I practice psychiatric medicine and am a Vietnam combat vet (101st Airborne Division & 173rd Airborne Brigade; 06/68-09/69).
Per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (DSM-IV-TR), 17 possible symptoms that can develop following the experience of a traumatic event are divided into three clusters:
I. Re-Experiencing Symptoms
-Frequently having upsetting thoughts or memories about a traumatic event.
-Having recurrent nightmares.
-Acting or feeling as though the traumatic event were happening again, sometimes called a "flashback."
-Having strong feelings of distress when reminded of the traumatic event.
-Being physically responsive, such as experiencing a surge in your heart rate or sweating, to reminders of the traumatic event.
II. Avoidance Symptoms
-Making an effort to avoid thoughts, feelings, or conversations about the traumatic event.
-Making an effort to avoid places or people that remind you of the traumatic event.
-Having a difficult time remembering important parts of the traumatic event.
-A loss of interest in important, once positive, activities.
-Feeling distant from others.
-Experiencing difficulties having positive feelings, such as happiness or love.
-Feeling as though your life may be cut short.
III. Hyperarousal Symptoms
-Having a difficult time falling or staying asleep.
-Feeling more irritable or having outbursts of anger.
-Having difficulty concentrating.
-Feeling constantly "on guard" or like danger is lurking around every corner.
-Being "jumpy" or easily startled.
Clearly many of these could pose a significant danger to diving.
All divers must show attention, concentration, decision making capacity, impulse control and behavioral modulation that are fully adequate to meet the demands of scuba. These faculties may be compromised in persons diagnosed with PTSD and treated with mood stabilizers such as the SSRI citalopram (Celexa) and the anti-convulsant divalproex sodium (Depakote).
Before returning to SCUBA, it would be prudent that: (a) mental status examination demonstrates the condition(s) to be well controlled; (b) the diver who is taking medication(s) has been on them for an extended period and side effects dangerous to scuba are neither reported nor observed upon careful examination; (c) there are no other contraindications, mental or physical, in the clinical picture; (d) the diver feels he is up to it and fully comprehends any additional risks; (e) the diver has been cleared for diving by his physician and makes full disclosure to the dive op (which likely will want to see written clearance) and to his/her dive buddy.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such. Consult with your physician before diving.