Schizophrenia. Most people have heard the term, but how many really know what this disorder of the mind is? Schizophrenia is a very serious mental illness that affects a person's ability to connect their thoughts, feelings, and actions. Approximately 1 in 100 people are affected by the disorder and that means that there are many divers or potential divers who have or will develop this form of mental illness. Schizophrenia is usually diagnosed in a person in their late teens or early twenties, but the illness can begin later in life. It is unclear what causes schizophrenia, although it is thought there may be a genetic link in some people and for others drug use may be the culprit.
So what is schizophrenia exactly? Schizophrenia is a mental illness in which people experience what are called “positive” symptoms and “negative” symptoms. In reality, all these symptoms are bad. Positive symptoms often come in the form of hallucinations and delusions and a person can get thoughts in their head that appear to have been put there by some outside force. The person might hear voices, which is the most common form of hallucination, and these are often so realistic that the person truly believes that these voices are coming from outside themselves. These people also often suffer from delusions, which are beliefs that are generally unusual and false. These delusions can range from a simple belief that everyone is out to get them to the belief that they have been abducted by aliens. Negative symptoms generally manifest themselves in people as an emotional flat line, and they avoid people and conversation. Schizophrenia sufferers sometimes shout out at the voices they hear, are generally be difficult to understand, and occasionally attempt to hurt themselves or others.
People with schizophrenia were, at one time, hospitalized for life but now that there are medications to treat the condition, 25% of the individuals who receive treatment after their first episode have a good recovery and live a normal life. Approximately 60% to 65% of these people will have recurring episodes throughout their life, but in between these episodes can live a normal life. The rest of the schizophrenia population which is approximately 10% to 15%, will have ongoing issues will not be able to function normally.
The initial drugs, which were released in 1954 include clozapine and risperidone, and were designed to block the chemical dopamine and are able to address the positive symptoms only. These same drugs are known to cause Parkinson’s Disease-like symptoms which required individuals to also take anti-Parkinson drugs in addition to the drugs used to treat the schizophrenia. These older drugs, many of which are still in use today, also cause sleepiness, a slowing up of the body, and weight gain. Other potential side effects, depending on the drug, include seizures (in 1%-2% of patients), tiredness, dizziness, low blood pressure, increased heart rate, dry mouth, insomnia, and headache. Most of these symptoms are mild and disappear after a few weeks on the medication. However, they can all affect diving and should be closely monitored. Fortunately, there are newer drugs out today, such as olanzapine, that are designed to block different chemicals and these work to address the positive and negative symptoms. The side effects of these newer drugs, while similar to the old ones, are far less likely to rear their ugly heads. All types of schizophrenia drugs often require many people to take the drugs for years and, in some instances, their entire lives.
So what does all this mean when it comes to diving? Well, while most people with schizophrenia should not dive, each individual should be considered on the merits of their own personal situation. If a diver’s case is mild, they have responded well to medication, and they have been free of the disorder for a long time, then they may be able to dive, provided that they can cope with the physical demands of diving and that their decision making capabilities have not been compromised. All divers with schizophrenia should inform the divemaster of their condition and all medications they are currently taking. Those divers with schizophrenia should be monitored for signs, including the inability to make decisions, paranoid behavior, and unusual ideas to help avoid complications underwater. For those who can dive safely with schizophrenia, the great wide ocean is waiting for you to take the plunge.