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B Y A D A M R O T H , M . D .
T
he task of assessing psychiatric fitness to dive
conjures the anxiety of a deep sea explorer sitting
upon the deck of her boat about to open a box of
unknowns as she eagerly wipes away the dirt, sea
detritus and rust. What will she find? Pandora’s box
or Blackbeard’s treasure?
For many years prospective divers with various medical
illnesses were automatically and often arbitrarily denied
clearance to dive recreationally. Fortunately, many divers
with diabetes, asthma, remitted cancer and other serious
medical disorders have now been able to partake in the
wonder of visiting the underwater world. Psychiatric illness,
unfortunately, often still mystifies evaluators seeking a simple,
clear algorithm to determine a candidate’s ability to dive.
As with so many medical conditions, there are no simple
answers when it comes to psychiatric fitness to dive. But we
can help divers and evaluators learn what questions to ask. It’s
a tall order and an exhaustive discussion impossible to cover in
the scope of a single article, so for now let’s review psychiatric
illness, its treatment and concerns about the safety of divers
who have been diagnosed or treated for such conditions.
The information provided will provide at least a glimmer of
illumination into what has generally been a stygian darkness.
A SIMPLE FACT
To start, major depressive disorder (commonly referred to
as “depression”), bipolar disorder (formerly described as
“manic depression”), generalized anxiety disorder, panic
disorder, phobic disorders, post-traumatic stress disorder
and schizophrenia are but a few illnesses now increasingly
understood to be medical diseases; in other words, they are
biological disorders. There are multiple statistical analyses
of data, including genetic, demographic and epidemiologic,
biochemical, neuroanatomic, neurophysiolologic and
neuroimaging data that demonstrate a high degree of
correlation between episodes of illness and biological findings
— correlations that differ from groups of individuals not
subject to the illnesses.
A LOOK AT
MENTAL HEALTH
AND DIVE SAFETY
Improved understanding
of psychiatric illness is
shedding new light on
dive fitness standards.
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