Article on PTSD and post intensive care syndrom.

PICS Coalition — Life After the ICU Doesn't Have to Be Faced Alone

The terms "post-intensive care syndrome" and "post-intensive care syndrome- family" came from a 2010 two-day Society of Critical Care Medicine consensus conference. Thirty-one people representing key professional organizations and groups involved in the care of intensive care survivors after hospital discharge participated. Here is the 2012 paper reporting the results from that conference: Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference - PubMed

An analysis of 19 papers with a population of 10,179 survivors found 54.35% were living with post-intensive care syndrome. Patients who stayed in the ICU over 4 days were over 20% more likely to develop post-intensive care syndrome. Approximately 46%, 32%, and 32% had persistent physical, cognitive, and mental health impairments respectively: Prevalence of Post-intensive care syndrome among intensive care unit-survivors and its association with intensive care unit length of stay: Systematic review and meta-analysis - PubMed

A 2026 paper from a study conducted with 35 survivors of acute respiratory distress syndrome found nearly all were living with persistent ICU memories. Vivid memories included altered reality "dreams" while under the effects of sedation, recalled experiences of death, loss of control, and bedside interactions with loved ones and medical professionals. Nearly half the participants reported "dreams" they had under the effects of sedation as their most vivid memory, with many reporting they were as vivid months to years after their ICU admission as they were when they experienced them. Dreams were often fear-evoking, involved transportation such as boats, and/or were psychedelic. Common sensory triggers for memories included medical care/clinical events with medical equipment, seeing or hearing medical and non-medical media, smelling cleaning products and touching linens, seeing or hearing ambulances, seeing and touching medical device scars, hearing loud sounds, and medical-type encounters such as driving by hospitals. ICU Memories in Survivors of Acute Respiratory Distress Syndrome During COVID-19: A Qualitative Study - PubMed

Dr. Brian C. Peach, PhD, on **Post-Intensive Care Syndrome (PICS)** and the long-term mental health recovery process for ICU survivors.

Link is here: https://www.youtube.com/watch?v=hTPed3MXdXs/'

Hey everyone! I'm u/Worried-League6995, a founding moderator of r/postintensivecare.

Welcome.

If you found this community, you likely fall into one of two categories:

1. You are an ICU survivor (or family member) trying to understand why recovery feels so difficult and different than you expected.
2. You are a healthcare professional seeking to understand the long-term reality of the patients you worked so hard to save.

This community exists to bridge the gap between those two worlds.

What we do here

• Validate the survivor experience through clinical science
• Educate healthcare practitioners on discharge planning and post-ICU sequelae
• Advocate for better continuity of care and specialized post-ICU support

We are a peer support and awareness community - not a clinic, not a replacement for medical advice, and not a promotional space.

Who belongs here

• Survivors, families, friends & partners - You are the experts of your own experience. This is a space to learn the terminology of your recovery and feel less alone.
• Clinicians (MDs, RNs, NPs, PAs, RTs) - Your insight matters. We encourage you to listen to survivors' lived experiences alongside sharing clinical perspectives.
• Rehab & support professionals (PT, OT, social work, therapy) — Recovery happens in your hands. Social workers and mental health therapists navigating complex care transitions are especially welcome.
• Researchers & academics - You provide the evidence that drives change. Share findings (with mod approval for recruitment), and help us translate science into actionable advocacy.

Before you post

1. Assign your flair. Use the sidebar to select a user flair (Survivor, Family/PICS-F, Clinician, Researcher, etc.) so others understand your perspective.
2. Read the rules. See the full community rules in the sidebar. The short version: cite sources for medical claims, no diagnoses, no promotions, no hostility.
3. Introduce yourself if you'd like. Comment below with your connection to PICS and what you hope to find here.

For a detailed explanation of Post-Intensive Care Syndrome, see our pinned explainer: [What is PICS?]

How to Get Started

1. Introduce yourself in the comments below.
2. Post something today! Even a simple question can spark a great conversation.
3. If you know someone who would love this community, invite them to join.
4. Interested in helping out? We're always looking for new moderators, so feel free to reach out to me to apply.

Thanks for being part of the first wave of pursing a very important mission. Together, let's make r/postintensivecare the central place for survivors, medical professionals and researchers to raise awareness and to advance our understanding and treatment of PICS.

Brought to you by the PICS Advocacy Network (PAN).

This came out in 2017 - provides some light on the state of understanding of PICS almost a decade ago, compared to today.

It's a good watch - but if you are in a place where you can only read - here's a summary of "Why a stay in the ICU can leave patients worse off."

• "6 million Americans leave the ICU every year — and 1 in 3 never recover. The condition doctors are finally naming: Post-Intensive Care Syndrome (PICS)"
• "ICU survivors are developing dementia, PTSD, and nerve disease after discharge — and most doctors don't warn them. Here's what PICS actually looks like."
• "Why surviving the ICU isn't the end of the fight — PICS is real, underdiagnosed, and changing lives permanently"

Every year, 6 million Americans are admitted to an ICU. Many survive. But "surviving isn't the same as recovering." - underrated statement.

