Can the ICU Cause PTSD?

The New York Times recently had a very interesting article, titled, “Nightmares After the ICU,” and we’re not talking about the bills the patients receive after their stay. But seriously, the article dives deeply into the idea that stays in the ICU can be so traumatic and stressful that they can cause PTSD. And, research is showing that stays in the ICU can not only cause PTSD for patients experiencing the treatment, but also for family members who witness it.

The article describes vivid and terrifying hallucinations that patients have experienced –even health care professionals when they were patients –hallucinations so terrifying and real that even they couldn’t discern them as fake and couldn’t shake the experience, post-ICU stay. This is a unique aspect of ICU PTSD when compared to others who suffer from PTSD: soldiers, natural disaster survivors and sexual assault survivors, for example, all tend to relive their very real experiences –not hallucinations. The article goes on to state that about 5 million people experience an ICU stay each year, and that up to 35% may have symptoms of PTSD for as long as two years afterwards. Yet, very little is done to try and identify these patients. (Family members are also starting to become another recognized group of PTSD sufferers. Witnessing a loved one on life support, near death and/or suffering can adversely impact these individuals long-term as well.)

Patients who may be at a higher risk for PTSD post-ICU include women, patients with a longer stay, younger patients, patients with a history of depression or other emotional problems, patients who experienced a violent event that landed them in the ICU, the use of sedation, including benzodiazepines and opioids.

The article goes on to describe several initiatives being undertaken by critical care nurses in several countries to help both patients and families manage their inpatient experiences, hoping to head-off experiences so awful that they cause PTSD.