Scuba diving therapy is a type of treatment that consists of a variety of scuba diving activities and exercises. Essential elements are increased body awareness, social bonding, and breathing techniques. The goal is to improve physical and psychological well-being.[1]
Description
editScuba diving is generally considered to be a high performance adventurous recreational activity that requires a multitude of safety precautions. The relatively risky sport or component of military service, has been established as a provisional element of therapy. Scuba diving has shown effectiveness as a therapeutic and rehabilitation process for veterans who had acquired traumatic physical and/or psychological injuries.[1] Scuba diving was shown to be a therapeutic process that can help people with various disabilities to reconnect with such activities while simultaneously focusing on the clear goal of coping with their impairment.[2] It can seem a very challenging activity for them but the apparent weightlessness in the water facilitates their experience. Even in extreme cases like with people in a wheelchair they regain a feeling of equalness in the water along with general mental improvements. Scuba diving therapy and rehabilitation relies on extensive stimulation of the entire human body.[2] Benefits were also seen in the improvement of psychological aspects such as anxiety disorders, PTSD and an abatement in social dysfunction and depression.[1][2]
Types
editRecreational diving as therapy
editAs with other recreational activities, freediving and scuba-diving can provide immersive experiences that can help to reduce stress.[3] A study by Marlinge et al. (2019) has shown that scuba diving helped to promote relaxation which can lower levels of multiple stress markers like cortisol, copeptin and ischemia-modified albumin (IMA) levels.[4] Additionally, researchers from the Johns Hopkins University of Medicine found scuba diving to result in a significant improvement of PTSD symptoms, with a reduction of muscle spasticity by an average of 15%.[5]
Adaptive diving
editAdaptive scuba diving is scuba diving by people with disabilities using techniques modified to allow the diver to participate as independently as their abilities allow. Learners are assessed according to their ability to perform each necessary skill-set.[6] Adaptations to procedures are made during training as applicable. It is possible that an adaptive diver may be certified at the same level as an able-bodied diver, but where this is not possible they may be certified to dive with a specially trained dive buddy or buddies who can provide necessary assistance for acceptable safety.[6]
Adaptive diving is an acceptably safe form of diving that helps people with amputations and other disabilities to dive as independently as reasonably practicable. The practical training is adjusted individually to suit each person. Through adaptive diving people can improve their body balance, and fine motor control in their hands.[7] Studies with veterans have shown that body balance after losing a leg can be improved with the help of adaptive diving.[7] The studies also report an improvement of 3.7 and 3.9 points [clarification needed] of the veterans anxiety and depression symptoms.[7] The improvements were shown with higher self confidence, emotional calm, goal and purpose.[7]
A diving service provider would generally need to provide extra diving support staff to ensure acceptable safety for an adaptive diver. A medical professional would be consulted to assess the diver's prospective abilities and suitability for training. Modified diving equipment is a common requirement.[8]
Adaptive diving equipment
editThe diving industry can support adaptive divers by developing specialized equipment to help manage various problems. These include access to the water, which can utilise chair lifts or wheelchair ramps, vehicle modifications for wheelchairs, hoists or cranes similar in principle to diving stages used by commercial divers, and lifting harness similar in principle to those used by surface supplied divers.[8]
Adaptive diving equipment includes specialized personal equipment, including protection of residual limbs and scar tissue, and propulsive equipment by way of customised fins for arms and legs, and inherently stable buoyancy control systems.[8]
Area of application
editScuba diving can decrease depression, anxiety, and post-traumatic stress disorder (PTSD) in military veterans and people who are dealing with similar mental illnesses.[7] Diving allows people to achieve a feeling of liberty, due to the concentration needed for the duration of the dive. This leads to an increase in mindfulness and a decrease in depression and anxiety levels. The risks that are involved in scuba diving may also lead to a decreased urge for control in life. This helps individuals reach acceptance of uncontrolled events.[7] Next to a decrease in stress and anxiety, veterans participating in scuba diving also reported improved levels of concentration and focus.[9]
The use of diving in therapy, specifically scuba diving, is applied to a wide range of disorders. The therapeutic effects range from psychological to physiological.[10] In Norway, for example, it is applied to people who have lost their vision, suffer from multiple sclerosis or amputees. The aim is to increase their sensory awareness and promote the strengthening of confidence.[10]
