It’s a slow and painful process, as the body is gradually overwhelmed. This is sometimes dubbed secondary drowning, when breathing is rendered impossible by liquid in the lungs, per Healthline. This is distinct from cases of drowning back on land, which can occur (though rarely) as the body tries to lessen the danger by restricting the respiratory system. This is sometimes referred to as dry drowning.

In a situation where somebody is sucked beneath the water of a river or ocean, they would be able to hold their breath for about a minute and a half on average, according to Outside Online. Guinness World Records reports that Budimir Sobat of Croatia claimed the male record for the longest time holding his breath voluntarily in March 2021, lasting an astonishing 24 minutes and 37.36 seconds. But however much breath somebody has, they will run out sooner or later. During the process, the lack of oxygen causes the blood to lose its red color and the limbs to fill with lactic acid. Terrible aches result.

The water seeping into the lungs overcomes the vital air sacs, Outside Online continues, and this sustained lack of oxygen damages the brain. Survivors have reported that this breaching of the lungs is the most painful part, per Speeli. Within twenty minutes of first being submerged, death results. Apparently, the body sinks, only floating as gases are created as it begins to break down.