I have a long history of nearly drowning to death starting as a young child, about 5, through age 16 when I nearly drown off the coast during a trip to Costa Rica. When I was approximately 5-years-old, I visited my uncle at his country club (don't get too excited, it was in western Wyoming...). I was curious about a vent near the bottom of the pool and I decided to investigate. I forgot/didn't realize you can't just breathe underwater and it takes time to return to the surface. My uncle jumped in a saved me. I was choking and gasping on the pool deck with random strangers looking on. My uncle asked if I was okay. I nodded, he grabbed me by my wrist and ankle and threw me back into the pool. After that I can recall at least four other instances of almost drowning. Once in a natural pool in a stream, twice at public pools, and then in Costa Rica. I'm fairly stubborn. I think many people would have given swimming up after the first few times. Ironically, I don't have a fear of swimming in the water, but I'm fairly positive I am going to die trapped in a car that careens off of a bridge into water (or so I imagine every time I have to cross the Mississippi or the Missouri). It's fairly good exposure therapy to have to drive across a bridge at least four times a day.
Something more challenging is drowning on dry land in a swirl of life. A colleague calls distress "living in pain without a voice". It has been a long time since I've been in a position to compare physical drowning with psychological drowning. The emotional experience and the corresponding physical experience is quite the same. Struggling with fear and pain while being unable to say or possibly do anything is a visceral part of being pulled under. There is also a deep sense of loneliness and helplessness which is further contrasted by a realization that death is a distinct possibility. The existentialists would encourage taking this realization into account and using it to create meaning in life.
Each time I've nearly drowned I recognized what was happening while being aware of the experience. I can tell I've been caught by an emotional rip tide, and I am being pulled further and further away from the shore. The more I fight, the worse it gets. Distress. Sometimes it is the struggle itself that causes the most harm. The trick is choosing between letting yourself slip under or allowing yourself to be carried a little further out in order to escape the current and return to shore. I think perhaps I have been treading water too long...time for action.