Do Panic Attacks Cause Triathlon Deaths?

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There’s a certain level of risk that accompanies almost everything we do.  Our favorite hobby of Triathlon is not an exception to this.  The risks, thankfully, are fairly minimal, and are usually not traumatic.  The fact is that folks do occasionally die when competing in triathlon events. 

Rewind to August 7th….the date of the annual New York City Triathlon.  As you may recall, Amy Martich and Mike Kudyrk drowned during the race.  You can read my tribute to them here.  Analysis of the autopsies done on Martich and Kudryk, as well as those of other folks who have died during triathlon thus far in 2011, have not revealed any acute medical condition that was the proximate cause of their death.  None of the athletes apparently died of a stroke or heart attack.  Some had some underlying cardiac issues, but none of those were apparently life threatening.

Over the years, there have been various articles written about death in triathlon.  Specifically, the articles have centered on deaths during the swim portion of a race.

The numbers of studies on the causation of deaths in triathlon have been limited.  One relatively famous analysis was completed by Dr. Kevin Harris, et al, in 2010, and confirmed that the overwhelming majority of deaths in tri occurred during the swim portion of the race. 

Dr. Harris was later interviewed by Scientific American, where he opined that safety in triathlon could be achieved in a twofold manner:  (a) athlete awareness of his on potential for underlying medical conditions and (2) athlete knowledge of inherent risks associated with the sport.

An interesting article came out this week in the Washington Post wherein the author spells out his hypothesis that death in triathlon is caused proximately by panic attacks in the afflicted athlete.  The crux of the article is that since none of the athletes that died this year in triathlon had significant, acute injuries, there had to be some other root cause.  To the author, the logical conclusion was panic attack.

The author described in his article the nature of the swim start as we know it.  A washing machine full of arms & legs, kicks to the head, tight wetsuits, getting swam over.  We’ve all experienced it.  The difference between triathlon swims and “normal” open water swims is that you have the elements of competition, pressure, and hundreds (or thousands) of bodies in very close proximity.

The article has generated a significant amount of traffic and posting on triathlon message boards.  Some folks agree, naturally, others don’t. 

I think that I personally agree with the concept that one can fall into a panic attack during a race and end up in a bad place.  Why do I agree?  Well, personal experience – both mine and that of a friend.

My first triathlon this year was in mid-April and involved an ocean swim.  The water temps were not that warm, therefore I wore my wetsuit.  Additionally, my friend MB raced that day too.  He raced in a wetsuit as well.  My swim was not the highlight of my race that day.  In my race report (here), I talked about how my swim sucked…how my wetsuit was too tight and how I felt like I couldn’t breathe.  In retrospect, I think I might have been experiencing the early stages of a panic attack.  MB described his experience very much in the same regard.

According to the Mayo Clinic, a panic attack is a sudden episode of intense fear that develops for no apparent reason and triggers severe physical reactions.  Symptoms include a rapid heart rate, shortness of breath, hyperventilating, tightness in your throat, faintness, and many others. 

I can say without a shadow of doubt that I’ve experienced some of these symptoms at the start of a race.

Looking back, some of those episodes were related to some underlying stress relating to my physical conditioning, the water temperature, the number of competitors at the race (specifically at the mass-start for IMFL), or the sheer distance (2.4 miles in a river, anyone?). 

I can totally see how someone could have a panic attack and how that could lead to a catastrophic series of events while in the water. 

Could this be the underlying root cause of all triathlon swim deaths?  Certainly, I don’t know.  Further, I’m not sure that we’ll ever really know, as panic attacks don’t leave physical evidence like a heart attack would.  To me, however, the concept seems plausible.

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