Psychological fitness to dive

Fitness to dive is important

We can understand that physical fitness to dive is important because we know that our bodies will need to be able to cope with some stresses, like the pressure on our ears at depth, or the effort of our heart in swimming against a current.  Staying physically fit-to-dive is essential. But how often do we consider psychological fitness-to-dive? Because it is equally important!

Think about the demands of scuba diving to:

be aware of what is happening, pay attention to air supply and depth, remain calm and alert, think clearly about what we are doing, respond to stresses and problems, learn new skills, recognise narcosis, deal with social pressures, and say no …

Being a scuba diver requires psychological fitness-to-dive, as much as physical.

It is for everyone!

We all need to be fit-to-dive, whether we have a specific condition or not. Our fitness-to-dive can be influenced by everyday factors: fatigue, lack of sleep or stress  …   a bad day or significant life events   … all our health varies. 

You may not have a mental health issue, but you can still have a few off days.  Just like if we have the common cold for a few days.  And just like a cold, it may mean canceling dives.  When we talk about “psychological fitness” it is important to remember that covers as wide a range of issues as does “physical fitness”. 

Psychological conditions and psychiatric diagnoses

Awareness of our mental health and the need to take care of it is growing.  There are also more and more people reporting conditions like depression and anxiety. The list of diagnoses is growing and a greater number of people are receiving these labels.  This means that there are now more divers than ever with some form of psychological condition or psychiatric diagnosis.

Mental health issues and their impact varies on a continuum from mild/infrequent to severe and chronic.  Consider the impact of your condition on function.  Mood, awareness, concentration and decision making ability can be affected, and so there are risks that need to be considered when diving mental health conditions. Important to seek medical opinion regarding fitness to dive, and plan how you will recognise when you are not fit-to-dive.

However, there is also research looking at the therapeutic benefits of scuba diving.  Where divers have specific physical or mental conditions, then adaptive approaches may be appropriate in order to provide necessary support and safety measures.  An increasing number of organisations provide this. Whether someone is able to access diving safely via usual routes or requires more specialist support will depend on each person and their condition(s).

Medications and other substances

Substances such as medication and other drugs may have a range of influences on mood, behaviour and thinking ability.  Some have physical effects, such as drowsiness.  Some have psychotropic effects that change behaviour, for example by altering inhibitions.  In addition, medications are not tested for use under water, where physical differences in the environment (e.g. pressure) may have an effect on how they work.

If taking any medication, talk to your doctor or pharmacist about the suitability for scuba diving, in many cases talking to a doctor with specific expertise in diving would also be recommended.

Other substances such as alcohol and illicit drugs are known to alter physical, mental and emotional state and therefore present vari0us risks in diving.  Alcohol and illicit drugs should not be used when scuba diving.

Psychological competence and capacity

Psychological competence to scuba dive is one aspect of fitness-to-dive. Psychologically competence to dive depends on our ability to “self-regulate” our emotions, thoughts and behaviours.  In order to do that, our neuropsychological function needs to be intact.   We also need to have the capacity to learn the skills for safe diving. 

Self-regulation and psychological fitness-to-dive

In an extreme environment we need to have the ability to regulate our responses to stresses and problems.  Intense emotions and mental distractibility may pose a risk to safety.  Self-regulation means that we can (roughly) keep ourselves calm and focused, and have some ability to manage attention and remain aware.  We all vary in this at times!

However, there are conditions that involve severe difficulties with self-regulation.  For some people, when we take into account issues such as psychological competence and ability to self-regulate, scuba diving may not be an appropriate activity.  Or, perhaps only with support , within a specialised organisation.

Motivation to address fitness to dive

Taking care of psychological wellbeing is as important as physical health.  If you have a specific condition that may impact on your psychological fitness-to-dive, then seek help and address it. There are plenty of evidenced-based therapies such as CBT and EMDR.  What better motivation that getting back in the water when you feel better. 

Scuba diving, is a great reason to stay psychologically fit.  For most people, that may be simply about balancing rest and activity: getting enough sleep, time to relax and exercise.  Connection to friends and family is also important for well being.  Diving can actually help with all of these activities!