15/03/2026
SCUBA Diving as a Possible Complementary Therapy for Mental Health: A Professional Commentary by Jennifer Turner, LCSW, DSW-C, NAUI Instructor Trainer, DAN First Aid Instructor
Authors: Bellvert Rios, A., & Albaladejo Blanco, C. (2022). El buceo como posible terapia complementaria de salud mental [SCUBA diving as a possible complementary therapy for mental health]. Medicina General y de Familia (Edición digital), 11(4), 185-187.
Objective: This clinical commentary, authored by primary care professionals affiliated with the Llefià Primary Care Center in Badalona, Spain, investigates the potential mental health benefits of recreational SCUBA diving. The article originates from a compelling personal case in which a healthcare professional experienced marked improvement through recreational diving after post-traumatic stress symptoms developed following the first wave of the COVID-19 pandemic. The article seeks to examine the existing literature on this subject and propose that aquatic activities may be considered therapeutic environments worthy of clinical attention.
Clinical Case: The article presents the case of a 32-year-old male who presented with approximately one month of anxiety symptoms, difficulty concentrating, insomnia secondary to hypervigilance, social isolation, occupational impairment, and depressed mood accompanied by recurrent distressing memories and dreams related to patients under his care. Following six 1.5-hour SCUBA dives, he reported a pronounced salutogenic effect, including improved subjective well-being, increased self-esteem, and enhanced mental equilibrium with respect to concentration and relaxation. This clinical improvement was quantified using the GAD-7 anxiety questionnaire, with scores decreasing from 16 prior to the diving course to 5 upon completion—a reduction from above to below the established cutoff score of ≥10 for generalized anxiety disorder.
Literature Review and Key Findings: To contextualize this anecdotal evidence, the article presents a literature review examining studies investigating the psychological effects of SCUBA diving. The reviewed studies, all utilizing autonomous SCUBA equipment, yielded several noteworthy findings:
Beneton et al. (2017) conducted an exploratory trial demonstrating that recreational diving practice produced statistically significant reductions in perceived stress and improvements in mood and mindfulness skills when compared to a control group participating in other sports. Carreño et al. (2020) evaluated the mental health effects of diving and found positive outcomes, with particularly noteworthy findings among subjects taking regular medication for chronic or psychiatric conditions, who exhibited significantly greater reductions in mood disturbance scores relative to other divers. Morgan et al. (2018) evaluated a therapeutic diving program for United Kingdom ex-military veterans with physical and psychological injuries, reporting improvements in anxiety, depression, social functioning, and reduced insomnia among participants. Leger et al. (2019) conducted an online survey of 729 recreational SCUBA divers, finding that 15% reported mental health disorders, half of whom had active problems requiring psychiatric medication. Notably, 16% of all respondents perceived diving as beneficial to their mental health, prompting the study authors to suggest that clinical guidelines for anxiety and depression might warrant reconsideration in light of these potential benefits.
Proposed Mechanisms of Action: The article proposes several mechanisms that may explain the observed positive mental health effects.
The environmental context; the diving occurred during a vacation period, removed from the stressful work environment, likely contributed to the improvement.
The physiological requirement for slow, deep, and sustained breathing underwater increases parasympathetic autonomic nervous system activity, producing effects analogous to meditation or mindfulness practices.
The homogeneous somatosensory stimulation provided by water immersion activates tactile, temperature, proprioceptive, and nociceptive pathways, potentially enhancing self-perception and self-esteem.
Conclusion and Clinical Considerations: The article concludes that, given the substantial public health burden of chronic stress and its associated sequelae including anxiety, depression, and increased cardiovascular risk, consideration should be given to developing programs that incorporate aquatic activities as therapeutic environments. Despite the logistical challenges inherent in SCUBA diving, including specialized equipment requirements, environmental limitations, and economic considerations, its growing recreational popularity and potential mental health benefits render it a viable option for inclusion in such programs.
The article appropriately emphasizes the need for additional research to evaluate both short- and long-term benefits, as well as to investigate whether outcomes vary with duration of practice or according to predominant personality characteristics of divers relative to the general population. It also provides important cautionary guidance regarding the well-established medical contraindications to SCUBA diving, including respiratory and otorhinolaryngological conditions, cardiac disease, and pregnancy, as well as neuropsychiatric contraindications such as epilepsy, anxiety with agoraphobia, and intellectual disability. Psychological fitness assessment is advisable for those seeking to pursue professional diving practice.
