It can take several months—and sometimes more than a year—to recover fully after intensive care. During this time, you may feel very weak, become tired after even minor effort, and find everyday activities such as dressing, moving around or eating difficult. This loss of independence can be disorientating and hard to accept. Intensive care is a demanding and intense experience that can leave lasting effects, despite everything the healthcare team does to support you. Learn more about the patient experience in intensive care.
The physical, psychological and/or cognitive difficulties that can appear after discharge are known collectively as Post-Intensive Care Syndrome, or PICS.
Their course varies and is difficult to predict: they may improve, persist or change over time. If you think you may be experiencing these symptoms, speak to a healthcare professional. Appropriate support can reduce their impact on your quality of life and help you recover as well and as quickly as possible.
At other times, you may feel invincible or unusually powerful because you survived. Some people move back and forth between these emotional extremes.
Hallucinations, nightmares and flashbacks: some patients continue to have dreams linked to their time in intensive care or to episodes of delirium during coma or while waking. These dreams can be very distressing and feel entirely real. They may be connected to feelings of helplessness in the ICU, to restraints used to prevent patients from accidentally removing life-sustaining tubes and catheters, to painful procedures, or to other experiences during care.
Memories of real events or “ICU dreams” may also intrude during the day while you are doing something else. They can interrupt your day, briefly pull you out of the present and take you back to what happened. These are called flashbacks.
These symptoms may be related to post-traumatic stress disorder (PTSD). PTSD is one way the mind can respond to the extreme stress experienced during critical illness. If this is happening to you, speak to your GP and a psychologist or psychiatrist. Effective treatments are available, including medication and psychological therapies.
Talking to the people who visited you, or reading an ICU diary if one was kept, may reveal details that help you understand and make sense of your ICU dreams. Understanding how the mind wove real sensations and events into these often unpleasant dreams can be very helpful.
Katia’s storyRecovery continues after discharge
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after an intensely distressing event. It is relatively common after intensive care and reflects the severity of what you have been through.
Anyone can develop PTSD after an event in which their life was at risk. Several effective treatments are available, but it is important to seek support.
Please note: avoidance is one possible symptom of PTSD. This may include avoiding places associated with the trauma. If you find that you cannot return to the hospital where you were treated, speak to your doctor or psychologist so that your care can be adapted without compromising your recovery. After intensive care, both your physical and psychological care—and your medical follow-up—remain essential.
You can find useful resources about PTSD on the website of France’s National Centre for Resources and Resilience.
You may experience anxiety after intensive care: fear of becoming ill again, fear that you will no longer be capable of doing things, loss of confidence, or fear that someone close to you will become ill. These reactions are common after the intense experience of critical illness, and they are not your fault. You can speak to your GP, a psychologist or a psychiatrist about your fears. If symptoms are significantly affecting your life, treatment—including anti-anxiety medication when appropriate—may help. For many people, anxiety gradually lessens with time.
Depressive symptoms are common after intensive care. Once again, these psychological effects are not your fault. You have been through a major and deeply destabilising event, and you may now be facing rehabilitation that is long, exhausting and discouraging.
You are allowed not to feel all right. You may feel sad, overwhelmed or uninterested in anything. You have lived through an experience that few people truly understand. Surviving does not guarantee immediate happiness; that sense of relief may take time. It may come only after your body has recovered further, you have had time to care for yourself and you have begun to make sense of what happened.
You are also fully entitled to ask for help from family and friends, healthcare professionals and mental health professionals. Depression is treatable, particularly when recognised early. Talk about what you are experiencing and share your perspective.
Family and friends may sometimes struggle to understand why you are “not okay” when they feel that the worst is over. From their perspective, the most dangerous period—when your life was at risk and they feared losing you—has passed, and they may want to move on. For you, however, this may be the point at which everything begins to sink in: what you experienced, the effects that remain, the time still needed to rebuild your life, and any temporary or lasting adjustments required. Speaking to someone outside your immediate circle can be invaluable and help you feel less alone and more understood.
