Panic Attacks While Scuba Diving

A second lieutenant ripped her respirator mouthpiece, making it inoperable, when she panicked during a dive. She blacked out 30 feet from the surface. (Photo by TSgt Samuel Bendet)

Panic is one of the leading causes of death for scuba divers. The death certificate may say drowning, however, in many cases had the diver not panic they would have likely survived. Over 20% of deaths are directly attributed to panic and another 23% list panic as a contributing factor. A DAN report cites a survey that showed 3,300 divers out of 12,000 surveyed reported at least one panic episode and cites another survey that shows 50% of divers have experienced a panic episode or near panic episode. The fact they took the survey shows that having a panic attack does not mean you will die. You may feel like you will, but you can recover.

Another survey among experienced active divers showed that 20% of them had a panic episode or near panic episode within the last two years. Sadly after 18 years of diving and near 600 dives, I am one of that 20%. Happily, I am still here to tell about it.

A Dive Gone Wrong

This is not to the intensity of the lesson for life articles, still, it did give me a great deal to think about. It is about a number of small things that ended up going nearly out of control. It has been about 5 months since my last dive. A minor eye operation kept me out of the water for a few months and during that time I relocated from the tropical paradise of the Philippines diving Subic Bay and the South China Sea to upstate New York near the shores of Lake Ontario a Great Lake and the 14th largest lake in the world. The Great Lakes due to their size and weather patterns are considered some of the most dangerous waters in the world for shipping. Some family commitments, a delayed dive season and a few other issues added a few months of not diving after my arrival.

As I finally arrived at the marina to meet the divers from a local dive center for our dive I was looking forward to the dive. I did have three small concerns for the dive.

First and foremost was my mask. Because of my eye operation, my eyesight in one eye had changed. That meant I had to change the lenses for that eye in my mask. I ended up buying a new mask and adding one of my old lenses into it and leaving the other with the standard lens. While the mask seems okay at the surface allowing me both distant viewing and close up, I had not tested it underwater and at pressure.

Second was that I would be wearing a rental 5mm wetsuit. I wear a 3mm shortie when I dive. I do not like long sleeves, and the only time you will see me wearing a long sleeve shirt is at a more formal event. Those happen only one or twice a year. The 5mm suit fit well, but did feel less comfortable than my normal wetsuit. My movements seem stiffer. Of course, I felt like a novice when I tried to put the suit on wrong. The 5 zipped in the back and my 3 zips in the front. I became a little irritated at myself because of that mistake.

The third was the dive conditions. My diving has been tropical and seldom below 80° f. We were expecting around 70° f, a big difference and the reason for the thicker wetsuit. Visibility in Lake Ontario is never great but can drop to just a few feet. I was not overly concerned about either the temperature nor the visibility. The water temperature would be new but I am used to low-vis.

When I arrived on the boat and set up my gear everything seems fine. However, when I turned on my dive computer with its integrated air to check the tank pressure I saw that my battery level was down to 79%. This was shocking as they were newly charged batteries and I had checked the charge level just a few hours before and it was 100%.

Because the lake was smooth and the weather great, the dive site selected was a coast guard landing craft that had sunk in 70 feet of water. It was a forty minute boat ride and I found myself not relaxing. I was upset at myself for looking like a fool with the wet suit and was puzzled by the low battery reading.

The Dive Itself

When we reached the dive site, I gather the weights I would need for my dive. I generally dive with about 20 pounds of weight but since I was going up to a 5mm full suit I added an additional 4 pounds. I had problems fitting the weight pockets into my BCD with the extra weights, it felt like I was all thumbs. Finally giving up, I added the extra weight into the BCD pockets. My frustration seemed to elevate a little more. With everything ready, I turned the dive computer back on only to find the battery was low. A quick check in my dive bag showed that my save a dive kit was not there. I had removed it when I was flying to my carry on bag and forgot to return it. It had extra batteries and my back-up dive computer. It was time to cancel the dive. I told the dive leader, I was canceling my dive because of my computer. He had an extra computer and regulator on board so we just swapped out my gear.

Ready to get in the water, I went to inflate my BCD using the power inflator and it filled slowly. It inflated when I did it orally so decided to go anyway. If needed I could do an oral inflation, it is a skill I do practice. My dive buddy was a dive master who was just about finishing his instructor training.

The giant step off the bow was fine and the shock of the cold water wore off fast. After a minute or two, I did a final check of the straps and my dive buddy and I descended. Things started to go wrong almost immediately. When I flipped to a horizontal position to start descending, the cold water on my face took my breath away. I could feel my diaphragm tighten up and my breathing was irregular. At the same time, I was sinking fast, much faster than I was used too. Pushing the power inflator had no effect. I needed to clear my ears and experienced a mask squeeze at the same time. I was able to clear those two problems, flair my body some and slowed my descent. When I reached the bottom, My breathing was very fast, I felt I was hyperventilating. I could feel the panic starting to set in. My thoughts were I needed to get back to the surface before I passed out. I knew if I did pass out because of hyperventilating there was no chance I would make it to the surface alive.

While those thoughts were raging in my mind, I was still trying to add air to the BCD with no results. Trying to orally inflate the BCD did not seem to be an option as I was still not breathing well. I signaled to my dive buddy that I had problems. The first thing I did was pass over to him some of my weights. I will say, I was still near the panic stage and had no idea where the anchor line was. Also while my breathing had slowed slightly it still was not under control. I signal to return to the surface and together we went to the anchor line. After starting up, using the anchor line to help me ascend, my breathing slowed enough to add some air to my BCD. There must have still been having some tunnel vision, as after the dive my dive buddy said I started to ascend much too fast. I never saw any warning of that on the dive computer. I did notice the safety stop on the computer and followed that. By then the near panic was gone and I even spent a few extra minutes at the safety stop.

Looking back, I should have canceled the dive. The inflator problem should have been the final straw. The anxiety I had been building up, being upset with myself because of trying to put the wetsuit on backward and the rapidly discharging batteries set the stage for a bad dive. Not diving with my own computer was another factor. Had the power inflator failed while my breathing was normal, I could have used the oral inflator. The total of things was just too much. There was another item that amplified the buoyancy control problem and accelerated the problems. A mistake on the surface the day before the dive. I was about 10 pounds over weighted. While Lake Ontario often has ocean like conditions and eventually empties into the Atlantic Ocean, it is, in fact a fresh water lake. I did not make a weight adjustment from salt water to fresh water.

Signs of a Panic Attack

Doctors tell us there are certain signs to look for to recognize anxiety, panic, and near panic conditions. Some of these are not observable in the water.

  • Rapid breathing or feeling like you can’t get enough air.
  • Rapid heart rate, palpitations or heaviness in the chest.
  • Irritability
  • Gastrointestinal distress, “butterflies,” nausea, vomiting or diarrhea.
  • Muscle tension, headache or tremors.
  • Trembling voice or inability to speak.
  • Sweating, chills or hot flashes, feeling out-of-control or impending doom.

While diving, hyperventilating is one sign that a diver may be near panic. Watching another divers air bubbles will show the breathing problems. Also look for jerky movements, a diver may have tunnel vision and look around rapidly to see what around them. A panicked diver may act in a manner that is unreasonable. The desire of ripping out the regulator and bolting to the surface is common.