How might I feel after being in the ICU?

Your mood may change often and you may:

• feeling upset and tearful,
• always feel tired and not be able to sleep properly,
• not care what you look like,
• be quick-tempered and snappy,
• feel guilty for causing so much trouble and worry,
• forget things,
• not feel hungry,
• not understand what has happened to you and how ill you have been,
• feel scared that you almost died, and
• worry about getting ill again and how long it's taking to recover

Your family and friends will be pleased to have you home, but they may not understand why you may feel sad. Talk to them about how you feel. Also, go to see your GP who may be able to offer you treatment or counselling to help you through this difficult time.

As you get better and start doing more, you will face new challenges. They can make you feel scared – try to keep calm and take slow, deep breaths.

After ICU you may experience some psychological symptoms, such as anxiety, depression, stress or post-traumatic stress.

It is possible to develop post-traumatic stress disorder which does need clinical intervention. If left untreated it can be triggered by a sound, smell or something you see.

Symptoms may include the following:

• intense, vivid dreams or nightmares that feel very real
• disturbing, sudden, vivid memories of events in the past (flashbacks)
• experiencing hallucinations by seeing things that aren’t there
• feeling much more worried, nervous or anxious about things than usual
• feeling tearful or depressed, or having deep feelings of hopelessness, and
• not enjoying the things that you usually do or lacking energy or interest in life.

These symptoms can be quite normal in the immediate aftermath of critical care, but if they worsen over time but you may need to talk to a healthcare professional, or if the symptoms are long lasting or if they are worrying you. The ICU or your GP may be able to advise you where you can get some help.

Treatments, such as EMDR (Eye Movement Desensitising and Reprocessing) aim to reduce symptoms of trauma by changing how your memories are stored in your brain. An EMDR therapist does this by leading you through a series of bilateral (side-to-side) eye movements as you recall traumatic or triggering experiences in small segments, until those memories no longer cause distress.

Sleep

You need regular sleep to keep your body healthy. It can take time to get back into a normal sleep routine. You may find it harder to fall asleep, or you may often wake during the night. If you have trouble sleeping, try a milky bedtime drink but avoid tea and coffee as the caffeine in them can keep you awake. Reading or listening to the radio before you go to sleep may also help. Your GP can give you advice if you have trouble sleeping, but things should return to normal as you become stronger and more active.

Understanding what has happened to you

People feel differently about their time in intensive care. For some the experience is no more worrying than any other stay in hospital. Some have no clear memory of it, or they may try to forget it. For others, being so ill can be a very traumatic experience and it may take time for them to come to terms with it afterwards.

The strong drugs and the treatment the ICU staff had to give you to help support your body, will have affected your body and mind. It is common for patients in an ICU to experience hallucinations, nightmares or dreams that can seem real and very frightening. At times, you may have felt slightly aware, but didn't know where you were or what was happening.

Hallucinations and paranoia

It's common for patients in an ICU to have hallucinations or nightmares often called ICU Delirium. You may have had dreams or feelings of being tortured, trapped in bed or felt as if you were being held captive. This can be caused by having drip lines and catheters inserted into your body to help support your body's normal functions and monitor your condition. The fear this causes can remain for weeks after you have been transferred to a general ward or discharged from hospital.

You may also have felt some paranoia as you tried to make sense of things when you were confused. This too normally passes with time. If going back to hospital for a follow-up appointment frightens you, take along someone you trust to reassure you.

Things that may help you get over what happened

After leaving hospital you may have questions about your stay in the ICU. Some hospitals offer a follow-up clinic. This usually involves being invited back to the ICU you were in to look around, see some of the staff who looked after you. The idea of going back to the unit can be frightening and it may be some time until you feel ready to do it. However, it can be very helpful to see where you were and find out more about what happened to you. Some ICUs keep diaries for their patients during their stay, and you may receive this at the clinic appointment.

You won't remember everything that happened to you in the ICU. Writing down what you can remember may help you to collect together your memories. You could try to remember something about each day you were in hospital to help make sense of the time you lost. It may help to ask your family and friends what they remember about it.

If your relatives or visitors kept a diary while you were in the ICU, reading it can help you understand what happened. It may take a while before you feel ready to read it, and it can be very emotional, but many patients who have read their relative's diary find it helps them understand what happened.

If it helps, take the time to understand the medical side of what happened to you. Staff at the follow-up clinic will be able to help with this or you can ask your GP about it.