Cognitive and emotional effects of recovering from ICU

Neuropsychology

A guide for patients and their relatives

What is Cognition?

Cognition is a term used to describe our thinking and memory skills. It comprises our ability to remember things, use and understand language, attend to information and make decisions.

Non-urgent advice: Symptoms

After leaving hospital you might experience problems with your cognitive function, particularly memory.

These symptoms are usually nothing to worry about and will typically disappear over time, but could include the following:

  • Going into a room and not knowing why you have gone in there
  • Losing things
  • Noticing that your thinking has slowed
  • Immediately forgetting what someone has just said to you
  • Finding it difficult to plan and organise as well as you used to do
  • Forgetting important tasks, such as a doctor’s appointment
  • Finding it more difficult to make decisions

Causes of cognitive difficulties

There are usually several factors that can contribute to cognitive or memory problems after a period of physical ill-health.

These may include:

  • Fatigue
  • Pain
  • Low mood
  • Anxiety
  • Effects of medication
  • Continuing physical health problems

When to seek further support

If your symptoms persist for more than three months and are interfering with your abilities to work or live your life independently, please speak to your GP or hospital doctor.

Emotional responses

After being critically unwell, you might experience a range of different emotions and periods of feeling stressed. This is normal and could be due to the illness, your time in hospital or the treatment used to help you get better.

How you might feel You may find that your mood changes often and you might:

  • feel upset and tearful
  • always feel tired
  • be quick tempered and snappy
  • not have an appetite
  • have difficulty sleeping
  • worry about getting ill again

Additional symptoms

These might be triggered by a sound, smell or something you see. These symptoms usually disappear over time but could include the following:

  • intense, vivid dreams or nightmares that feel real
  • disturbing sudden vivid memories of events in the past (flashbacks)
  • avoiding anything that reminds you of being ill or feeling numb
  • feeling irritable, jumpy and easily startled
  • feeling more worried
  • feeling low in mood or having feelings of hopelessness

When to seek further support

If your symptoms persist for more than four to six weeks, please speak to your GP or self-refer to your local wellbeing service. In Cambridgeshire this is CPFT’s Psychological Wellbeing Service, also known as Improving Access to Psychological Treatment (IAPT).

Self help

Sleep

Aim for a regular sleep routine, avoid caffeine/screens before bed.

Relaxation

Engage in activities that will promote calm, for example taking a bath or reading a book.

Stay connected

Maintain social connections with friends and family.

Engage in pleasurable activities

Do things you find enjoyable.

Feeling in control

Focus on the things you have control over.

Feeling hopeful

Talk to others about your experience but ensure this is balanced with the positives in your life.

Establish a routine at home and be organised

Find a single place to put your keys, phone and diary, make a ‘to do’ list, set alarms as reminders.

Managing fatigue

Avoid overexertion, rest when needed and alternate between more demanding thinking tasks and low energy activities.

Coping strategies

Use coping strategies that have worked well for you in the past and avoid unhelpful strategies (caffeine, alcohol, drug use).

Self-care

  • Stay active and take regular exercise with guidance from a doctor
  • Eat and drink healthily with small and regular meals/snacks
  • Get as much sunlight, nature and fresh air as possible

Wellbeing apps

  • Unmind – offers coping strategies
  • Headspace – meditation to improve wellbeing
  • Sleepio – to improve sleep
  • Daylight – ways to combat worry and anxiety