The behavior of an active-drowning victim usually begins with struggling. Movies and TV often portray this by showing victims who violently panic and yell for help. In reality, this never happens. Usually the victim begins struggling without making much noise. Among toddlers and babies, drowning is often silent. This is why responsible adult supervision is so important.

In real life, this struggling involves arms moving rapidly up and down and legs back and forth - a far cry from portrayals. Lifeguards sometimes call this behavior "climbing the ladder." As they struggle, a victim begins to hyperventilate as the head goes lower and lower. Sometimes a victim will attempt to roll over on their back, but usually this is futile. Finally, the victim submerges.