Everyone at some point in their lives has experienced anxiety, panic, or fear. These are normal responses to a situation in which a person needs to be wary or in which a person's life or safety and well being may be in danger. However, there are many people who experience anxiety, phobias, and panic attacks on a regular basis. Anxiety in particular, is a response to a situation in which a person feels threatened in some way. This is normal and healthy most of the time. However, if the response lasts too long, either because the situation that prompted the response is ongoing or because the person cannot let go of the feeling, it can interfere with the everyday activities of that person. There are some individuals in which a feeling of anxiety persists with no known cause and this produces a feeling of dread and apprehension.
A panic attack is essentially extreme anxiety, when there is a sudden onset of fear in a person. In people who have extreme and unexplained anxiety, panic attacks may be frequent and intense. There is also the issue of phobias which is intense fear that is unfounded and is usually centered on something that most people do not find fearful. These phobias can play into anxiety and panic attacks. Regardless, anxiety is categorized in one of two classes. There is state anxiety, which is the short-lived anxiety that is brought on by a specific event or situation. Then there is trait anxiety, which is a psychological phenomenon that is a part of a person's personality and that is generally an ongoing feature in that person's life. There is a test that will help determine a person's level of trait anxiety and those who score high on this test are at greater risk for panic attacks when the same event or situation might cause state anxiety in another individual.
In terms of diving, anxiety is something that should be taken very seriously; especially when the anxiety is trait anxiety and particularly when it can easily lead to panic attacks. Panic attacks are extremely dangerous for divers and can often lead to death for the submerged diver. Panic attacks in the water often occur in instances when a diver feels threatened, such as the appearance of a sea creature, becoming entangled in fishing net or seaweed, or the dive mask filling with water. When a diver panics he or she often experiences irrational behavior that can endanger their own life and the lives of other divers as well. For this reason, a person who scores high for trait anxiety should not dive. It is also important to note that panic attacks are not restricted to novice divers and that plenty of highly experienced divers have had them for no apparent reason, although it is suspected that these panic attacks came on simply because they had become disoriented or had experienced sensory deprivation.
There are medications available for those who experience trait anxiety and panic attacks. Many of these medications are those that are also used to treat depression and include benzodiazepines, beta blockers, Celexa, Prozac, and Luvox. When a diver requires medication it is crucial that the potential side effects of that medication be considered as many times the side effects can increase the potential risks of diving. The medications used to treat anxiety and panic disorders have a variety of potential side effects, including drowsiness and dizziness. Beta blockers can cause dry mouth, which is not good for the diver as divers already breathe in a dry gas mixture which can lead to dehydration if the diver isn't careful. They also can cause low blood pressure and decreased heart rate, which may result in the diver not being able to handle the physical activity level required for diving. Celexa, Prozac, and Luvox can cause increased bruising and bleeding, which may increase the risk of barotraumas and hemorrhaging, and the latter two can also cause tremors. Some of these symptoms will go away with continued use.
If a diver is experienced and does not suffer from severe trait anxiety or panic attacks, then he or she may still dive. However, each case must be considered individually, including history of panic attacks and individual reactions to medications (if they are required) and their side effects. The time a person can remain anxiety-and-panic-free should also be considered. Any diver who suffers from increased anxiety and panic attacks should consult with a physician to determine whether diving is safe and should also inform the divemaster of the condition and of any medications required for treatment. This will help ensure that the diver with the anxiety condition as well as all other divers remain safe while submerged in the big blue.