ICU Stays Can Lead to Post-Traumatic Stress Disorder

I haven’t read anything on this topic before, but patients who spend long periods in Intensive Care Units have been developing post-traumatic stress disorder (PTSD) after experiencing frightening hallucinations while hospitalized and drugged.

The New York Times Tuesday published an article, “Nightmares After the I.C.U.,” about this issue. The newspaper reported that annually 5 million patients spend time in ICUs, and as many as 35 percent of them have PTSD symptoms for up to two years after their hospital stay.

http://well.blogs.nytimes.com/2013/07/22/nightmares-after-the-i-c-u/?ref=science&_r=0

“Yet I.C.U.-induced PTSD has been largely unidentified and untreated,” The Times wrote.

There are several anecdotes about ex-ICU patients and their experiences. The prime case study is that of Lygia Dunsworth, a registered nurse in Dallas. She had been hospitalized for abdominal infections, and she had a series of terrifying hallucinations.

According to The Times, Dunsworth saw helicopters evacuating patients outside her window, and at one point thought that she had fled from the ICU and hid in a freezer, which turned out to be filled with body parts. For years after her release, Dunsworth suffered from PTSD, suffering memory loss and insomnia.

Why does this happen?

The Times pointed out that the ICU setting itself, where many patients are intubated, a tube put down their windpipe to help them breathe, is frightening to patients.

And the drugs that ICU patients are prescribed can cause hallucinations, according to The Times. Sedatives are a part of the ICU, as are pain killers. And the sedative class benzodiazepines can “intensify” the hallucinations of ICU patients, the Times reported.

Benzodiazepines can cause patients to have amnesia, and can also prompt hallucinations and delirium, later leading to PTSD, according to The Times.

This was a problem that the Society of Critical Care Medicine addressed in January, when it issued new guidelines for sedating ICU patients. It recommended that ICU physicians “treat pain first and only then weigh using benzodiazepines for anxiety,” The Times wrote.

Perhaps the article in The Times will raise awareness of the problem of ICU stays leading to PTSD in the minds of both doctors and patients.