ICU Syndrome: The Psychological Impact of Critical Care - Psychiatry

ICU syndrome

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Hello Dr.
Liao, at the end of last year, I underwent major surgery and experienced significant blood loss during the procedure, which led to my transfer to the ICU for monitoring.
During that time, I developed DIC, resulting in hypovolemic shock and necessitating a second exploratory laparotomy.
While in the ICU, I was mostly in a state of deep sleep; even when I was awake, my consciousness was foggy or dulled.
I believe this was due to the effects of sedatives and morphine.
Occasionally, when I was awake and saw my attending physician and the medical team by my bedside, I felt a surge of emotion.
I longed for someone to hold my hand, to feel a bit of human warmth instead of just the cold, sterile equipment and beeping sounds.
Neither my attending physician nor anyone else knew that I was aware during that time because I couldn’t speak due to intubation, and my hands were restrained, preventing me from communicating with them even through writing.
So, after the doctors left, tears streamed down my face—not from the pain of my wounds, but from the feeling of being "invisible."
I suffered greatly when the nasogastric tube was inserted and during suctioning, but the nurses kept encouraging me to endure and cooperate so I could leave the ICU sooner.
I understood how much I wanted to escape that place, which stripped me of my dignity.
During the second exploratory laparotomy, I was put under anesthesia and remained in a comatose state until I returned to the ICU after the surgery.
When I finally woke from that deep sleep, I saw my attending physician and the ICU doctors at my bedside, and I felt a sense of loss because waking up meant I had to once again endure the pain of being filled with tubes.
Once my vital signs stabilized, I was transferred to a general ward.
I couldn’t sleep at night because every time I fell asleep, I was jolted awake by nightmares.
For three consecutive nights, I dreamt of being crushed by a large truck or being killed in a collapsing building during an earthquake.
The pain from those dreams felt so real that I can still sense it now.
I’m grateful that my attending physician, upon learning of this, immediately called in a psychiatrist for an evaluation.
During the consultation, I could only cry.
Thanks to the medication prescribed by the psychiatrist, I managed to hold on until my discharge.
After leaving the hospital, I signed a DNR and organ donation consent because I didn’t want to experience such inhumane suffering again.
However, after undergoing two surgeries, I discovered that I had developed a deep affection for the feeling of anesthesia—being unconscious and free from dreams, just sleeping deeply.
I didn’t know that death might feel like this; I even considered finding a way to get "milk shots."
During my follow-up appointment, my attending physician still hoped I would soon overcome the psychological trauma from the ICU and the hysterectomy.
As I am single and unmarried, my attending physician suggested that if I couldn’t move past this, I should allow the psychiatrist to reassess me and not resist.
However, I didn’t follow the medical advice because I didn’t know how to tell the doctor, "I want to be anesthetized; I long for that feeling." Now, I have become accustomed to recalling that light, floating sensation of being under anesthesia before I sleep, where I feel no pain or discomfort, and I can finally relax and fall asleep.
Dr.
Liao, am I unwell?

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Zi Lu, 30~39 year old female. Ask Date: 2021/11/20