One Patient's ICU Psychosis Story

Looking back, I'm not 100% positive if I had ICU psychosis or postpartum psychosis. Granted, I wasn't "believing-that-the-neurosurgeons-had-implanted-a-chip-in-my-brain-that-caused-me-to-flood-the-city-with-a-heavy-downpour-of-rain-psychotic" until I was in the ICU after cranial surgery; but looking back... I definitely had some (although significantly less predominate) postpartum psychosis symptoms before I left the hospital after giving birth several weeks before.

The Downward Spiral of Psychosis

I've been trying to tell this story for a few years, but it's a hard one to get out. It's hard to tell #1 because no one ever wants to admit that they went crazy and #2 because I'm not exactly sure how to make a logical story out of what was running through my head while I was psychotic without writing a novel or boring everyone to tears.

So I'm going to try to quickly outline my spiral into psychosis before I give much detail or helpful resources. I'm going to keep adding to this story as my memories come back and as time permits. But for now you get a quick outline of facts and dates.

1. August, 2005 Had constant, severe back pain. Of yeah and a multitude of other "unrelated" annoyances (like frequent headaches, and diminished hearing).

2. August 30, 2005 The day Hurricane Katrina hit New Orleans I found out I was pregnant. I knew I wanted to be medication free, and would do whatever it took to endure the pain I'd become so used to without medication for the rest of my pregnancy.

3. May 8, 2006 I gave birth to a healthy baby girl. So excited, I couldn't sleep the entire 48 hours I was in the hospital even after they gave me sleeping medication.

4. May 11, 2006 I was in so much back pain I couldn't walk.

3. May 12, 2006 I started blacking out at random, and moved back home to mom and dad's for additional help.

4. The Rest of May and June, 2006 No one knew what was wrong with me. I couldn't sleep, couldn't walk, and quickly lost the ability to even crawl or sit up.

5. Sometime around July, 2006 A paramedic watched me black out and noticed the way my eyes dilated and knew I either had epilepsy or a brain tumor. Turns out it was a brain tumor.

6. Several (4) cranial surgeries and ICU stays later... Still not sleeping much. I was acting a little manic, but nothing out of the ordinary for someone that could have just died. Eventually got back to sleeping regularly and everything seemed okay.

7. August 15, 2007 I had to go back for another cranial surgery to remove the last of the tumor. Stopped sleeping 48 hours before surgery, and started getting manic. Post-op was in a full blown manic episode but didn't realize that something was wrong until I after I was released from the hospital a few days later.

8. August - October, 2007 - Spent most of the time is psychiatric hospitals not sleeping, making collages out of magazine rippings and writing on the walls (so that the people that were programming my new existence could write my recommendations into the next version of my life) with markers. Was eventually released, but it was at least another three months after being at home before I came back down to reality.

Postpartum Psychosis and ICU Psychosis

I had many hospital experiences that were boarder-line psychotic.

Before I even left the maternity hospital after giving birth, I remember just feeling not like myself. I never would have classified this as postpartum depression because I didn't feel depressed. But I had a lot of energy, and was incapable of sleeping even when medicated. Every time I fell asleep I was either woken up by my new baby girl, or a nurse to check my vitals. At some point it was almost like my body quit trying to sleep, and even after I was released to go home I continued being insomniac.

At the ICU after my first cranial surgery (probably in June, 2006) I remember being extremely happy to be alive and to have a diagnosis. No one would have classified me as psychotic, but I was tending to not sleep and every time I did sleep was woken to have my vitals checked, my VP Shunt (that was still attached to a stand beside me rather than inside my body) re-calibrated or to a buzzer or monitor alarm. I saw things that weren't there (certain people, especially those with a positive and loving attitude, had eyes that sparkled and glowed) and I always heard locusts (just like in the summer time). No one seemed concerned when I told them theses things. I wasn't sure if it was a side effect from the drugs, the cranial surgery, or if God was just giving me some coping-mechanisms in the form of psychosis.

1. When I started tethering the blood drain (still attached under my skin to collect the excess blood from surgery) at my visitors.

2. When I woke up at 4am in the morning demanding to the attending nurse that I get access to email before my surgery (even though it was at last 48 hours post-op).

3. When I started calling my friends in the middle of the night and leaving them random messages about the utter perfection and beauty of life (thank goodness no one answered).

4. When I started blaring my healing iPod mix so that the other recovering patients could "enjoy" the mix as well.

When it Rained in my 4th Floor Room

After my surgery, heavy thunderstorms came through the city I lived in. I was definitely already manic, and not sleeping. I remember being in a regular room (not in the ICU at that point) and listening to my music, pacing the floors wondering if I could "volunteer to sleep in the hospital" once a month just because it was so much fun.

And the rain kept getting heavier and heavier, and then at around 4am in the morning my hospital room sprung a leak. And not just ANY leak! The water started pouring into my room and started going out into the hallway (a bucket wouldn't even contain it).

So I pressed my call button. I had a great time trying to get my nurse to explain to me why rain was coming into my room (on the 4th of seven floors). I think they ended up telling me that an air conditioning unit ended up breaking, but during my manic episode I had a MUCH more plausible explanation...

What causes ICU psychosis is not fully known

Some things that can either cause (or contribute to) ICU, Postpartum or any type of Psychosis include:

- Unfamiliar and Uncomfortable Surroundings

- Sensory Overload (all the buzzers, and monitor alarms day and night)

- Stress

- Pain

- Medication

- Sleep Deprivation (when you do sleep they have to wake you up!)

- Disruption of natural day and night rhythm

- Lack of control (maybe the patient can't even get up to go to the bathroom on their own anymore)

But anyone can get ICU Psychosis. It does not mean you're weak or crazy! I even read a blog post about a surgeon that developed ICU Psychosis (and somehow found that very comforting).