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Common psychological issues

Common psychosocial issues

While returning home might feel like a big relief for some people, it can also feel quite overwhelming to be without the reassurance and support of hospital staff.

It is common for the first few weeks and months of being back home to feel quite strange. You may not quite feel like you did before you became ill, and it can sometimes be hard for others to fully understand what you have gone through and how it feels to face the future.

For some, it can be helpful to speak with other people who have had similar experiences.

For people who were in Guy’s or St Thomas’ ICU, we offer an Online Peer Support Group (contact icuclinic@gstt.nhs.uk if you want to find out more).

ICU Steps, a national charity set up by ICU survivors, also has support groups across the country. You can find out more from their website at www.icusteps.org

 

Upsetting nightmares and ‘flashback’ memories, worry about the future, feeling detached from others, irritability, a deep sense of loss, feeling more vulnerable than before, difficulty sleeping, finding it hard to enjoy things and a general sense of unease are all very common after critical illness requiring intensive care. These often pass by themselves with time, as people get back into a rhythm of life after hospital and with the support of family and friends. 

If these problems continue for several weeks without improvement, or cause significant distress and impairment, you can seek professional help.

Improving Access to Psychological Therapies (IAPT) services are available across England and have been developed to provide talking therapies to help people who are:

  • Feeling down, low or depressed
  • Feeling stressed or anxious
  • Finding it hard to control worrying
  • Anxious in social situations
  • Experiencing low mood or anxiety in pregnancy or the first year after birth
  • Experiencing panic attacks
  • Experiencing flash backs of traumatic events
  • Caught up in excessive washing or checking
  • Experiencing anxiety, stress and low mood linked to a long-term medical condition
  • Worry or stress related to caring for someone with significant health or emotional needs

You can talk with your GP for more information, or read more tips in our article called 'getting help'. 

If you are very worried about your emotional wellbeing and you need help in a crisis:

  • Talk with trusted friends or family who you think will be supportive if you are in distress
  • If you need urgent help but can wait until the next day then your GP can be the first point of contact to help navigate the best service for you. You can request an emergency appointment with whoever is on duty.
  • If you feel unsafe and need immediate help go to your nearest hospital with an Accident and Emergency (A&E) Department where the psychiatric liaison team can help you (24 hours a day, 365 days of the year).

You can also Call 116 123 to talk to the Samaritans day or night for free or email: jo@samaritans.org for a reply within 24 hours.

 

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Document: Post-traumatic stress-a patient's story

This is a short article in the British Medical Journal 2012. It was written by a former patient who was training to be a Doctor at the time when she became ill.

Web Link: Psychology Tools

Psychology Tools is a resource library of self-help tools. It has detailed and high-quality information on different aspects of psychology and mood and information on treatment options.

Web Link: Shout website

Shout is the UK's first and only free, confidential, 24/7 text messaging support service for anyone who is struggling to cope. Launched publicly in May 2019 and we’ve had more than 1.7 million conversations with people who are anxious, stressed, depressed, suicidal or overwhelmed and who need in-the-moment support.

External Video: Sleep and dreams after ICU: Jackie's story

In this video, Jackie talks about her difficulties sleeping after ICU. She also talks about having dreams about ICU when she got home, and some delirium in ICU. Jackie's delirium sometimes made her think she was at sea, which is a very common ICU delirium theme. She also said that some of her delirium has led to a hobby!

Article: Sleep disturbances

Feeling tired is very common It’s very common to have problems sleeping in the first few weeks after you get home, even though you may feel very tired. You might struggle to get to sleep, have broken sleep, sleep for much longer than usual or sleep at different times to which you normally would (including napping during the day). Why can't I sleep? It's likely that many people experience sleep deprivation during their time in hospital. Some people wake several times...

Web Link: Sleep problems- Every mind matters website

If you're having sleep problems, this trusted NHS website has some simple steps you can take to ease those restless nights. Find out more on how to get to sleep and how to sleep better.

External Video: Stress and anxiety following a critical care admission - FICM video

This website contains a useful video explaining why stress and anxiety happens, how to get help and inlcudes patients talking about their experiences.

External Video: Struggling to sleep when you get home - Jada's experience

Some patients who have spent time in ICU find that they struggle with sleep when they are discharged home. In this video, Jada talks about her difficulties sleeping when she returned home. She talks about how when she was in ICU, she thought healthcare staff were trying to get her to sleep so that they could harm her (this is a common theme in ICU delirium), and this made her anxious to fall asleep even when she was at home. She talks about how discussing this with a psychologist was...

Web Link: Top tips for a good night's sleep

Sleep and rest are effective ways to reduce the symptoms of fatigue. However, a good night’s sleep isn’t always easily achieved. Despite being extremely tired, many people have difficulty falling asleep, staying asleep, or waking too early in the morning. A lack of sleep has many negative effects on a person’s physical and mental wellbeing, especially in the early stages of brain injury recovery. It may also exacerbate some of the symptoms of the brain injury, such as...

Web Link: UK Government Information; Personal Independent Payment

This link provides information on Personal Independence Payment (PIP) scheme