A bad scare such as almost running out of air, witnessing
another person suffer a heart-attack underwater,
or even being incapacitated by severe leg cramps,
can make a diver hang up his or her fins forever. When
you've witnessed someone recovered from the water but
unsuccessfully resuscitated, the aftermath could make
you reassess whether it's worth it to keep on diving.
Experienced divers can sometimes underestimate the
stress a new diver goes through, and there are plenty of
divers who haven't been battle-hardened by the slings
and arrows of misfortune that await anyone involved
in this adventurous activity.
In short, we divers should be more aware of simple
post-traumatic stress disorder (Simple PTSD) that
can affect all of us, says James A. Lapenta, a veteran
dive instructor who runs UDM Aquatic Services in
Canonsburg, PA, and has created multiple technical
diving courses. Lapenta has also written two books
on diver training and safety, and in his most recent
one, SCUBA: A Practical Guide to Advanced Level
Training, Volume 2, he states that PTSD is a real
possibility for those who have just been involved with
a life-or-death situation in a recreational dive setting.
Accidents that seem to have only caused injury to a diver's ego may actually have deeper, more damaging effects on all divers involved.
Below is an excerpt from Lapenta's book about
The rescue/recovery of a human being is a
profound experience. Ask any firefighter, police
officer or EMT. Any of them will tell you honestly
that each rescue has an effect on them. That
even though they may have performed thousands,
there's often one that has affected them for
a long time.
Members of our armed forces were the first to
be diagnosed with PTSD. Previously it was called
"battle fatigue," "shell shock," or some other
term. Soon psychiatrists, psychologists and therapists
began to see the exact same signs and symptoms
in patients who had never experienced combat
or saw the effects of it. What they realized was
these people were experiencing the same effects of
PTSD as a result of having been involved in traumatic
events, or, in some cases, from witnessing
Whatever the cause, the result can be summed up
by saying that anyone involved in a serious rescue scenario with a fellow diver stands a chance of being injured by that scenario -- not physically injured, but
What we are talking about here is PTSD that
is brought on by a single event. Known as Simple
PTSD, it is a reaction of the subconscious mind
to a single violent or frightening event. For our
purposes, this single event is a diving accident.
It need not be a fatality or even a life-threatening
event to shock the system and produce signs and
symptoms of PTSD. Even an event with a successful
outcome can have long-lasting effects.
So, what are the signs and symptoms that
someone may be experiencing this?
Signs and Symptoms of PTSD
Repetitive Thinking: A frequent sign of PTSD
is repetitively thinking about the event. These
thoughts may suddenly come into your mind even
when you don't want them to. They may come
in the form of nightmares or flashbacks about the
event, and can result in inflated reactions at inconvenient
times. You may get upset simply by being
reminded of what happened. You may react when
someone mentions it, you see a picture of the place
where it occurred, or you see another person who
was there. You may also experience these episodes
in small snippets of the event. You may see the face
of the victim or others who were there.
All of these incidents have the potential to
occur at any time. These are normal occurrences
in the period immediately after the event, but
when they persist and interfere with daily life,
they need to be addressed.
Hypervigilance: Another common sign of
PTSD, this state of heightened alertness is brought
on by a mental injury. Many situations call for one
to be alert and watchful, but the person suffering
from PTSD is often like this constantly. They're
not able to relax, and the smallest disturbance can
create an overblown reaction. It may also lead to
dangerous situations when an overreaction to a
stimulus happens in a situation where that reaction
presents the opportunity for injury.
Anyone involved in a serious rescue
scenario with a fellow diver stands a
chance of being injured by that scenario
-- not physically, but mentally.
Insomnia: Thoughts and images of the event
may cause you to lose sleep or keep from getting
truly restful sleep. Insomnia may be a result of
seeing the event when you close your eyes, it may
be hypervigilance, or a reason you cannot identify.
In some cases, medication may help, but only
for a short time. Another common complaint is
that while you are exhausted and sleep for what
should be a sufficient period of time, you wake up
still feeling rundown and lacking energy.
Avoidance: You may find yourself going to
great lengths to avoid things that remind you of
the event; the location where it happened, the
people who were there, maybe even the activity
itself in extreme cases. Some people involved in
a diver rescue that did not have a good outcome
may go so far as to stop diving. If the events are
so traumatic and upsetting that recalling them detracts from the dive-planning process -- so that
diving itself now becomes unsafe due to inattention
to detail -- then perhaps it is for the best that
the diver stop diving.
Everyone knows and says it wasn't
your fault. You may be able to accept
that in your head fairly quickly. It's in
your heart that can take a long time.
Panic attacks: These appear as a feeling of
intense fear, accompanied by shortness of breath,
dizziness, sweating, nausea and a racing heart.
Other physical symptoms may be chronic pain,
headaches, stomach pain, muscle cramps or low
back pain. If you are able to recognize this occurring,
stopping whatever you are doing, closing
your eyes, thinking of a calm setting or relaxing
image, and breathing deeply and slowly may help
greatly. Another valuable technique is to assess
your current location. Look around, observe the
area, focus on a few items and decide if they
would truly be located in the place where you
experienced the event.
Feelings of mistrust: This wariness may be
directed toward strangers, friends, family, or the
world in general, and can result in feelings of
loneliness and isolation. In addition, you may lose
trust in people you know and look at the world itself as something to be feared. This may result in
errors in judgment or being overly cautious to the
point of inaction.
Chronic fatigue: Another possible sign that
something may be wrong, especially if no physical
cause can be pointed to as the source of your
feeling tired. It takes a great deal of energy to
maintain a hyper-vigilant state. Not being able to
rest or sleep only adds to that. The panic attacks
also use up valuable energy.
Guilt: Another possible sign of trouble is a
sense of guilt or responsibility toward others who
may have been affected by the event. You may
see yourself as being somehow responsible or not
having done enough.
Don't Say, "I Know How You Feel"
Instructors, divemasters, assistant instructors and
other professionals associated with the dive can be
especially at risk here. They may feel that this happened
on their watch, and while nothing they did
could have prevented the event, they still may feel
the need to make up for something. It may affect
how and whether they will ever teach again.
Everyone is different and will react differently.
But there is a huge difference in the theoretical
versus the real-life experience of someone who
has been through this. Those who have not experienced
this really have no idea how it feels, and
while support is appreciated, one thing to avoid
saying is "I know how you must feel." Because you don't. An injury or death where a student is
involved is like nothing you've ever experienced.
The diver may have been highly experienced
and very well trained. They had all the right
medical clearances. No one did anything wrong.
It wasn't even a dive accident as far as the medical
examiner and doctors are concerned. Everyone
knows and says it wasn't your fault. You may be
able to accept that in your head fairly quickly (a
few weeks, months maybe). It's in your heart that
can take a long time.
Why? Because you cared. You care about
other divers and it annoys you when you see
safety taken lightly. You have seen first-hand
how quickly life can be completely turned upside
down in every possible way, in a few seconds or
feet, and it seems that others don't get that.
Those are the feelings you need to be aware of
that can cause you to overreact or react too fast,
too slow, or not at all. So we need to be sure we
are ready before getting back in the water. That
may take a little time and require the help and
support of others we trust and can rely on.