A stay in the intensive care unit (ICU) can be traumatic. Patients are confronted with their own mortality. They are rolled in and hooked up to machines. Perhaps they are ventilated or catheterised. They might drift in and out of consciousness, seeing a different set of faces each time they wake. Confusion, sedation, and delirium make it difficult to communicate; intubation makes it impossible. Mysterious alarms ring at strange times. If the stay is long enough, there is likely to be a death, perhaps more than one, elsewhere in the ward. Hallucinations are common, some of which sound like a scene from a horror movie. “I have had patients talk about seeing blood dripping down the walls, or children with no faces”, said Joseph Bienvenu (Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA).
Symptoms of post-traumatic stress disorder (PTSD) vary from person to person, but typically include a combination of flashbacks and nightmares, avoiding reminders of the traumatic event, emotional numbing, and hyperarousal. Symptoms generally develop within a month, but some patients experience delayed onset. Around 60% of patients recover naturally within 5 years.