Life List: Panic Attack Deep Underwater? Check.

The interesting thing about going somewhere completely different is that once things start to go wrong, or you feel sick, weird, or out of wack... it's very difficult to figure out the cause. In my case, in Mozambique, I started to feel a bit "off" after about a week. Who really knows what the cause was? Have I been sleeping too little, is it because I'm drinking every night, is it the malaria medicine with all the possible side effects that I've never taken before, is it the water, is it all the different foods that I'm eating, or is it the anxiety that I'm very far from credible medical care or any semblance of "home". It is within this context that you can go a little nutty. And I did.

Before The Dive

As I woke up on Day 9, tired from sleeping only three hours, I was invited on what would be the last deep dive of the trip. At 7:00am, I told Mike a solid no and put my head back into my pillow. A half hour later, though, unable to sleep anymore, I got up to check on the dive shop and get some water. I learned that the dive would be delayed three hours, which likely meant four or even five hours when adjusting for African time. I couldn't go back to sleep at this point (I wasn't sure why), so I started drinking water and ordered some breakfast at the bar. As the morning rolled on, I decided that I would be going on the dive. As you saw in the videos and stories from the last post, I felt like I'd be very disappointed in myself if I missed the last Mozambican deep dive of the trip, only to hear stories and see photos when a jubilant crew returned. So I began kitting up for my fifth trek into the ocean.

Our first dive with the resort.

From the very beginning, this dive felt more stressful than others. Not only was I feeling a bit "off", but it was my first time diving without my instructors Sean and Nick, the two people that have taught me to dive in Cape Town and whom I'd gone out with on all the dives in the last few days. I didn't think it would be a big deal, but just kept realizing, in my head, the difference I was feeling of not having them as calming reassurance. This was because my two new dive masters from the resort we're a bit cold and set lots of rules and expectations for the dive. This shouldn't have stressed me out, because it is how diving works, but for some reason it just changed the mood of getting ready and going out.

On the way out to the dive site it felt like things kept going wrong. We got hit by another big wave and, reminiscent of a few days earlier, it broke a piece of the steering wheel enclosure off. We stopped and tried to radio back, only to find that the radio was not working. As we headed to our dive site I noticed that the pontoon I was sitting on was deflating slightly, which lead them to reinflate it every 15-30 minutes or so. The dive master was shaking some from the wave impact, and the current was so strong that we had to move our dive site from Sherwood Forest to Giant's Castle. With full gear on, we slowly drove for about 20-25 minutes to the new site, while I got a bit seasick in the process. All along I had a million thoughts going through my head, while I was thinking "I don't want to be here right now." Feeling very anxious, I was hoping that once I got in the water things would get better, as they usually do, and I would get it over with and go back to Bamboozi.

Working on our sea sickness.

In The Water

"Masks ON! Regulators IN" 3. 2. 1." Bail.
Except I noticed that two of my friends didn't actually have regulators in their mouths as we fell in, because the staff didn't check that everyone was ready. I fell in the water and realized that I was floating for some reason, despite having sucked the air out of my vest. I began to swim down, kicking harder to get my fins in the water and past the surface to catch up with people. I began to descend, trying to get back into the swing of things. I looked for my buddy Alexei, he gave me an "Ok?" symbol and I reciprocated as we went down 20ft, 40ft, 60ft, 80ft, and finally reached the bottom at 100ft. Once down there, I was still feeling a bit out of it and my heart rate increased. Because we were so deep, air is compressed by 4x and is thus consumed that much faster. "We'll only have a bottom time of about 14 minutes", I thought. "Get past it and we'll be done." I knew my body was starting to freak out, because despite what I was telling myself, I kept thinking, "I don't feel safe right now, I cannot be down here." For about two minutes, I tried to get control of my breathing as my heart rate increased, and my dive masters tried to locate someone that had not come to the bottom with us. It all felt very hectic.

Alexei turned to me again and made a joking face and gesture. I thought, "You shouldn't surface for this. You might shake your confidence diving, and at worst could develop some phobia of diving. Push through it." At the same time, my heart was racing out of control and I was just about hyperventilating as my mind struggled to calmly sort through how to fix my problem. I decided that I would need to surface. I slowly shook my head "No" at Alexei, and the following conversation took place all in diving hand signals.

Me: "I have a (problem). I need to (go up)." Alexei looked at me to see if I was joking. Again: "I have a (problem). I need to (go up)." He grabbed the female dive master (DM) and signaled the same.

She came to me, grabbed me by the straps on my vest, and gave me her best, eyes wide open "What is wrong!?" face. Unable to figure out a way to tell her, I just repeated "I have a (problem). I need to (go up)."

DM: "Where is your (buddy)?" I pointed at Alexei, shook my head about that question, and repeated the only phrase that seemed to make sense underwater. More rushed hand signals... DM: "Have you (lost your buddy)?" I shook my head no. "(No), I haven't (lost my buddy). I'm having a (problem) and I need to (go up). DM: "(Out of Air?)". Me: "(No)." Again, she gave me the demanding WHAT!? eyes as she grabbed me.

I was getting upset with how long the communication around this was taking. I started to think that with how inherently dangerous diving is, you'd think more communication than normal would be needed, but here I practically had none. This turned into a very serious game of underwater charades, where I could not find a way to tell her: I'm having a panic attack, and being 100ft underwater isn't suiting me very well. Not only do I feel like I need to be at the surface immediately, I know full well that if I inflate my vest or begin swimming up too fast, I'll get decompression illness and might die. And there isn't a recompression chamber anywhere near. "Okay, try again." I began to hit my chest with my hand very fast, my best attempt at saying what had happened.

