ICU Psychosis: The Causes, Common Symptoms, How It's Treated and How to Avoid It

ICU psychosis, also known as ICU syndrome, is actually a temporary psychosis that affects about 1 in every 3 patients that spend a lot of time in a hospital's intensive care unit, or in an environment that is similar - for instance, it has also been documented to have happened on regular medical floors of the hospital or even in nursing homes. But most of the time, it happens in the ICU, as the surroundings much of the time can be very disorienting there. There are many different causes of ICU psychosis, either to do with the setting the patient is staying in or medical issues in the patient, or both.

The Causes

The ICU ward can be one of the most hectic, sensory-deprived wards in any hospital. Many times the rooms lack windows and lights will be turned off and on at random throughout the day and night, which can make a person lose orientation as to what time of day it is, or even how many days have passed. This can be very confusing and disturbing for a patient who is already undergoing intensive care.

Sleep deprivation is another factor, as it is easy to have sleep disturbed in one of the busiest areas of the hospital. Doctors and nurses work all throughout the day and night, and when someone is in intensive care they need to be checked on even more often than they would otherwise. So constant disturbance of a nurse coming in to check a patient's vitals among other things can interrupt sleep.

Strict visiting hours are also in place in the ICU a lot of times, and a patient who may get comfort and support from having their loved ones around has to deal with the fact that they can't always be around. This can add even more stress to their already delicate situation.

There can be other causes, of course, that are not to do with the ICU environment. Medical issues, for instance, have a good chance in playing a role in developing ICU psychosis. Lack of pain medication, serious injury or illness, a bad drug reaction, or infection are all things that can lead to this. Of course, such things can be likely to happen on any floor of the hospital, as well.

The Symptoms

If you think someone you know may be developing ICU psychosis, be on the lookout for these signs:

- Severe anxiety
- Restlessness or inability to sleep
- Irritability
- Confusion
- Excitability
- Nightmares, delusions and/or hallucinations
- Paranoia
- Disorientation
- Any sort of behavior which seems to be abnormal

ICU syndrome is a real psychosis, albeit temporary, and should be treated as such. The symptoms each patient might have vary, but the above is just a list of the most common signs to be on the watch for. If suspected, a psychiatric evaluation should be conducted right away, along with a medical evaluation to rule out other issues that may be causing similar symptoms.

The Treatment

Once the ICU psychosis has been diagnosed, usually there will be one-on-one care where there will be always someone to stay with the patient, to ensure they won't cause harm to themselves. A sedative and/or anti-psychotic drug may be distributed, as well. Most of the time the psychosis will abruptly vanish after the patient has had some well-needed rest, or after several hours. In rare cases, it has been known to last up to two weeks! But in almost all cases, it completely disappears upon leaving intensive care.

How to Avoid

While it can be difficult to completely ensure an avoidance of ICU psychosis, more and more hospitals are taking precautions against it. Providing set sleeping times, keeping the natural biorhythms normal through keeping the lights set to follow day and night patterns, opening longer visiting hours, etc. are all methods that will greatly help towards preventing the psychosis. If you are a friend or family member of someone who is in intensive care, you can help by spending time with them and offering words of comfort, encouragement and familiarity.