Military veterans may undergo therapeutic diving, when they suffer from physiological or psychological impairments, such as traumatic brain injuries or Post Traumatic Stress Disorder (PTSD).[10] Scuba diving has the potential to benefit veterans with PTSD, as they respond less to conventional treatments than the non-military populations.[11]
Diving therapy is advantageous for milder types of anxiety and chronic stress disorders, by increasing mindfulness and a sense of relaxation.[12] Scuba interventions have been organized for people with neurological and neurodevelopmental disorders, such as autism spectrum disorder.[13]
Therapeutic scuba programmes are delivered by local or international organisations which have an interest in supporting the physical and psychiatric rehabilitation and recovery of people with physical or mental health conditions.[14]
Diving therapy is applied in different countries, ranging from Malaysia to the Bahamas, and the UK.[10][15][16]
Effectiveness
editScuba diving has proven to help with physical, mental and social issues. For people with physical disabilities, scuba diving can help improve their self-perception.[2] Through positive experiences and mastering the partly challenging techniques that are required in scuba diving, levels of self assessment can rise and levels of depression can significantly decrease. This can be explained by the reduced weight experienced in water, that accommodates people with disabilities to participate in physical activities. This allows the feeling of the disability to be diminished since individuals are not limited under water and they are even able to enhance their movement and improve their muscle strength.[2] Diving can give individuals a feeling of accomplishment and therefore an increase in the level of contentment.[7] Studies have also shown scuba diving therapy to help with social interactions and relationships: Participants noted that scuba diving has helped them to regulate their mood and made them less irritable in daily life.[9] For some, even just thinking back to the dive can have a calming and relaxing effect. Apart from this, scuba diving can also have physical treatment effects. For instance, training to breathe under water can heal people suffering from chronic obstructive pulmonary disease by increasing the peak and endurance exercise capacities.[2]
Scuba diving can decrease depression, anxiety and PTSD in military veterans and people that are dealing with such mental illnesses.[7] Diving allows patients to achieve a feeling of liberty, due to the concentration needed for the duration of the dive. This leads to an increase in mindfulness and a decrease in depression and anxiety levels. The risks that are involved in scuba diving may also lead to a decreased urge of control in life. This helps individuals achieve acceptance of uncontrolled events.[7]
Next to a decrease in stress and anxiety, veterans participating in scuba diving also reported improved levels of concentration and focus.[9]
Limitations
editMany mental or physical health issues make it unsafe for a patient to undergo scuba treatment, as it requires processes such as thinking, concentration, or problem-solving.[14] Before starting the therapy, a medical professional should evaluate the fitness-to-dive state of the patient.[14]
Specific psychiatric medications are not compatible with diving, and scuba therapy is not recommended when they are used.[14]
Higher costs are associated with scuba dive therapy, so the therapy is limited to patients who are able to finance it. Several organizations and charities have started fundraising to make the therapy more accessible to lower-income patients.[2]
Scuba diving requires specialized equipment to ensure safety and comfort of the divers underwater. This leads to limitations due to the availability and cost of obtaining such equipment.[14]
Trained professionals are needed to supervise therapy dives to ensure safety.[14]
Training
editTraining as an Adaptive Support Diver is provided by PADI, with the claimed goal of increasing awareness of diver's varying abilities and techniques applicable when diving with a buddy with a disability. The specialty training has prerequisites of Freediver or Open Water Diver certification and current Emergency First Response primary and secondary care certification. Adequate buoyancy control and trim skills are also recommended.[17]
See also
editReferences
edit- ^ a b c Morgan, Alice; Sinclair, Harriet; Tan, Alexander; Thomas, Ellen; Castle, Richard (2019-11-06). "Can scuba diving offer therapeutic benefit to military veterans experiencing physical and psychological injuries as a result of combat? A service evaluation of Deptherapy UK". Disability and Rehabilitation. 41 (23): 2832–2840. doi:10.1080/09638288.2018.1480667. ISSN 0963-8288. PMID 29958006. S2CID 49615858. Archived from the original on 2024-03-02. Retrieved 2023-05-14.
- ^ a b c d e f g Henrykowska, Gabriela; Soin, Joanna; Siermontowski, Piotr (January 2021). "Scuba Diving as a Form of Rehabilitation for People with Physical Disabilities". International Journal of Environmental Research and Public Health. 18 (11): 5678. doi:10.3390/ijerph18115678. ISSN 1660-4601. PMC 8198635. PMID 34073170.
- ^ Beneton, Frédéric; Michoud, Guillaume; Coulange, Mathieu; Laine, Nicolas; Ramdani, Céline; Borgnetta, Marc; Breton, Patricia; Guieu, Regis; Rostain, J. C.; Trousselard, Marion (2017). "Recreational Diving Practice for Stress Management: An Exploratory Trial". Frontiers in Psychology. 8: 2193. doi:10.3389/fpsyg.2017.02193. ISSN 1664-1078. PMC 5741699. PMID 29326628.
