderal, Clonidine, and Zoloft. Ritalin and Adderal have possible side effects that are relevant to divers, including cardiac arrhythmias, a false sense of safety and well-being, and irritability and nervousness. There is also the potential for seizures with these medications, particularly for those who use Nitrox while diving. Clonidine may cause drowsiness, dizziness, weakness or fatigue and can also cause low blood pressure and cardiac arrhythmias. Finally, Zoloft’s side effects include dizziness, drowsiness, anxiety, headache, tremors, fatigue, and weakness. Any of these side effects can cause major problems for a diver while underwater, impeding their ability to function efficiently and in some cases increasing the likelihood of injury and illness.
The question remains as to whether individuals with ADD/ADHD in general should be able to dive. While many teenagers have been turned away due to their condition, these were generally those whose condition was severe enough to warrant the use of medication to control the disorder. There are some basic guidelines for divers with ADD/ADHD, including the need to get medical clearance from a doctor. After a medical clearance is granted, ADD/ADHD divers will be restricted to diving to a maximum depth of 12 m (40 feet). While ADD/ADHD can be extremely severe, to the point of making it impossible for a diver to multitask, in many cases the disorder is mild and does not greatly affect the person's ability to perform. The key is to assess each diver on a case-by-case basis, looking at not only the person's level of physical fitness, but also the person's past performance in other areas of life, such as in school, work, and social settings and even other areas of athletic performance. If a person has been able to function well in these areas, then diving should pose no additional concern.
ADD/ADHD can profoundly affect a person's life at work, at school, and at play. However, most of these situations, while difficult, are not life threatening. This is not the case with diving. When a diver cannot perform to his or her fullest, this not only puts their life in danger, but also the lives of other divers in the water. A diver must have the energy and presence of mind to perform multiple tasks regularly and simultaneously along with the ability to handle emergency situations. If this is not possible, then the diver should not be diving. All ADD/ADHD divers should examine their situation very carefully and should consult a doctor if they are unsure as to whether their condition is severe enough to prevent them from diving. ADD/ADHD divers who are able to dive, must undertake some general safety precautions to ensure that all involved remain safe and sound while exploring the underwater world.