Long COVID Self-Management - Coping with Confusing or Frightening Memories of Your Hospitalization

Being ill in hospital can be a very stressful experience. Illness is usually unexpected. Health-care workers may have done assessments and procedures to keep you safe. You may have felt out of the loop with what was happening. You may also have needed a breathing tube to help with your breathing. This would have caused problems with being able to talk. You may have felt unsafe, unsupported, helpless, and/or hopeless. You may have noticed difficult thoughts or feelings related to your survival. You may have also seen or heard the struggles that other patients were having.

In addition, you may have been in pain. You were in a new, busy place full of bright lights and new sounds. It could have been hard to tell if it was daytime or night time, making it harder to sleep. You also may have felt lonely, as hospital restrictions limited any visits by loved ones.

If you had any of these experiences, it makes sense that you may continue to have some mental or emotional challenges. You might be having trouble thinking and difficulty sleeping. You may also be feeling anxious, on-guard and sad. Please see Managing Stress, Anxiety, and/or Low Mood.

People who have been severely ill, especially if they needed a breathing tube, may also notice changes in thinking abilities. If you’ve noticed changes in your mental processes, please review the managing changes in attention, memory, and clarity of thinking module on the Cognition page.

For strategies to improve sleep, visit the Sleep page.

Symptoms of trauma are not uncommon after a scary event. These often get better with time. The following information will focus on coping with confusing or scary hospital memories.

Understanding Delirium

You may have had uncomfortable or strange experiences while in the Intensive Care Unit (ICU). It could be hard to tell what was real and what was not. You may have:

• Had scary thoughts that shocked you.
• Seen or heard something that was bizarre or not really there.
• Believed that others were out to hurt you.
• Been aggressive to staff, even though this is not how you are typically.

This is not uncommon. These scary situations can happen in people who are experiencing delirium. This is a serious disturbance in mental abilities that can make a person feel confused and less aware of their surroundings. Delirium can come on quick, within hours or a few days. The strength of it can vary as well. Delirium can be caused by the illness itself, from medication or treatments. It will often go away as you start to recover. Lastly, a person's awareness level could be disrupted.

It is important to remind yourself that you were not in control of your thoughts or behaviour at the time.

Understanding Possible Reactions After a Frightening Experience

After a traumatic event, such as spending time in the ICU, you may have some trauma-related symptoms, including:

• Ongoing negative memories about the event.
• Nightmares, vivid dreams and insomnia.
• Flashbacks, or moments where it seems you were back in hospital and the scary event was recurring.
• Feeling very upset and/or having strong physical reactions when reminded of the event. For example, heart is racing, shortness of breath, feeling tense.
• Changes in the way you think about things
  • You might not be able to remember something important about the event (or feel that your memories of being in the hospital are not very clear).
  • The experience may have changed the way you think about yourself, others, and the world.
• Changes in your mood.
  • Often feeling fearful, angry, guilty, or ashamed.
  • Less interest in doing things that you used to enjoy.
  • Feeling more cut-off from others.
  • More difficulty feeling “positive” emotions, like happiness, love, satisfaction.
  • Changes in body reactions.
  • Feeling more annoyed.
  • More angry outbursts.
  • On high alert, on guard.
  • Easily startled.
  • Trouble sleeping.
• Avoiding internal and external reminders of the illness or your time in the hospital. For example, avoiding memories, thoughts, and feelings (internal). Or, avoiding places, people, conversations, and situations (external).

Coping After a Traumatic Event

After frightening experiences, people want to feel safe and regain some control over their lives. Some coping strategies to consider using are:

• Reflect on what helps you to feel safe.
• Build routine and predictability into your day. Visit the Coping with Uncertainty page.
• Use grounding techniques if you feel distressed or have a flashback.
• Bring yourself back to the present moment.

• Engage your five senses- what are five things you can see? Four things you can feel? Three things you can hear? Two things you can smell? One thing you can taste?
• Focus on your breathing.
• Pick up an object and describe it in detail. Describe its colour, size, weight, scent, texture etc.
• Remind yourself that you are safe in this moment.
• Be mindful about how you are trying to cope.

• It is natural to want to avoid thinking about or feeling emotions related to a frightening experience. However, if you go out of your way to avoid thoughts, feelings, and reminders related to this, your symptoms could get worse. Some people avoid their thoughts and feelings by self-medicating with alcohol or drugs, which also can negatively impact recovery. Try to improve sleep. Feeling on-guard or unsafe can make it hard to fall asleep.

• Consider what would make your sleeping environment feel safer? Perhaps having someone else sleep next to you would help or having a phone within reach.
• See the Sleep page for general tips for improving sleep.

It can be normal to experience symptoms of trauma after a frightening event and these symptoms often decrease with time. Speak to your physician if your trauma symptoms stay the same or do not improve after one month, increase, or make it hard for you to function. Of course, you can reach out for support prior to this as well!