Beneath the Surface: Scuba Diving as a Mindful Adjunct for People Living With PTSD

Posttraumatic stress disorder (PTSD) can narrow a person’s world. The body may remain prepared for danger long after the threat has passed; attention can become captured by intrusive memories, hypervigilance, avoidance, and the exhausting work of simply feeling safe. Recovery is not about returning to a prior version of oneself. For many people, it is a gradual process of reconnecting with the present, the body, other people, and a sense of meaning.

For some, scuba diving may offer an unexpected setting for that reconnection.

Underwater, the ordinary pace of life falls away. Movement becomes deliberate. Breathing becomes audible and rhythmic. Visual attention is drawn to light, color, marine life, and the quiet task at hand. In this environment, a diver must attend to the present moment—not as an abstract exercise, but as a practical necessity. That quality makes diving an intriguing, though still emerging, complementary activity for individuals living with PTSD.

Importantly, scuba diving is not a replacement for evidence-based PTSD treatment. Trauma-focused psychotherapies remain central to care. Rather, for medically appropriate and interested individuals, diving may function as a meaningful adjunct: a structured activity that can support mindful attention, confidence, social connection, and renewed trust in one’s own body.

Why Diving May Feel Restorative

Scuba diving naturally incorporates several elements associated with mindfulness and trauma recovery:

• Focused breathing: Divers breathe slowly and continuously through a regulator, often becoming acutely aware of the breath’s pace and sound.

• Present-moment attention: Monitoring depth, buoyancy, equipment, surroundings, and a dive buddy requires sustained attention to what is happening now.

• Embodiment: Water provides sensory feedback, while buoyancy can create a temporary experience of reduced physical burden and freer movement.

• Competence and agency: Learning dive skills in small, progressive steps can foster mastery, self-efficacy, and a renewed sense of control.

• Connection: Diving is rarely a solitary activity. Training, buddy systems, and shared exploration can reduce isolation and create opportunities for trust.

• Meaning and wonder: Encounters with a world beneath the surface can invite awe, humility, gratitude, and—for some—spiritual reflection.

These features do not erase trauma. They may, however, create moments in which trauma is not the only organizing force in a person’s life.

The Mindfulness Connection

Mindfulness involves intentional, nonjudgmental awareness of present-moment experience. In PTSD, this can be challenging: turning inward may initially feel uncomfortable or even unsafe for some trauma survivors. Yet carefully structured mindfulness-based interventions have shown potential to reduce PTSD symptoms.

A 2024 umbrella review of 69 systematic reviews found that mindfulness-based interventions were associated with a medium reduction in PTSD symptoms, although the quality and rigor of the underlying reviews varied substantially. [1] A 2022 meta-analysis also found that higher trait mindfulness was associated with fewer PTSD symptoms, particularly in domains such as acting with awareness and nonjudgment. [2]

Diving is not a standardized mindfulness intervention, and it should not be presented as one. Still, it contains recognizable mindfulness-like components: paced breathing, sustained attention, reduced distraction, body awareness, and purposeful action. The underwater setting may make these practices more accessible for some individuals who struggle with seated meditation or who find conventional mindfulness exercises too activating.

Slow, intentional breathing may be particularly relevant. A 2023 meta-analysis of randomized trials found that breathwork interventions were associated with lower self-reported stress than control conditions, with the strongest effects seen in slow-paced breathing practices. [3] Although this evidence does not establish that regulator breathing treats PTSD, it offers a plausible rationale for studying the role of breathing-focused activities within trauma-informed recreation.

What Does the Evidence Say About Scuba Diving for PTSD?

The evidence for scuba diving specifically as a PTSD intervention is promising but limited.

Qualitative research involving British veterans with PTSD described diving as a meaningful source of calm, embodiment, human connection, and purposeful leisure. Participants framed diving not as a return to an “old self,” but as part of a path toward a “new self” shaped by recovery and posttraumatic growth. [4] This distinction matters. Healing after trauma is often less about restoration of what was lost and more about discovering that a meaningful future remains possible.

Small clinical studies and registered trials have explored scuba-based interventions for PTSD, including programs that incorporate diving instruction, mindfulness, breathing techniques, journaling, and occupational therapy. However, published outcome data remain sparse, samples have been small, and methods have been heterogeneous. Existing trials have examined outcomes such as PTSD symptoms, quality of life, anxiety, depression, and autonomic measures, but stronger randomized trials with longer follow-up are needed before diving can be considered an established PTSD treatment.

Current guidelines appropriately reflect this uncertainty. The 2025 American Psychological Association guideline concluded that evidence is insufficient to recommend for or against meditative diving as a PTSD treatment. [5] This does not mean diving lacks value; it means the evidence is not yet strong enough to determine its clinical effectiveness, durability, or risk-benefit balance as a formal intervention.

