Bipolar Disorder

Mood should be stable for at least 1 year, confirmed by the individual’s psychiatrist and GP.

There should be a return to previous levels of functioning.

The individual should be compliant with a mood stabiliser and free of any side effects (especially sedation).

There should be avoidance of any recognised precipitants e.g. abstinence from drugs/alcohol if there is a known association.

The individual should be able to provide confirmation of regular monitoring.

There should be a mechanism / care plan in place for recognising early relapse with supporting information from the treating psychiatrist or care coordinator.

Previous sectioning under the Mental Health Act indicates complete loss of insight and higher assessment thresholds should be used.

A maximum of one mood stabiliser and one other psychotropic drug at a non-sedating dose is permitted.

Medications should not be altered purely to permit diving.

No decompression limits.

Initial depth restriction of 20m to ensure no interaction between medication and pressure.

The individual should dive only with regular buddies who are familiar with their condition and able to recognise signs of altered or deteriorating behaviour.

Given the potential complexity in most cases, discussion with a referee who has a special interest or experience in psychiatry and diving is advised.

Participation in UKDMC audit is essential in determining the effectiveness of these guidelines and developing them further.