The psychological impacts of the entire pandemic have been vast, but little exceeds the impact that the fear of losing loved ones has on our psyche.

A new study has found that post-traumatic stress disorder (PTSD) is common in people whose family members spent time in intensive care with COVID-19. The study showed that these effects lingered with family members still struggling with PTSD 3 months after ICU admission.

This study looked at the families of patients who were admitted to the ICU with increased oxygen requirements at 12 hospitals in Colorado, Washington, Louisiana, New York, and Massachusetts. Prior to this study, the accepted figure for the instance of PTSD among family members of ICU patients was approximately 30%. This study revealed a far higher figure of 63%, suggesting that the impact that severe COVID-19 cases have on family members is far higher than other ICU admissions.

Traumatic COVID-19 experiences

PTSD has been alarmingly common during the pandemic, impacting people who have been admitted to the ICU with additional oxygen requirements and frontline workers alike. Fearing for your own safety, losing loved ones, or spending each day watching patients struggle can all have massive impacts on our mental health.

Healthcare staff have described the frontlines during the pandemic as ‘a war zone’ as they struggle to compensate for staff shortages and battle immense waiting lists. The attrition rate in the sector is incredibly high as more and more staff wind up grappling with PTSD and high levels of burnout owing to the traumatic experiences of the past two years.

While many people may experience stress following a traumatic experience, people with PTSD get stuck in that stress response for prolonged amounts of time. PTSD involves intrusive flashbacks to the traumatic event that caused it, resulting in the person reliving the event. These flashbacks can be triggered by certain stimuli or events, which in turn leads to anxiety around these triggers. People with PTSD may also be more emotional than usual and struggle to regulate their emotional responses.

A subtype of PTSD known as Complex PTSD, or C-PTSD, is ‘caused by multiple, long-lasting, repeated or continuous traumas’ which can include living under sustained threat for a long period of time. Some healthcare staff who have been working consistently in ICUs throughout the pandemic may be dealing with this complex form of PTSD.

Treatments for PTSD and C-PTSD include Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) which can help process the memories and break out of the cycle of reliving events.

PTSD in the families of ICU patients

Family members being admitted to the ICU is never easy and comprehending the health dangers associated with COVID-19 has been found to lead to additional trauma.

Instances of PTSD in family members of COVID-19 ICU patients were found to be highest in those who are Hispanic, female, and had used psychiatric medications in the year before the ICU admission.

The pandemic and associated restrictions have meant that many people have been unable to see their loved ones whilst they are in hospital, adding to the stress of the situation and heightening the chances of developing PTSD. The families have then also been unable to develop a relationship with clinicians, which can lead to distrust and potentially the belief that medical teams did not do everything they could have to support their loved one. This is backed up by the findings of the study which found that people with the highest PTSD symptoms also exhibited greater distrust of practitioners. To the knowledge of the study’s creators, ‘​​no previous linkages between PTSD and distrust of health care practitioners have been reported; thus, this finding warrants further study.’

As the majority of people in the ICU due to COVID-19 are unvaccinated, there are likely to also be feelings of guilt, shame, blame and frustration surrounding the admission to the ICU.

On top of this, thinking about the virus has been inescapable; the world as it stands serves as a constant reminder of the virus that placed loved ones in such a precarious position. This will not only be a PTSD trigger but also exacerbate stress for those who haven’t fully developed the disorder but are still coping with the traumatic experience of having a loved one in danger

If you are experiencing any symptoms of PTSD or struggling with your mood, do not hesitate to seek support. PTDSD UK provides excellent resources and Mind provides a directory of available mental health support services.