She finally understood and turned to the other dive master. With all the lost buddy confusion, he thought I was without my buddy and proceeded to go through the same confusion that had already happened. About 30 seconds later, I was upset that my highly trained dive masters, whom I didn't particularly trust in the first place, were not effectively communicating while I was freaking out and trying to stay calm to solve my problem. I began to swim up without them, slowly, until she noticed and called me back. After a bit more communication, and after what felt like minutes had passed (they probably did), we began to ascend together. Let me just say, when you're at the bottom and all you want is the top, and 100ft of deadly water is sitting between you and a solution, trying to work the stress away isn't particularly easy. The ironic thing is that while an ascent is the solution, it is also the source of the stress and makes things worse thinking about it. It began to feel like a negative feedback loop, of things getting worse as I thought of them, despite trying to calm down. I just kept breathing, paid attention to the air in my vest so that I wouldn't shoot up too quickly, and held onto her while she controlled our ascent rate. I looked up, could see the surface very far away and just repeated to myself that I'd be up there soon. It felt like a very long time, but we surfaced.

At the top, I was fine. I explained what happened, apologized for making her end her dive, and we clarified all of the confusing progression at the bottom. She said it was the right thing to come up, and it happens even to the best of divers. She also commended me on using my training, because an actual "panicked diver" would have ripped off his mask, pulled out his regulator, and began breathing water while trying to kill the people that were attempting to help. I was now calm, and sat on the boat talking to the skipper until the dive was over. We discussed South Africa, Mozambique, studying abroad, and sunglasses (because he asked why only one of my eyes was open as I looked toward the sun). I responded that I'm a silly Norwegian with blue eyes and can't handle African, let alone Wisconsin, sun.

On Shore Aftermath

Yet when we got back on land, I realized that I felt much worse than I had thought. I originally thought the panic attack was just the result of anxiety and feeling unsafe (which was definitely a big part), but now realized that I was going a bit crazy from being awake so long. I recalled my cumulative 11 hours of sleep over the last three days, and wanted nothing more than sleep. In fact, I felt as though I'd been awake for three days straight and now had enough adrenaline in my body to simulate five cups of coffee. As a result, I wasn't thinking straight, I had a million thoughts going through my mind, all while trying to maintain an appearance of outward composure and the ability to hold a conversation. In fact, I thought I might be slipping into a nervous breakdown and thought "this must be what it is like to go crazy. I'm just going to snap soon. I need sleep this second." I was also losing the ability to tune out all the noise around me, and being around just 10 people at once became cacophonous and overwhelming.

Here is a photo of me, taken in the middle of all of this, as I was waiting to be driven back to the resort from our boat landing:

You may notice that my eye is folded over itself.
I'm not doing so good, Pearl.

As you can tell, I'm looking somewhat wily. I immediately went back to my hut, changed, and moved to a more silent place in someone else's room. I was left in silence trying my hardest to "get to sleep", while fighting thoughts of what had happened underwater just an hour ago, reassuring myself I wasn't going crazy and that a few hours sleep would bring things back to normal, while also wondering if I was having a heart attack based on how fast and irregular my pulse was running, and where in the world I would go if that did happen. In my near-insane soul searching, I found irony that my problem was again my solution. I had gotten to this point by not sleeping, and the stress of still being awake and not knowing what was happening to my body and mind was keeping from my solution--sleep. That was a scary feeling.

Admitting to myself that this was some sort of medical sleep deprivation, I sought out my friends and told them how I was feeling. For all I knew, I was going to die in the hut or something from poisonous levels of adrenaline or who knows what (more stress). Alexei, Daniel, and Mike jumped into action and made me feel much better, seeking out some nausea medicine to calm me a bit, while Lauren came and sat with me for over an hour to calm me down and help me sleep. I asked her, "Will I ever sleep again?" I was fully conscious of what was happening and what I was feeling, I just didn't have the means to fix it myself or improve things. It felt terrible. To make things worse, I kept feeling pinches all over my body, which I first thought to be nitrogen expanding from too fast an ascent, but must have been psychological in some way. Anyway, I fell asleep after two hours of laying down in silence, and slept for just three hours or so.

What I hadn't thought of was the malaria medicine, though. I looked at the side effects later and saw that it causes insomnia and lack of sleep. Granted, what happened to me was no doubt a combination of pushing my limits too hard in many ways, but I now know that the malarone was playing a big part. Ironically, drinking at night was helping me get to sleep, because I wasn't able to nap in the afternoons, and didn't feel tired at 4-5am when it was time to retire. Over the next few days I was mostly good, but wavered from thinking anxiously about my dive experience to still being in Mozambique to getting a bit of jungle fever.

Lastly, upon getting home I was supposed to take the malaria medicine for another seven days. I wasn't drinking any alcohol, was sleeping much more regularly, and was eating normally. Essentially, everything was back to normal, but about two hours after taking a malaria pill I would realize that I felt messed up, almost in an altered state of mind and my heart rate would change. After realizing this... I just stopped taking them altogether. I think I'd rather have malaria.

So yes, I think what happened was a combination of the stress of the dive, things going wrong, not having Sean or Nick around for it, and not being able to handle the anxiety due to lack of sleep, being jacked up on malaria pills, working through a hangover, and perhaps dehydration. Who knows? You can't find you're limits unless you pass them. The rest of the trip outside of this day was absolutely phenomenal as I have been saying, and I was even able to wind down on this night by chilling out and pacing myself. My new goal is to get back in the water and dive as soon as I can.

In my next and final post about Mozambique, I'll be recalling the trek home and the rioting at the border post.