A post by Dorothy Wade
In my work as an intensive care psychologist, I frequently hear from patients about the vivid and frightening experiences they undergo. Bombarded by hallucinations and delusions, their visions and thoughts are inescapably real to them. Often involving bizarre elements such as aliens, medieval monks or cannibals, the episodes could be mistaken for scenes of a horror movie (Wade et al 2014).
Marilyn believed there was a baby factory in the hospital basement. She told me the nurses were manufacturing ‘Frankenstein babies’ with disabilities, as a scam to claim welfare benefits. She had seen it for herself, and urged me to go and check the basement. Irene saw puffins jumping on the bed next to hers, shooting blood at her from plastic rifles and laughing day and night. She was scared, but didn’t tell staff or family about the gun-toting birds in case they thought she had lost her mind.
Like thousands of seriously ill people in hospital every day, Marilyn and Irene were suffering from an altered state of consciousness known as delirium. In the aftermath they were terrified, both from the experience, and the belief that they were going mad. Delirium is like imagination on steroids (often literally). There seems to be no limit to the ideas, emotions and extraordinary tales the mind can generate in this state. Delirium in ICU results from brain changes caused by illness, medications (sedatives, opioids or steroids) and a disorientating environment. Although usually temporary, the syndrome may leave people with significant cognitive problems and psychological scars.
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