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Ten Questions and Answers about...
The Risks of Panic in Scuba Diving
An interview with Dr. William Morgan regarding his Sea Grant research on panic and scuba diving
by Phil Davis
How common is panic among scuba divers? | How big of a factor is panic in diving fatalities? | Is the tendency to panic restricted to novice or beginning divers? | What exactly is "panic behavior" by a diver? | Are anxiety and panic problems discussed in scuba diving instructional materials? | How do men and women compare on the incidence of panic behavior while diving? | Can individuals with high anxiety be trained in techniques that will reduce the risks of panic? | Are certain diving activities more likely to lead to panic episodes? | Can we predict whether someone will experience panic while scuba diving? | Should some people be discouraged from scuba diving?
How common is panic among scuba divers?
Dr. Morgan: More than half of the scuba divers in our study reported that they had experienced panic or near-panic episodes on one or more occasions.
How big of a factor is panic in diving fatalities?
Dr. Morgan: The cause of death in more than 60 percent of scuba diving fatalities is listed as drowning, usually caused by such specific problems as lack of air, entanglement (in fishing nets, rope or kelp), air embolism, narcosis — and panic.
However, when "lack of air" is given as the causal explanation, often other sources of air are available via buddy breathing or a pony bottle. Also, air embolism, a common cause of diving fatalities, may result from rapid ascent due to panic, and the inability to free oneself from rope, nets or kelp may also be caused by a panic response. Diving authorities generally agree that panic behavior is responsible for many of the diving accidents and fatalities that occur in recreational scuba divers.
Since 1970, the number of annual U.S. scuba diving fatalities has varied from a low of 66 to a high of 147. However, the total number of active scuba divers is unknown; estimates range from 1.5 million to 3.5 million in the United States alone. Therefore, valid estimates of risk using traditional methods are not possible. Fatality estimates range from a low of 2 or 3 per 100,000 to 6 to 9 per 100,000, depending on the number of fatalities and estimations of the number of active divers in a given year.
Moreover, most studies of diver fatalities define a diver as someone certified as a diver. This is problematic because some individuals (1) scuba dive, but have not been certified, (2) are certified and never dive, and (3) may hold as many as 25 advanced level certifications, with the result that such a diver would be treated statistically as 25 divers. And, risk estimates in this activity have not considered the fact that someone who dives once in a given year is treated statistically in the same way as a diver who makes several hundred dives.
Is the tendency to panic restricted to novice or beginning divers?
Dr. Morgan: No. Scuba divers with many years of experience sometimes experience panic for no apparent reason. One theory is that panic may occur in such cases because divers lose sight of familiar objects and experience a form of sensory deprivation. This problem has been labeled the "blue orb syndrome." However, in the case of inexperienced divers, there is usually an objective basis — for example, loss of air — for panic responses.
What exactly is "panic behavior" by a diver?
Dr. Morgan: In simple terms, panic behavior is when a diver behaves in an irrational manner. An objective, observable stimulus is usually responsible for this inappropriate behavior, such as the sudden appearance of a shark, loss of visibility, loss of air, entrapment in a kelp bed and so on. A diver might develop problems with his or her regulator and, because of the lack of air, perform a rapid ascent with resulting air embolism. This action would be judged as a panic response because the diver might have access to a pony bottle, or other divers might be present who could share their air supply and perform a gradual ascent. Eyewitnesses have reported accounts of divers removing their regulators while diving, an action thought to be caused by a perception of inadequate air.
Are anxiety and panic problems discussed in scuba diving instructional materials?
Dr. Morgan: No. Terms like "anxiety" and "stress" don't appear in the index of many books commonly used by national certifying bodies involved in scuba training. Panic, along with the problems that can occur in scuba diving as a consequence of panic, isn’t even addressed in these training manuals.
How do men and women compare on the incidence of panic behavior while diving?
Dr. Morgan: Surveys indicate that more men than women take part in scuba diving. One recent study of 245 scuba divers revealed that 71 percent of the respondents were men, and 29 percent were women. The incidence of panic was significantly higher in women (64%) as compared to men (50%). However, a greater percentage of the men (48%) than women (35%) perceived the events as life-threatening.
Can individuals with high anxiety be trained in techniques that will reduce the risks of panic?
Dr. Morgan: Apparently not. The use of interventions based on procedures such as biofeedback, hypnosis, imagery and relaxation in an effort to reduce anxiety responses in scuba divers exposed to various stressors have not been effective. Research has shown, for example, that hypnosis is effective in relaxing scuba divers, but it can also have the undesired effect of increasing their heat loss. Furthermore, relaxation is known to lead to increased anxiety and panic attacks in some "high anxious" individuals. This phenomenon is known as relaxation-induced anxiety (RIA). Individuals with a history of high anxiety and panic episodes should probably be identified and counseled during scuba training classes regarding the potential risks associated with this in diving.
Are certain diving activities more likely to lead to panic episodes?
Dr. Morgan: Yes. Diver panic is usually caused by such objective stresses as equipment malfunctioning, sudden loss of visibility, entrapment (for example, by seaweed or nets), threatening marine life like sharks, loss of orientation during a cave, ice or wreck dive, and so on. Therefore, diving with faulty or inappropriate equipment, or performing high-risk dives will have greater potential for panic episodes. However, it should also be noted that the problems resulting from high-risk dives can be prevented or minimized with appropriate training and cautionary actions.
Can we predict whether someone will experience panic while scuba diving?
Dr. Morgan: Yes. The psychological variable known as trait anxiety is regarded as a stable or enduring feature of personality, whereas state anxiety is situational or transitory. Individuals who score high on trait anxiety are more likely to have increased state anxiety and therefore panic during scuba activities.
Should some people be discouraged from scuba diving?
Dr. Morgan: Yes. It is clear that individuals who score high on measures of trait anxiety are potentially at a greater risk than those scoring in the normal range on this psychological variable. Of course, individuals with certain medical problems probably also shouldn’t scuba dive.
Dr. William
Morgan is director of the Sport Psychology Laboratory in the UW-Madison Department of Kinesiology. He is
the author of three books and more than 100 journal articles. He was founding president of
the Division of Exercise and Sport Psychology in the American Psychological Association
and is a former member of the Sport Psychology Advisory Committee for the U.S. Olympic
Committee. Morgan’s diver panic studies were conducted over
the last 10 years in a series of projects funded by the University of
Wisconsin Sea Grant Institute and published in the December 1995 issue of Sports
Medicine.
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Last revised
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© 1997 University of Wisconsin Sea Grant Institute
http://www.seagrant.wisc.edu/communications/diving/panic.htm