My take:
As a mental health and dive professional I witness the anecdotal evidence of SCUBA diving as a form of therapy every time I dive. The evolving understanding of mental health treatment increasingly acknowledges the value of complementary approaches that extend beyond the traditional consultation room. The clinical commentary by Bellvert Rios and Albaladejo Blanco (2022) presents a compelling proposition: that recreational SCUBA diving, an activity often pursued for leisure, may harbour significant, untapped therapeutic potential. By examining a striking individual case alongside a growing body of literature, the authors invite us to consider not just if diving can help, but how its intrinsic properties might align with established psychotherapeutic principles.
At the heart of their analysis lies a fascinating overlap. The benefits observed in the presented case: a reduction in GAD-7 scores from 16 to 5 following six dives are unlikely to be a mere placebo effect. Instead, they appear to stem from a confluence of factors that mirror core components of evidence-based therapies. The most immediate parallel is with mindfulness and somatic interventions. The underwater environment necessitates a pattern of controlled breathing. This is not a meditative add-on but a physiological requirement for the activity itself, directly stimulating the parasympathetic nervous system in a manner identical to techniques used in cognitive-behavioural therapy (CBT) for anxiety. Simultaneously, the homogeneous somatosensory stimulation of water immersion via the sensation of weightlessness, can ground an individual in their physical self, echoing the goals of body-focused therapies that seek to integrate somatic experience with emotional regulation.
The social and behavioural context of diving provides a powerful conduit for activation and connection. For individuals trapped in cycles of social isolation and occupational impairment, as seen in the veteran study by Morgan et al. (2018), the structured, goal-oriented, and inherently cooperative nature of diving acts as a form of behavioural activation. It counters anhedonia and withdrawal by providing a rewarding, mastery-based experience within a social framework, addressing two critical pillars of depression treatment.
However, it is crucial to delineate the boundaries of this overlap. The commentary wisely frames diving as a complementary therapy, not a substitute for professional psychological care. While diving can facilitate a state of calm and build self-efficacy, it does not provide the cognitive restructuring or trauma processing guided by a trained therapist. The immersive "blue space" offers a respite and a physiological reset, but the work of understanding and integrating difficult experiences often requires a different kind of depth.
Equally important are the significant caveats. The very real medical and psychological contraindications ranging from epilepsy to anxiety with agoraphobia, mean that diving is not a universally applicable intervention. This creates a selection bias that must be acknowledged when interpreting the positive findings from observational studies. With further research on mental health conditions and SCUBA diving, a more individualized assessment can be made before excluding candidates.
In conclusion, the work of Bellvert Rios and Albaladejo Blanco illuminates a promising frontier. The potential of SCUBA diving lies not in replacing the therapist's couch, but in offering a powerful, immersive environment with key therapeutic principles. Mindfulness, somatic awareness, and behavioural activation can be practised in a uniquely engaging way. For carefully screened individuals, it may serve as a valuable adjunct, a form of "active prescription" that harnesses the physiological and psychological properties of the deep. The challenge for future research is to isolate the active components of this complex intervention and determine for whom, and under what circumstances, its therapeutic depths can be safely and effectively accessed.
References
Beneton, F., Michoud, G., Coulange, M., Laine, N., Ramdani, C., Borgnetta, M., ... & Guieu, R. (2017). Recreational diving practice for stress management: An exploratory trial. Frontiers in Psychology, 8, 2193. https://doi.org/10.3389/fpsyg.2017.02193
Carreño, A., Gascon, M., Vert, C., & Lloret, J. (2020). The beneficial effects of short-term exposure to scuba diving on human mental health. International Journal of Environmental Research and Public Health, 17(19), 7238. https://doi.org/10.3390/ijerph17197238
Leger, M., Whalley, B., Waterman, M., Conway, R., & Smerdon, G. (2019). Diving and mental health: The potential benefits and risks from a survey of recreational scuba divers. Diving and Hyperbaric Medicine, 49(4), 291-297. https://doi.org/10.28920/dhm49.4.291-297
Morgan, A., Sinclair, H., Tan, A., Thomas, E., & Castle, R. (2019). 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. https://doi.org/10.1080/09638288.2018.14806
Link to the original article: https://portalrecerca.uab.cat/ca/publications/el-buceo-como-posible-terapia-complementaria-de-salud-mental/
