<\/strong><\/p>\n<\/div>\n[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”https:\/\/punkfish-academy.com\/wp-content\/uploads\/2025\/08\/Notfallsauerstoff-DAN-e1769457236461.jpeg” alt=”DAN Emergency Oxygen” title_text=”DAN Emergency Oxygen” _builder_version=”4.27.5″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.5″ _module_preset=”default” background_color=”#c1e2f2″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” text_orientation=”center” global_colors_info=”{}”]<\/p>\n
DCS: The Unreported Cases<\/h2>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n
What is the incidence of DCS?<\/h3>\n
DCS is relatively rare compared to injuries in other sports. Approximately one in 10,000 dives results in relevant symptoms \u2013 a risk most of us are willing to take.
But is it really that infrequent? Evidence suggests that many cases are never reported and don’t make it into statistics. This shouldn’t alarm us; after all, not every bruise from playing football ends up in an accident statistic. Most often, these are harmless symptoms that disappear on their own or with a little oxygen, which are not reported and perhaps sometimes not even noticed. Unlike a bruise, however, these symptoms are an indication: it seems the diver was close to their personal limit during this dive today. And even if that doesn’t say much about the next day or another dive, the sum of such cases could help close some gaps in today’s understanding of DCS.
Therefore, it would be desirable to talk much more about even minor ailments after diving.
In a blog article, we have analyzed very closely what is known about the incidence and how it is assessed. Here, the focus is on the best way to talk about DCS. <\/p>\n
[\/et_pb_text][et_pb_button button_url=”@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wb3N0Iiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjE1MjQxIiwiZW5hYmxlX2h0bWwiOiJvZmYifX0=@” button_text=”DCS Incidence and Unreported Cases” _builder_version=”4.27.6″ _dynamic_attributes=”button_url” _module_preset=”1b468ece-fbc6-41f0-9fbb-0d9bc6882bdc” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″][\/et_pb_button][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.5″ _module_preset=”default” background_color=”#c1e2f2″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.5″ _module_preset=”default” text_orientation=”center” global_colors_info=”{}”]<\/p>\n
What makes talking about DCS so difficult<\/h2>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n
Denial – “Not me!”<\/h3>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n
“The first symptom of DCS is denial”: Denial refers to the tendency to ignore and not want to perceive symptoms of illness that are too uncomfortable at the moment. This very human and understandable phenomenon is well-known in medicine and particularly dangerous because it leads to delayed or unSought treatment.
Now, in most cases, DCS is not a severe illness, but the phenomenon of ignoring or downplaying signs is still widespread.
The slight tingling in the skin, unusual fatigue, or the diffuse feeling that “something is different than usual” \u2013 should one really interrupt the day for that and perhaps spoil the next dive for others? Or even postpone a flight?
Unfortunately, ignoring symptoms can have serious consequences. The most important thing with DCS is to get oxygen as quickly as possible. This alone massively reduces the likelihood of permanent damage. But you only get it if you admit that something is happening.
Probably several reasons always play a role when symptoms are denied. Not to be underestimated are the logistical difficulties, the fear of having to be taken to a hyperbaric chamber with great effort, overturning vacation plans, missing dives or other appointments. But there’s also something else: the stigma associated with DCS. <\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” custom_padding=”0px|||||” global_colors_info=”{}”]<\/p>\n
Stigma – “What did I do wrong?”<\/h3>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n
We briefly mentioned that the stigmatization of DCS could be a relevant factor in why little is reported and much is hidden. This thesis seems difficult to prove when one sees how readily many responded to our survey. But even within this group of people who are happy to report, happy to help, and often explicitly mention that it is important to them to clarify that no one is to blame for DCS, something very important happens: the search for reasons. And that alone, as sensible as it may sometimes be, is part of the stigmatization.