Dominique’s storyDepression after intensive care
Katia’s storyThe right not to feel okay after intensive care
Cognitive difficulties affecting memory, concentration and communication are not uncommon after intensive care. Their severity and duration vary greatly from one person to another.
Everyday memory may be particularly affected. You may forget simple actions or important information more easily, which can be unsettling—especially when these difficulties are new and occur alongside other cognitive problems. Many patients also describe difficulty retaining or learning information, sometimes referred to as “brain fog”. Concentration may be fragile, attention may drift quickly, and even simple tasks can feel demanding, particularly when persistent fatigue is also present.
Difficulties expressing yourself, both in speech and in writing, may also occur. You may struggle to find words, lose the thread of a conversation, speak less fluently, have articulation problems, make spelling or grammatical errors when writing, or need to rely more often on aids for calculations.
These difficulties, which were not present before the illness, can affect many areas of daily life: reading, writing and communication, as well as activities such as driving. They may also affect family and social life, lead you to withdraw, and cause concern or misunderstanding among those around you.
If you notice cognitive difficulties after intensive care, do not ignore them. Speak promptly to your doctor or another healthcare professional involved in your recovery. A psychologist or speech and language therapist may also be helpful. A neuropsychological assessment can clarify the difficulties and guide suitable strategies, including cognitive rehabilitation.
Regularly exercising memory, concentration, learning and communication skills can also help. This may involve simple exercises, reading, or more engaging activities such as music, drawing, gardening, learning a language, or anything else that interests you and holds your attention.
Routines and clear reference points can make daily tasks easier to manage: write reminders, say the steps of an activity out loud, or plan your day. Tools and professional support are available. Because cognitive difficulties often overlap, they are best considered as a whole.
Above all, acknowledge the difficulties, respect your own pace, and treat yourself with patience and kindness as your abilities gradually return.
Your family and friends may have experienced the weeks you spent in intensive care as a period of intense fear and uncertainty. After you leave hospital, they may be especially protective—or even overprotective. This can feel comforting, but it may also be frustrating if you are usually very independent. Clearly communicating what you need—including help, but also privacy, quiet and time alone—can help everyone find a new balance. Tell them how you feel, and ask how they felt and experienced the period while you were in hospital.
Asking them to tell you about your hospital stay may help them release some of the anxiety they carried, while helping you understand why recovery may take time.
Laurie’s storyWhat loved ones experience when the patient wakes up
Rest and regular sleep are important for recovery, but your sleep may initially be very fragmented. The normal day–night rhythm was heavily disrupted in intensive care by round-the-clock treatment and monitoring. It may take several weeks for sleep to return to normal. Avoid coffee and tea later in the day and choose quiet activities, such as reading or listening to the radio, before bed. If sleep remains difficult, your GP can help.
Everyone experiences intensive care differently. Some people worry about the next stages of treatment; others try to put the experience behind them. For some, having been so critically ill is traumatic and takes considerable time and reflection to accept. Others feel a need to change their life or begin new projects. However you respond, what you feel is valid.
Jean-Yves’s storySearching for words
After discharge, you may have questions about your time in intensive care. Some hospitals offer follow-up after critical illness. This may include returning to the unit where you were treated, meeting some of the people who cared for you and discussing what happened.
The idea of returning to the ICU may be frightening. Wait until you feel ready, but bear in mind that a visit can help you understand both the events and your experience of them.
Reading and rereading an ICU diary written during your stay may help you piece together memories, fill gaps and make sense of what you experienced. You may wish to read it alone, or you may feel safer with someone close to you—either simply present or reading it aloud if you ask them to. Seek support if that feels right for you.
The ICU diary
Sharing your experience with people who have lived through something similar can sometimes help. The Second Life social network was created to enable former ICU patients to connect with one another. This secure community brings together former patients, family members and healthcare professionals. Discussions take place in channels that may be open to all three groups or restricted to one group.
The Second Life social network
If you experienced another psychological effect of intensive care that we have not covered, please tell us about it. LifeMapp is a web app that grows through the experiences shared by its users.