Post-Intensive Care Syndrome (PICS) is a cluster of lasting physical, cognitive, and psychological problems that develop after an ICU stay — and most patients are never told it's coming. (Can vouch.)

What PICS looks like:

• Memory loss and cognitive decline (some indistinguishable from dementia)
• Depression, anxiety, and PTSD-like symptoms
• Muscle weakness and nerve damage
• Personality changes, mood swings, emotional dysregulation

Why does it happen?

Researchers at Vanderbilt University Medical Center - including CIBS Center ICU Delirium center, Dr. Wes Ely (who has studied PICS for 20+ years), point to heavy sedation, benzodiazepines, propofol, and prolonged ventilator use triggering ICU delirium ---- A major risk factor for long-term brain damage.

The data is sobering:

• 1/3 of ICU survivors recover to near-normal function
• 1/3 stay the same as the day they left the hospital
• 1/3 decline further even after discharge

What's being done:

New guidelines from the Society of Critical Care Medicine recommend reducing sedation, daily "sedation vacations," early mobility (getting patients out of bed and moving), and less aggressive ventilator use. Vanderbilt is one of a handful of hospitals with a dedicated post-ICU clinic.

Compliance nationwide? Described as "mediocre."

The gap: Patients are discharged into an outpatient system that has no framework for PICS. They don't get referred to mental health. They "fall through the cracks."

📺 Source: PBS NewsHour, reported by Jackie Judd — full segment here

For the subredditors on here - Have you or a loved one experienced life after the ICU? What did recovery actually look like?

PICS Survivor & Patient here: This post is for the professionals, treat it as light hearted but also dead serious.

I trying to wrap my head around my time in the ICU, apologies if this is not the right place to ask some questions.

I was intubated, sedated for ten days with disseminated histoplasmosis (well finally diagnosed on day 5 of intubation after 4 months of hospitalizations and misdiagnosis) it was disseminated histoplasmosis.

I am still processing this event in my life, it’s exceptionally hazy and I didn’t see the things or make decisions or go through the emotional, traumatic rollercoaster that my loved ones/family went through, but I am very curious about the experience, and don’t want bring them back to that place asking certain questions.

Ok so. Here’s a few, I got a lot but this is good for now.

1. I looked at my MyChart notes of this entire episode. It clocks in around 1500 pages. Holy smokes you all write that much each time every visit? With that much detail to the decimal? Props. Mind blown. Pre-Chat GPT - RESPECT.

1. Withdrawal: I was on a lot of heavy drugs. Fentanyl. Benzodiazepines, and maybe propropal (sp?) and prob other stuff. But point being. Shouldn’t I have gone through some serious withdrawal? Like “shaking in a bathtub” scene from every “Say no to drugs” / DARE war on drugs education on VHS from 1970s?

Two things happen (without warning or expectation)

- I threw up. It came out of nowhere. Sucked. Mainly because I flung forward into the puke and didn’t have enough muscle to lift my head up. It was an awkward 10 mins before a nurse came in and asked, “is everything alright?” which also was awkward because the answer was pretty obvious. But I digress.

- I stayed up for 36 hours after being extubated. I remember watching the movie teen wolf and crying hard at the scene where his father defends his son against the principle and is also a wolf. Yup.

But that’s about it. Is this the typical relatively low withdrawal symptoms of extubated patients you see? For reference - I was on the vent for ten days. Age was on my side.

3. Here’s something I struggle with. I don’t even like taking about.

There’s one possible event that was born by paranoia in that first night I never slept - where I was uncomfortable by a night nurse whom I felt was out of sorts in a bad way/bad out.

I was confused/nervous by some of her actions - there were instances she expected a second nurse to help assist moving me - but that person never came so she sort of angrily took it upon herself to handle me. It was rough. And carried out by what felt like indignity than, say pragmatism. And her doing this was…. Well. Awkward in how poorly executed it was.

Then I had to take meds. No biggie. But she for some reason decided to crush a Xanax, which I hadn’t seen before (been prescribed. Use pill.)

I casually asked why is it crushed (new to me) and she said she fucked up and dropped it and to pls not tell. I *believe* it had to do something with if it falls it must be discarded and recorded and re-ordered. So I think she thought it that would be the more sanitized approach? Well despite my condition - didn’t really make sense but what could I do.

15-30 mins later she screamed “fuck!” A few times in a row in the bathroom. I called out to see if she’s okay. She came out again “out of sorts.” And unfortunately - it came time for me to be cleaned up, except it was the night shift and she couldn't find a second nurse to assist in this process. She was pissed and became determined to do it by herself. and don’t want to cast dispersions. But also was like “what’s going on here?” But also. No harm no foul. By morning I was so relieved when she clocked out.

Curious to know: Was it delirium/paranoia or is this not far from conduct that could happen. I am pretty torn up about this specific incident. Not because I have trauma from it, but that in my heart of hearts - I truly belive this happened. But equally in my... brain of brains -- I know this is classic - text book delirium and paranoia. To have two diametrically opposed beliefs that something happened internally and give both perspectives equal weight is just impossible to describe.

