ABSTRACT
Total immersion in a body of water may contribute in direct and indirect ways to the psychiatric phenomena and psychopathology seen among competitive swimmers. Disorders of anxiety, mood, psychosis, and eating, attention deficit and/or hyperactivity, substance abuse—including the abuse of ergogenic aids—the occurrence of transgenderism, sexual abuse, concussions and their respective sequelae, and issues relating to race and socioeconomics are discussed in the context of the competitive aquatic arena. Treatment strategies are then addressed through the lens of a sports psychiatrist.
