Scuba diving therapy

Scuba diving is habitually associated as a high performance adventurous sport that requires a multitude of safety precautions. The otherwise risky sport or even a 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 as 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 as a very challenging sport for them but the experienced weightlessness of the water facilitates their experience. Even in extreme cases like with people in a wheelchair they regain a feeling of equalness in the water alongside general mental improvements. Scuba diving therapy and rehabilitation relies on extensive stimulation of the entire human body.[2]  The concluding 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]

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.[8]

The use of diving in therapy, specifically scuba diving, is applied to a wide range of disorders.The therapeutic properties range from psychological to physiological treatments.[9] 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.[9]

Military veterans often undergo therapeutic diving, since they often suffer from both physiological and psychological impairments, such as traumatic brain injuries or Post Traumatic Stress Disorder (PTSD).[9] Scuba diving has the potential to benefit veterans with PTSD, as they respond less to conventional treatments than the non-military populations.[10]

Diving therapy is advantageous for milder types of anxiety and chronic stress disorders, by increasing mindfulness and a sense of relaxation.[11] Scuba interventions have been organized for people with neurological and neurodevelopmental disorders, such as autism spectrum disorder.[12]

Therapeutic scuba programmes are delivered by local or international organisations which have an interest in supporting the rehabilitation and recovery of people with physical or mental health conditions.[13]

Diving therapy is applied in different countries, ranging from Malaysia to the Bahamas, and the UK.[9][14][15]

Scuba 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 for 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.[8] 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.[8]

Many 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.[13] Before starting the therapy, a medical professional should evaluate the fitness-to-dive state of the patient.[13]

Specific psychiatric medications are not compatible with diving, and scuba therapy is not recommended.[13]

Higher costs are associated with scuba dive therapy, so the therapeutic service 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 in the availability and cost of obtaining such equipment.[13]

Trained professionals are needed to supervise therapy dives, to ensure safety and to avoid issues of for example decompression sickness.[13]

• List of therapies