The most responsible framing is therefore clear: scuba diving may be a personally meaningful wellness and recovery-support activity for some people with PTSD, but it should be pursued as an adjunct to—not a substitute for—comprehensive trauma-informed care.

A Trauma-Informed Way to Begin

For a person living with PTSD, the first exposure to scuba diving should be gradual, choice-centered, and free of pressure. The goal is not to “push through” fear. The goal is to build safety, skill, and confidence at a pace that honors the individual’s nervous system.

A trauma-informed introduction may include:

1. Start above water. Learn about equipment, practice breathing through a regulator, and discuss what diving feels like before entering the water.

2. Choose a calm environment. Confined-water or pool-based instruction may be more appropriate than open-water diving initially.

3. Maintain autonomy. The diver should know that stopping, pausing, or declining an exercise is always acceptable.

4. Use an experienced instructor. Seek a patient instructor who communicates clearly, welcomes questions, and understands the importance of predictability and consent.

5. Consider peer support. Veteran-focused, adaptive-diving, and trauma-informed programs may offer connection with others who understand the recovery process.

6. Integrate reflection. Brief journaling, grounding before and after dives, or discussion with a therapist may help a person make meaning of the experience without forcing disclosure or emotional processing underwater.

For some people, the most therapeutic step may not be a deep dive. It may be sitting at the water’s edge, practicing one slow breath at a time, and recognizing that they still have choices.

Safety Must Come First

Scuba diving requires medical fitness, emotional readiness, and reliable adherence to safety procedures. Panic, dissociation, severe claustrophobia, active substance intoxication, acute suicidal risk, unstable cardiopulmonary disease, poorly controlled asthma, seizure disorders, and conditions affecting a person’s ability to respond to an emergency may require further assessment before diving.

Diving can also be activating. Equipment sensations, restricted movement, darkness, limited visibility, underwater noise, or loss of perceived control may evoke distress for some trauma survivors. A person should never be encouraged to dive because it is presumed to be therapeutic. The activity must be genuinely desired and approached within appropriate medical, psychological, and diving-safety parameters.

The best dive is not the deepest or most difficult one. It is the one that ends safely, with the diver feeling respected, supported, and willing to choose what comes next.

Reconnection, Not Escape

Scuba diving should not be romanticized as an escape from trauma. The water cannot erase painful memories, repair every loss, or replace psychotherapy, medication management, community, or the patient’s own hard-won work of recovery.

Yet meaningful activities can widen the space around suffering. In the quiet repetition of breath, in the disciplined attention to buoyancy, and in the companionship of a dive buddy, some people may encounter a different relationship with themselves. They may experience their bodies not only as sites of alarm, but also as capable, responsive, and alive.

For people whose worlds have become constricted by trauma, the underwater world may offer more than novelty. It may offer a moment of presence—and, from that presence, a small but genuine horizon of possibility.

Resources for Further Exploration

• National Center for PTSD: Education, treatment information, and resources for veterans, families, and clinicians.

• Divers Alert Network (DAN): Diving medical information, emergency resources, and guidance on fitness to dive.

• Professional Association of Diving Instructors (PADI): Information on Discover Scuba Diving experiences, certification pathways, and local dive centers.

• Scuba Schools International (SSI): Entry-level training, diver education, and local instructor resources.

• Disabled Divers International: Adaptive-diving education and inclusion-focused resources.

• Deptherapy & Deptherapy Education: UK-based programs supporting veterans and others with life-changing injuries through scuba diving and peer support.

• Wounded American Veterans Experience Scuba (WAVES) Project: Veteran-focused scuba and community programming.

• International Association of Nitrox and Technical Divers (IANTD): Training resources and instructor directories for divers seeking continuing education.

• Local trauma-informed mental health programs: Programs that can help individuals incorporate meaningful activities into a broader PTSD recovery plan.

References

1. Jovanovic B, et al. Can mindfulness-based interventions reduce PTSD symptoms? An umbrella review. Journal of Anxiety Disorders. 2024;102859. doi:10.1016/j.janxdis.2024.102859.

2. Harper L, et al. Association between trait mindfulness and symptoms of post-traumatic stress: A meta-analysis. Journal of Psychiatric Research. 2022. doi:10.1016/j.jpsychires.2022.05.027.

3. Fincham GW, et al. Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports. 2023. doi:10.1038/s41598-022-27247-y.

4. Walker PA, et al. “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. 2022. doi:10.1080/09638288.2021.1995056.

5. Zoellner LA, et al. APA clinical practice guideline for the treatment of posttraumatic stress disorder in adults. American Psychological Association. Published 2025.