We want to take a closer look at this here. First, a little sociology: What is this stigma all about? <\/p>\n
DCS as a Potentially Stigmatizing Event<\/strong><\/p>\nA stigma is often understood as a visible characteristic that marks a group of people and labels them as “different.” However, it is not just about visible signs, but primarily about questions of human identity. In his seminal work, Erving Goffman describes stigma as an attribute that can discredit a person in the eyes of others and calls their social identity into question. The decisive factor is not the characteristic itself, but the social attribution: an event becomes stigmatizing when it is interpreted as an indication of personal failure, lack of competence, or a violation of norms. Stigma thus serves a dual function: it creates distance from the stigmatized person, thereby confirming one’s own normality.
“The term stigma will thus be used in relation to a deeply discrediting attribute, but it should be seen that a language of relations, not of attributes, is needed. One and the same attribute can stigmatize one type while confirming the normality of another, and is therefore neither crediting nor discrediting as a thing in itself.”<\/em> (Goffman: Stigma, 1975)<\/p>\nIn medicine, stigma is discussed as a barrier to appropriate treatment, particularly in relation to mental illness, but also regarding certain characteristics such as obesity. Patients affected by a stigma seek treatment less often, are taken less seriously, receive poorer treatment as a result, and\u2014knowing this\u2014seek treatment even less frequently. (Stangl 2019) <\/p>\n
In the context of diving, DCS can fulfill such a function. Although the risk cannot be completely eliminated even with compliant profiles, the occurrence of DCS is often implicitly associated with errors in the planning or execution of a dive, or other “personal risk factors” are identified. <\/p>\n
Against this background, an experienced DCS can become an event that questions one’s own competence as a diver. Especially for experienced divers or professionals whose identity is strongly linked to their expertise, this can represent a potentially discrediting situation. <\/p>\n
The intensive search for reasons can therefore also be understood as a strategy of stigma management. By identifying external factors \u2013 such as dehydration, physical exertion, or anatomical peculiarities \u2013 the event is made explainable without fundamentally questioning one’s own competence. <\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_blurb title=”Erving Goffman: Stigma ” url=”https:\/\/en.wikipedia.org\/wiki\/Stigma:_Notes_on_the_Management_of_Spoiled_Identity” url_new_window=”on” image=”https:\/\/punkfish-academy.com\/wp-content\/uploads\/2026\/03\/Stigma.webp” _builder_version=”4.27.6″ _module_preset=”9d47ade3-d583-4ea6-a36c-a0486d9e1169″ link_option_url=”https:\/\/en.wikipedia.org\/wiki\/Stigma:_Notes_on_the_Management_of_Spoiled_Identity” link_option_url_new_window=”on” global_colors_info=”{}”]<\/p>\n
In his 1963 classic “Stigma: Notes on the Management of Spoiled Identity,” Erving Goffman describes how societies devalue and exclude individuals based on certain characteristics.<\/p>\n
[\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_blurb title=”Stangl: The Health Stigma” url=”https:\/\/link.springer.com\/article\/10.1186\/s12916-019-1271-3″ url_new_window=”on” image=”https:\/\/punkfish-academy.com\/wp-content\/uploads\/2026\/03\/Stangl-Health-Stigma.webp” _builder_version=”4.27.6″ _module_preset=”9d47ade3-d583-4ea6-a36c-a0486d9e1169″ link_option_url=”https:\/\/link.springer.com\/article\/10.1186\/s12916-019-1271-3″ link_option_url_new_window=”on” global_colors_info=”{}”]<\/p>\n
The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. Published by BMC Medicine, 2019. <\/p>\n
[\/et_pb_blurb][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” custom_padding=”0px|||||” global_colors_info=”{}”]<\/p>\n
Hindsight bias – you’re always smarter afterwards<\/h3>\n
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Hindsight bias describes the tendency to interpret events retrospectively as “predictable” as soon as their outcome is known. In diving, it looks like this: Tiny deviations – a few meters deeper than planned, ignoring the computer’s safety level, an unusually long surface – go smoothly over countless dives. However, once symptoms occur, the same little things suddenly seem like the only logical explanation. This tempts us to pin down causes prematurely and ignore the fact that a good deal of chance plays a role in diving. It is more helpful after an incident to first collect what is really certain, to leave questions unanswered and to accept that not every piece of the puzzle was visible from the beginning. This leaves room to learn from the overall picture instead of blowing up individual details into big mistakes afterwards. <\/p>\n
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And now? A practical, open approach to DCS<\/h3>\n
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Those who consistently take symptoms seriously have usually already taken the most important step. This begins with the willingness to accept fatigue, itching, or vaguely aching joints as potential warning signs. It doesn’t have to be serious \u2013 but talking about it and getting a little oxygen? That truly never hurts.
