After a scuba diving accident or incident

Information about the psychological impact

This page is intended to inform divers of options for support and self-help for the mental and emotional impact after a scuba diving accident or incident. This may include people who have been hurt or otherwise directly involved, rescuers or bystanders. The information here is based on the assumption that the diver has received or is receiving appropriate medical care for physical injuries and diving-related illnesses arising from the trauma; or was not physically injured. The information is also oriented to UK-based divers. The information is provided by Dr Laura Walton, Clinical Psychologist / Scuba Diving Instructor specialising in Diving Psychology. There are links to find out more or book services, as well as setting out options for support and basic self-care measures. If you would like to speak to Dr Laura Walton about the services to help with post-trauma or other concerns after a scuba diving accident or incident, use the button to book a videocall.

Self-Help

We are working on a free self-help guide on ways to help yourself or a buddy following a significant (traumatic) event in scuba diving. Here are some brief "dos and donts" for divers who have been involved in accidents, incidents or other distressing situations. If signs/symptoms of physical injury or illness, seek medical attention.

  • REST & SLEEP - Traumatic or distressing incidents stimulate activity and bodily processes that deplete energy. It is not unusual, after the initial shock, to feel tired. Seek somewhere you feel safe and supported. Rest and, over the next few days make sure to get enough sleep.

  • AVOID OR LIMIT ALCOHOL - Wanting to drink alcohol after a stressful event is understandable. However, the brain and body need to process what happened and alcohol can stall that processing. It can also increase risk of further harm via accidents or by impairing mental health in the long run.

  • TALK - Talk to people who can understand and listen. Talking through the event is part of helping your mind to process it. Consider talking with a friend while walking, as the movement can aid processing. Who you speak to is your choice. Be aware that some people may react strongly to your story, and this may not be helpful. If unsure, consider contacting a professional listener, like a therapist or mental health support line.

  • TIME-OFF - Depending on how you feel, consider taking time off work. Immediately after a traumatic event, memory, concentration and energy levels may be affected, which could impact you at work. If you are unsure whether you are fit to work, talk to your GP.

  • DIVING AGAIN - Consider taking a break from diving, at least not diving the same day as a significant distressing event. If you are medically fit to dive, and want to dive, make sure to take it easy for a while, doing more conservative dives for a while and building-up gradually to your usual level. If you are experiencing stress, anxiety or panic when diving, it would be advisable to stop and seek help. Not only is there a risk to immediate safety, by repeatedly diving while distressed, the problem may become more entrenched and take longer to fix.

  • ALLOW TIME - Processing and healing from what happened can take time. Nightmares, anxiety and low mood are common reactions for a few days, and do not mean that you are ill. If these continue, seeking professional help is advised.

When to seek professional help after a scuba diving accident or incident

If you are physically unwell or injured, it can be obvious that medical assistance is needed. But what about for psychological injury?

Maybe you were not physically hurt and struggling to understand why you are having a hard time. If you are not feeling right after a scuba diving accident or incident, consider seeking professional help straight away. This is the case whether you were hurt or not, and whether you were a victim, rescuer or bystander. In the UK there are guidelines to indicate what therapy is offered. In some cases, a doctor is likely to advise "watchful waiting" where you check in later and ensure you are recovering. They can provide information about what to expect and monitor in case you need more support. Guidelines indicate psychological therapy if the issue has not been resolved within one month. There has also been recent research showing that EMDR (eye-movement desensitization and reprocessing) is effective immediately after an incident: supporting the nervous system's natural healing processes.
help after scuba diving accident or incident

Where to access psychological therapy & support

Recommended options for post-traumatic stress, stress injury, anxiety or other mental health concerns due to diving trauma are similar to those for people who have had an accident / incident in any other area of life (e.g. road traffic incident, assault, severe illness). You may also want to consider how important it is to you that the healthcare professional understands scuba diving.

  • NHS

    In the UK psychological therapy is available via the NHS, accessed via your GP. If you have received care from a diving doctor (e.g. recompression therapy), and have signs/symptoms of PTSD or other mental health issues, the diving doctor may include this in the referral to your GP. Your GP then provides follow-up care & further referral to local mental health. To our knowledge, there are no specialist Diving Psychology services via NHS.

  • Health Insurance

    Private Health Insurers will often cover psychological therapy for post-traumatic stress and other mental health issues. You may need a formal diagnosis of PTSD to access therapy. You would need to check with your provider whether or not you are able to claim therapy sessions; and whether their providers have expertise in diving.

  • Self-Funding

    If self-funding is an option for you, access a therapist / psychologist in private practice. This option often opens more options to access a therapist of your choice. You can also access private therapy without a diagnosis (e.g. concerns that are specific to diving, prevention and improving skills). Therapy can be within practice or remote, online.

Diving Psychology Services

How can I help?

If you are not sure, book a free video call and I will see what I can suggest. The purpose of these calls is to meet and find out whether the service is helpful for you, with the view to booking self- or insurer-funded sessions. However, I will also let you know about other options and resources that may be helpful.

FAQ

  • I am experiencing nightmares and/or panic episodes, is this normal?How long should I wait before therapy?

