2. Detecting and Dealing with Stress

Stress is a potential risk on almost every dive we make. Some of the more obvious examples are time-pressure stress from having a limited air supply, task-loading stress from needing to do a number of things simultaneously and compound stress, which is what happens when a number of stressful factors coincide.

In scuba diving, stress is particularly unwelcome as, if it is not controlled, it can very quickly lead to panic and when we panic our untrained responses usually make the situation worse rather than better. Panic is always life threatening when it occurs under water and is the most common contributing factor to diving fatalities.

A classic example is the nervous diver who is worried that his regulator will not give him enough air. He gulps greedily when inhaling but only partially exhales before trying to take the next breath. Eventually, he finds it impossible to breathe in because his lungs are still full but, instead of breathing out, he concludes that his regulator has failed, tears it out of his mouth and bolts for the surface, holding his breath.

To deal with stress you must first recognize that it is present and to do this you need to be both aware of the signs and in tune with what your mind and body are doing.

Indicators of stress include clumsiness, delayed response, disorientation, fixation on gauges, an increased breathing rate, irritability, tension, unease, and unusual anxiety or apprehension. Be conscious of your mood and remain objective so that you interpret it correctly. For example, if you begin to find something your buddy is doing intensely annoying, it is far more likely that you, rather than your buddy, are the one with the problem.

Once you have identified that stress is present, your intuition will tell you that there must be a logical reason for it. That is to say, because you feel worried, you must therefore have something valid to worry about. This is, of course, not always the case. An increased breathing rate accompanied by a feeling of unease or apprehension can simply be a result of a build up of carbon dioxide in the bloodstream following a hard swim against a current.

The secret to coping with the onset of stress underwater is to clear your mind, analyse the situation and then act according to your training.

To clear your mind, stop all activity; grab a rock, (making sure first that it IS a rock,) and rest. Exhale slowly and completely, compressing your diaphragm to expel as much CO2 laden air from your lungs as possible then inhale fully expanding your diaphragm. Do this a few times.

As your brain clears you will be able to work out what is going on. Do you have any valid reason to be worried? Is there any urgent need for action? Look at your pressure gauge and make sure you have plenty to breathe. Check your decompression status or no-decompression time remaining. Run a quick check over your dive gear to make sure everything is in place and working.

Then act. If you have plenty to breathe, are comfortable with what your computer is reading and all your equipment is functioning correctly then you may just choose to continue your dive, reducing your effort so the panic does not return.

If you are low on breathing gas and/or have exceeded your planned decompression status then your priority will be to make a controlled ascent to a shallower depth.

It is always wise to take a moment to gather your thoughts before you act to make sure that you are about to do the right thing. However, taking too long over this process when you are deep underwater can exacerbate your predicament due to the limits of your air supply. Therefore your thinking time is equally limited.

This is the main reason why it is important to practice emergency and self-rescue skills intensively to the point where your response to an emergency will be automatic, instinctive and appropriate.

Technical divers constantly practice gas sharing and switching between their primary and secondary regulators. Their responses are so conditioned that if a real-world emergency takes place and an out-of-air diver grabs the regulator they are breathing from, they will automatically switch to their back up regulator before they are intellectually conscious of what has happened. The emergency is over almost before it has begun.

Anticipation

The most effective way of dealing with stress is to anticipate it or spot it in the early stages so you can act decisively and nip it in the bud before it escalates into panic. Therefore you need to be constantly alert.

Professionals are not only required to monitor their own status but also learn how to identify the signs in others. This skill is sometimes acquired through bitter experience. At least once in our careers most of us have experienced that heart-stopping moment when a diver in our charge suddenly bolts for the surface. Yes, it is true that certified divers are ultimately responsible for their own safety whether a divemaster is present or not but nevertheless, we mentally kick ourselves for not having seen that the diver had a problem until it was too late.

In the following two case histories, the divers concerned recognized that they were suffering from stress but did not fully appreciate the potential consequences. Fortunately, both events took place in a training scenario so an instructor was there to over-ride their instincts and anticipate the threat on their behalf.

Case History #1 Anxious Andrew

“I was one of three students on a deep diving course. We had spent a long time discussing the dive plan and were all looking forward to it. We descended quickly down the reef wall but when we arrived at depth I felt uneasy. I was breathing more quickly than normal and I became anxious and disorientated. My instinct was to abort the dive but I didn’t want to let down my instructor or the other guys in the class who had spent so much time preparing so I decided to tough it out and when the instructor signalled OK? I just responded OK. However, instead of moving on, he looked at me for a few seconds with a quizzical expression in his eyes then collected us all together and signalled up with his thumb. “

 

“I felt an immense sense of relief but when we arrived back in the shallows at the top of the wall, my mind cleared, my anxiety disappeared and I felt terribly guilty at having spoiled the dive. So I signalled to the instructor that I was happy to go back down again but he shook his head and we spent time in the shallows instead running through skills. The deep dive was rescheduled for the next day and everything went fine.”

 

It is possible that had the group remained at depth on the original deep dive, the affected diver’s mind would have cleared after a few minutes and the dive would have gone smoothly. However, once the instructor noticed that one of his students might be on the verge of panic, he assessed that, given the relative inexperience of the group, there was a high risk that keeping them at depth would cause the situation to escalate rapidly. His prompt action defused the situation immediately, ensured there was no escalation and completely eliminated the possibility of a host of adverse scenarios. The diver himself was aware that he was compromised and should abort the dive but decided to carry on and accept the additional risk in order not to disappoint the other members of the team. He was unaware that he was suffering from perceived peer-pressure stress as well as his other symptoms and this one additional factor could have led to disaster, had it not been for the instructor’s intervention.

Case History #2: Bad News for Ruth

“I was at the dive centre with my buddy preparing our gear for the final dive in our TRIMIX course when one of the divemasters arrived with the news that a diver that we knew from another dive centre had died in the recompression chamber following an incident that had taken place the day before.”

 

“On the boat, the news was playing on my mind but I told myself not to dwell on it as I had to concentrate on the forthcoming dive which would be our first to 90m (300ft.) On arrival at the dive site, we saw that a strong current was running and that it had carried the buoy, which was to be our ascent platform, underwater. I glanced at my buddy and he looked concerned. It felt like everything was conspiring to prevent us doing this dive but it was the last day of our course and we would be flying out the following night so we were going to have to do the dive now, whatever the conditions.”

 

“Our instructor came over as we were changing into our wetsuits and asked if we would mind postponing the dive to a future trip, given the circumstances. I almost cried as a strange combination of emotions flooded through me all at once, including grief for the diver who had died and also relief that we were not going to dive today. In the end, we rearranged our flights and enjoyed a perfect 90m (300ft) dive a couple of days later.”

 

The instructor could not have known for sure how the news the students had received would work on their minds at depth. He did know, however, that the fact that they were undertaking a big dive would already be creating a certain level of anxiety, and that a strong current might lead to additional task-loading. Aborting the dive before they had even entered the water made absolutely sure that what seemed like a steadily cumulating series of stressors did not result in a tragedy. Even though the diver correctly identified a number of the indicators, the diver mistook the time stress created by their flight plans for the next day as a factor...