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What to do if you have a panic attack in a lake

Published 19 August 2019. Written by Chris Worfolk.

One of the things that many would-be triathletes worry about is open water swimming. There are lots of reasons for this: cold water, being unable to touch the ground, floating weeds, swimming in packs. Or, it could be fear of having a panic attack.

If so, what do you do if you do actually have one? This article will offer some advice.

What happened at Castle Howard

Before we get to the advice, I am going to tell you a story. If you want to get straight to the strategies, feel free to skip to the next section.

I like open water swimming. It is fun. Better still, it is something that other people are often anxious about, so being confident about it makes me feel like a king.

However, when I moved up to Ironman, I started doing longer training swims. Unfortunately, if I swim for more than 90 minutes, I cramp up.

It was a shock the first time it happened! I experienced some initial panic, but then remembered to roll onto my back and let the wetsuit do the work. There was no paddle boarder nearby, which turned out to be a blessing because being left floating there taught me that my wetsuit would keep me above water even if I do cramp up and it will eventually go away.

It happened again in my Ironman race itself. An hour and a half in, I decided I was fed up and increased my pace. Fifteen seconds later, my left calf went.

After these incidents, my confidence took a knock. I started to worry, even in shorter swims, that if I went hard, I would cramp up. This came to a head at Castle Howard Triathlon, where I was worried about speeding up but trying to stay ahead of the wave behind me so that I would not have faster athletes swimming over me.

I could feel the early stages of a panic attack coming on. So, I applied my knowledge as a psychologist. I calmed myself down and managed to make it around the final buoy and towards the swim exit before the next wave could catch me.

Below, I will present the theory. But it is good to know that it has all been field-tested, too!

Slow down, or stop

The symptoms of exercise and the symptoms of anxiety are similar: tight chest, lightheaded, fluttering stomach, racing heartbeat, etc. In therapy, we often suggest to clients that they exercise more to acclimatise themselves to the feeling of panic and show them that it will not harm them.

Therefore, when you are experiencing these feelings, it is difficult to know if it is panic or if it is the cardio. If you try to keep swimming, you are going to pile more symptoms on the bonfire.

Instead, try slowing down or treading water for a bit. As your body calms down from the cardio, you should find your mood improves, too.

Focus on breathing

Try to take some slow, deep breaths.

Often, when we panic, we start to breathe too fast. This can increase the symptoms and so causes a feedback loop. We can break this loop by taking control of our breathing and slowing it down.

Are you in a race?

If this is a race situation, that could partially explain the symptoms.

Before a race, you are likely to be more aroused (arousal is a clinical term for the body being alert and ready for action) than you would be in training. You may be excited to get the race started, or you may be nervous about it. Either way that will mean you have more adrenaline running through your system.

Then the gun goes, and the race is on. People are swimming everywhere. You may get carried away and go out too hard. This leads to further arousal.

By this point, our body is pumped up. As we have already discussed, the symptoms of exercise, particularly hard exercise, and panic are similar. Again, the thing to do here is to slow down and remind yourself if this alternative explanation: "I feel this way because I am in a race and if I slow down I will calm down".

It is hard to drown in a wetsuit

You can drown in a few inches of water. But you probably won’t. If you are wearing a wetsuit, you can roll onto your back and float. So, even if the panic attack happens, and leaves you unable to swim, you will probably be okay. Remind yourself of this fact.

If you are not wearing a wetsuit, move on to the next step.

Remind yourself you have done the training

You have done the training, right?

Assuming you have, reminding yourself of this fact should be useful. You are not pushing into unknown space here. You have done this before. You have finished it before. This swim is well within your capability.

Do not just remind yourself of this in your head: say it out loud to make it even more convincing.

Switch stroke

It is totally okay to lie there and float until you calm down. But, if you want to keep moving, try switching to breaststroke or backstroke (if racing, check race regulations to see if you are allowed to swim backstroke) for a while.

It is okay to ask for help

If you are in a race or at an organised open water session, there will be a water safety crew. They are there to help you.

I have never seen anyone pulled out of a race for asking for help. You can be extracted if you ask to be, of course. However, in most situations, hanging onto the kayak or paddleboard for a minute or two will be all you need before carrying on.

Summary

The strategies I discussed in this article can be divided into several broad categories.

We have behavioural interventions: slowing down, stopping to tread water or floating on our backs, switching strokes and maybe even asking for help. These will help us deal with the physical symptoms so that we can calm ourselves down.

Second, we have cognitive interventions: we can reappraise the feelings as race arousal, remind ourselves that we will not drown and use some self-talk to remember that we have trained for this and can do it.

You can use all of these or just one. It will probably come down to what you can remember as recalling all of this information when anxious is tough! Good luck, and if you have any specific questions, drop me a comment.