    Following a traumatic event, it is not unusual to experience a range of issues including stress, tension, numbing, switching off, sleep disturbance, anxiety & panic. This can be part of normal processing and will often improve. Opinions vary on how soon trauma-focused therapy should be offered. On the one hand, naturally-processing does occur and many people will feel better with talking to friends and some rest. On the other, this can also risk the trauma being avoided, unprocessed and getting stuck. It then stays in the nervous system, potentially triggered by events that connect to the original trauma. Repeat triggering increases the risk of retraumatization and also generalising to other situations. A bit like if you have a broken leg and keep walking on it. Interestingly,r ecent research with EMDR has been showing that shorter, earlier interventions have been helpful. Psychological assessment and formulation (1 to 2 sessions) can make a big difference in understanding and processing what has happened. There are also options for ways to cope that support people to respond to their experience in more helpful ways.

  • What if I feel guilty and blame myself for what happened?

    Guilt, shame and blame are common responses when something goes wrong. This is likely more intense where someone was injured or died in a diving incident you were part of. Sometimes what happened can link back to older traumas and things we do not like about ourselves, and this tends to awaken old shame, guilt or fear. Often this is the case when someone cannot let go. It may also be that mistakes were made, and evidence that you or your team/group were at fault. This adds more pressure and can make it harder to move on. However, it is also useful to be aware that guilt and shame are often part of the post-trauma profile, even when someone did all they could. Either way, if you find guilt and self-blame are weighing on you, it would be advisable to seek support. Therapy can help you to process what happened, and reflect on the reality of the situation. It can also help move past holding on to guilt to learning from what happened and making changes.

  • Would it help to go for a few drinks with dive buddies?

    Heading to the bar or having a few drinks post-dive is part of diving for many people. So meeting up for a few drinks, to get back to normal and forget about what happened may be tempting. There are several reasons that it may not be the best idea though. During a stressful event, the brain processes information differently. You may even have noticed thoughts that you just could not deal with at the time because you were too busy being rescued or rescuing someone. At the time, it may have got shoved into the temporary storage of your nervous system. After the event it needs to be processed: thoughts, feelings, emotions, actions, images sorted out and filled away in memory. Alcohol tends to prevent that processing because it numbs. It can slow down the healing process. In addition, trauma affects emotions, you may feel angry, guilty, anxious .... alcohol can exacerbate that. There is also a risk of drinking to excess, and potential for further stressful events arising from that. Consider getting together with buddies or club, if that feels right, but without the drinks.

  • How long will it take me to get over this?

    The honest answer is that it depends. It depends on what your current issue is and how it has developed. It depends on how much support you have. It depends on how much stress you are currently under. It depends on your coping style and the strategies you use to respond to psychological pain. It depends on what you do. Everyone is different. Some people may have fully processed and integrated the event several days after it happens, some people may take weeks or months. For some, it may not even seem like a concern at all, and then turn up years later when something similar happens.

  • How long does therapy take? How many sessions will I need?

    The answer varies and depends on lots of other factors such as: other sources of stress in your life, severity and complexity of the incident; how you interpreted the event; how much support you have available. National guidelines suggest that for single incident traumas, 8 - 12 sessions is the norm. If there are multiple traumas, then more time is needed. EMDR tends to be faster than CBT, though both are effective. Often 1-3 sessions of EMDR can make a significant improvement. It also depends on how entrenched the issue is, and whether secondary traumas have occurred (for example due to panic episodes or repeat incidents when diving). There is also some evidence for preventative approaches, which support people immediately or soon (within first month) of an accident.

  • Is online therapy effective?

    Research shows that therapy is effective when provided by remote videocall. In some cases, it can be more effective than therapy within the same room. There are some advantages to remote therapy: convenience, less travel time, being more comfortable in your own environment, having more control over the process, feeling less inhibited etc. Since the pandemic in 2020, many therapist were pushed into adopting remote therapy. This has lead to the opportunity for gathering data for research. EMDR, which was previously under-researched with regard to online methods, has been found to be effective. There are also therapy tools via online platforms dedicated to providing EMDR.

  • How can I explain what I'm struggling with to non-diving friends or family?

    Sometimes it can be hard to talk to friends and family if they can't connect to your experience of diving. Some may not be able to understand what the upsetting part was, because they have never experienced anything similar. Many may hold the belief that all diving is dangerous and unintentionally respond with distress. Perhaps they tell you not to dive, and then expect that this would fix the issue. People find it hard to connect with something they do not have experience of. Try using an analogy like driving. In some ways, when a dive goes wrong it's a bit like a car crash or near miss. The driver may be physically hurt, or not. Either way, they could experience post-trauma or stress injury. They may have trouble sleeping, panic episodes, anxiety etc. They may be nervous of driving again, ... or perhaps not. Maybe they set off for a drive and it's only when a reminder of the accident happens that the trauma is triggered. After a while, they may feel low, even get depressed because they are worried they will not be able to drive: something that was an important part of their life and identity. When divers have issues following an incident, it's quite similar, re-read the above and remove the "r" from driving.

  • I can't stop thinking about the accident, what do I do?

    First, understand that you have been injured. If you are struggling after a traumatic event then you may have sustained a stress injury. This injury affects the nervous system (the brain and the nerves that control most of our body, hold our thoughts and create emotions!) Unlike broken bones, cuts and bruises, these types of injuries can not be seen. Second, know that people heal from these injuries all of the time. The feeling of being stuck and fear that it won't get better is actually part of the injury. Third, seek help, talk to someone: a supportive friend, doctor, therapist or one of the helplines listed above.