Crucial is a culture of error that describes processes instead of judging individuals. And above all, the recognition that no one can say why someone got DCS on that particular dive \u2013 at least, not most of the time. <\/p>\n
If profiles, gases, depths, and occurring symptoms are documented anonymously and shared with research teams or specialist forums, everyone benefits. For background knowledge on human factors, literature and workshops \u2013 such as those from The Human Diver<\/em> \u2013 offer a solid foundation for questioning beliefs and continuously improving one’s own practice. And we will show here how to talk about DCS. <\/p>\nDenial, stigma and hindsight bias are deeply human phenomena, but they do not have to jeopardize our safety. Recognizing and addressing them opens the space for honest conversations, faster help and informed learning from every incident. This not only makes diving safer, but also more relaxed: We are allowed to have limits and make mistakes – what matters is how openly we deal with them. <\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.5″ _module_preset=”default” background_color=”#c1e2f2″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.5″ _module_preset=”default” text_orientation=”center” global_colors_info=”{}”]<\/p>\n
Talk about DCS<\/h2>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n
We are collecting your stories: Have you ever had DCS? What was your experience like? Did you receive oxygen, was the insurance hotline involved? How did you feel afterwards?
You can help us collect data with the questionnaire if you have ever had DCS. <\/p>\n
[\/et_pb_text][et_pb_blurb title=”DCS Survey” url=”https:\/\/docs.google.com\/forms\/d\/e\/1FAIpQLSddgOO6iMgGTRovfwww5XmCDK9SLxBeLhbZkCcfBFZjXhalMg\/viewform?usp=header” url_new_window=”on” _builder_version=”4.27.6″ _module_preset=”9d47ade3-d583-4ea6-a36c-a0486d9e1169″ link_option_url=”https:\/\/docs.google.com\/forms\/d\/e\/1FAIpQLSddgOO6iMgGTRovfwww5XmCDK9SLxBeLhbZkCcfBFZjXhalMg\/viewform?usp=header” link_option_url_new_window=”on” hover_enabled=”0″ global_colors_info=”{}” use_icon=”on” font_icon=”l||divi||400″ sticky_enabled=”0″]<\/p>\n
Have you ever had DCS? Then tell us about it so we can include your story here!<\/p>\n
[\/et_pb_blurb][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.5″ _module_preset=”default” background_color=”#c1e2f2″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.5″ _module_preset=”default” text_orientation=”center” global_colors_info=”{}”]<\/p>\n
What we’ve been told<\/h2>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n
In early 2026, on a whim, we created a questionnaire and shared it in a few diving groups, asking who had ever experienced DCS. We had discussed how often we had observed DCS or heard about it from someone, and how different that was from the “1:10,000 risk” that we also share as a generally accepted estimate.
Although we explained above why talking about DCS is somewhat difficult, there seems to be a very strong need to talk about it. Responses to our very cautiously shared questionnaire came surprisingly quickly and with very detailed contributions. 37 out of 78 provided their email to be available for follow-up questions, and everyone I asked for a more in-depth interview was immediately willing to do so. It appears that this experience, or often multiple episodes, deeply affects the individuals concerned.
We will gradually present and discuss parts of the results here.<\/p>\n
<\/p>\n
<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"
Why is it so hard to talk about DCS, while every mountain hiker is allowed to cheerfully talk about their aches and pains after a day in the mountains? We need a different approach to DCS: less stigma, more research. <\/p>\n","protected":false},"author":1,"featured_media":15318,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","pmpro_default_level":"","footnotes":""},"class_list":["post-10627","page","type-page","status-publish","has-post-thumbnail","hentry","pmpro-has-access"],"yoast_head":"\n
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