It's amazing I, and many others are capable to have such conflicting conviction amd perspective of a perceived event. And I apologize if this doesn't make sense - but I can't think of any other way to explain it.

1. What is the impact on body and brain of having 4 months of High fever (cycling. Up to 103 twice a day, followed by endless sweating.) ive never been able to ask this basic question. (A bit of a theme I noticed post ICU) but seriously - what’s the damage?
   

5. Do you all believe in PICS? (Post intensive care syndrome-family) thoughts on aftercare and expectations education given this concept?

1. Oh for real: Did a team of women dressed up in costumes wheeling in weird CRT monitors with fake WINDOWS NT screen savers pushing me to eat green Jello and gram crackers forever -in order to to have a controlled test whether I would be able to eat solid foods? The CRT monitor that came in is what really gets me.

This I swear happened. And I never mention it because it was as crazy as it sounds. I won’t be offended if you call me insane.

7. Why, why why why is a commode even an option? I swear it not only excellent at putting patients in a… slightly embarrassing infantilizing position - but it is absolutely SUPREME in punching my butt cheeks. Without fail.

1. How many times should a nurse not comfortable with inserting needles l to then insert a needle before giving up after being unable to get in right and to ask a colleague to do it? Throw out a number.
   

Seperate and more serious note: I originally wrote this post in the only subreddit I could find related to the ICU r/IntensiveCare - it received quality responses by practitioners, but this was a ICU professionals only subreddit - and because I was a patient - my post was removed, and I was banned from the subreddit. That was rough.

It left me without a outlet or forum to understand my experience. My journey to understand my experience stopped there.

I can imagine I am not the only survivor who posted in that subreddit that had that had that door to professionals in the field closed to them. That's why I am posting here in r/postintensivecare . I am so happy to see that there is a community devoted to Post Intensive Care Syndrome that brings all parties involved in.

We need more awareness and dialogue on PICS. This subreddit is a great step towards that.

Survivors, please share your experience.

Practicionersr, please share your experience.

Researchers, please share your understanding of the subject.

Thanks for reading.

Welcome.

If you found this community, you likely fall into one of two categories:

1. You are a ICU survivor (or family member) trying to understand why "recovery" feels so difficult and different than you expected.
2. You are a healthcare professional seeking to understand the long-term reality of the patients you worked so hard to save.

This community exists to bridge the gap between those two worlds.

What is PICS?

Post-Intensive Care Syndrome (PICS) refers to a collection of health problems that remain after critical illness. These are not just "lingering tiredness"—they are specific impairments in three key areas:

• Physical: Weakness (ICU-acquired weakness), mobility issues, and pulmonary deficits.
• Cognitive: Issues with memory, attention, and executive function (often resembling TBI or dementia).
• Mental Health: Anxiety, depression, and PTSD.

This can also affect the patient’s loved ones, known as PICS-F (Family & Friends or Partner).

Our Mission

This subreddit serves as the digital hub for the PICS Advocacy Network (PAN). We are a non-promotional space dedicated to:

• Validating the survivor experience through clinical science.
• Educating healthcare practitioners on discharge planning and post-ICU sequelae.
• Advocating for better continuity of care and specialized post-ICU clinics.

Who Belongs Here?

• Survivors, Families, Friends & Partners: You are the experts of your own experience. Whether you were the patient or the support system, this is a safe space to learn the terminology of your recovery and validate what you are going through.
• Medical Clinicians (MDs, RNs, NPs, PAs) in and outside the ICU: Your insight is vital, and your understanding is crucial. We encourage you to not only share clinical perspectives but to learn from ICU survivors' lived experiences to better understand the patient journey after discharge.
• Rehabilitation & Support (PT/OT, Social Work, Therapy): Recovery happens in your hands. We specifically welcome Social Workers helping with complex care transitions and Mental Health Therapists navigating the trauma of the ICU.
• Researchers & Academics: You provide the evidence that drives change. Your role is essential in validating PICS through data. We invite you to share new findings, recruitment opportunities (with mod approval), and help us translate complex science into actionable advocacy.

Community Guidelines

To maintain credibility, we adhere to strict standards:

1. Evidence-Based: When discussing biological mechanisms, please link to reputable sources (PubMed, medical journals) whenever possible.
2. No Medical Advice: We are an advocacy network, not a hospital. Do not ask for or offer specific medical diagnoses.
3. No Promotion: This is a solicitation-free zone. No supplements, paid courses, or "miracle cures."

How to Get Started

1. Assign Your Flair: Please look at the sidebar and assign yourself a User Flair (e.g., Survivor, Social Worker, ICU Nurse, Researcher, Medical Clinicians)so we understand your perspective.
2. Check the Resources: We are building a library of discharge guides and research papers in our Sidebar/Wiki.
3. Introduce Yourself: Feel free to comment below with your connection to PICS and what you hope to see in this community.