- ^ Marlinge, Marion; Coulange, Mathieu; Fitzpatrick, Richard C.; Delacroix, Romain; Gabarre, Alexie; Lainé, Nicolas; Cautela, Jennifer; Louge, Pierre; Boussuges, Alain; Rostain, Jean‐Claude; Guieu, Régis; Joulia, Fabrice C. (March 2019). "Physiological stress markers during breath‐hold diving and SCUBA diving". Physiological Reports. 7 (6): e14033. doi:10.14814/phy2.14033. ISSN 2051-817X. PMC 6434169. PMID 30912280.
- ^ "Scuba Diving Improves Function of Body, Mind in Vets with Spinal Cord Injury - 09/17/2011". www.hopkinsmedicine.org. Archived from the original on 2023-05-16. Retrieved 2023-05-16.
- ^ a b "Adaptive Scuba Diving". www.adaptivesportsfund.org. Archived from the original on 25 January 2024. Retrieved 25 January 2024.
- ^ a b c d e f g h i Blumhorst, Ethan; Kono, Shintaro; Cave, Jasmine (2020-06-01). "An Exploratory Study of Adaptive Scuba Diving's Effects on Psychological Well-Being among Military Veterans". Therapeutic Recreation Journal. 54 (2). doi:10.18666/TRJ-2020-V54-I2-9954. ISSN 2159-6433. S2CID 219764802. Archived from the original on 2023-05-29. Retrieved 2023-05-29.
- ^ a b c Hoser, Kenneth J. (1 August 2020). "Innovations in Adaptive Diving". Diver's Alert Network. Archived from the original on 25 January 2024. Retrieved 25 January 2024.
- ^ a b c Krpalek, Dragana; Achondo, Naomi; Daher, Noha; Javaherian, Heather (2020-02-11). "Reducing Veterans' Symptoms of Depression, Anxiety, Stress, and Posttraumatic Stress, and Enhancing Engagement in Occupations with SCUBA Diving and Occupational Therapy". Journal of Veterans Studies. 6 (1): 98–106. doi:10.21061/jvs.v6i1.158. S2CID 213837957.
- ^ a b c d Blogger, Guest (2022-08-04). "Diving as Therapy". blog.padi.com. Archived from the original on 2023-05-14. Retrieved 2023-05-14.
- ^ Walker, Petra Ann; Kampman, Hanna (2022-11-20). ""It didn't bring back the old me but helped me on the path to the new me": exploring posttraumatic growth in British veterans with PTSD". Disability and Rehabilitation. 44 (24): 7455–7463. doi:10.1080/09638288.2021.1995056. ISSN 0963-8288. PMID 34714191. S2CID 240154445. Archived from the original on 2024-03-02. Retrieved 2023-05-14.
- ^ Gibert, Lionel; Coulange, Mathieu; Reynier, Jean-Charles; Le Quiniat, Frédéric; Molle, Aymeric; Bénéton, Frédéric; Meurice, Vincent; Micoulaud, Jean Arthur; Trousselard, Marion (2022-07-29). "Comparing meditative scuba diving versus multisport activities to improve post-traumatic stress disorder symptoms: a pilot, randomized controlled clinical trial". European Journal of Psychotraumatology. 13 (1): 2031590. doi:10.1080/20008198.2022.2031590. PMC 8823687. PMID 35145610. Archived from the original on 2024-03-02. Retrieved 2023-05-14.
- ^ Naumann, Karlee; Kernot, Jocelyn; Parfitt, Gaynor; Gower, Bethayn; Winsor, Adrian; Davison, Kade (2021-12-20). "What are the effects of scuba diving-based interventions for clients with neurological disability, autism or intellectual disability? A systematic review". Diving and Hyperbaric Medicine. 51 (4): 355–360. doi:10.28920/dhm51.4.355-360. ISSN 1833-3516. PMC 8920902. PMID 34897600. Archived from the original on 2024-03-02. Retrieved 2023-05-14.
- ^ a b c d e f "Scuba Diving in Therapy | Information for Scuba Divers". FIT TO DIVE. Archived from the original on 2023-05-10. Retrieved 2023-05-14.
- ^ Editorial, DIVER (2020-03-30). "Diving therapy for PTSD sufferers". DIVER magazine. Archived from the original on 2023-05-14. Retrieved 2023-05-14.
- ^ Russell, Mark 'Crowley' (2018-07-17). "New study confirms therapeutic benefits of scuba diving". DIVE Magazine. Archived from the original on 2023-05-14. Retrieved 2023-05-14.
- ^ "Adaptive Support Diver". www.padi.com. Archived from the original on 2 January 2024. Retrieved 2 March 2024.