Takeaway
For patients navigating the complex aftermath of critical illness, feeling heard and understood can be as impactful as any test, prescription, or referral. When clinicians approach patients with Post-Intensive Care Syndrome with curiosity and empathy, they can help transform survival into true healing.
Lifelong learning in clinical excellence | June 23, 2026 | 2 min read
By Elisabeth Nickels, PhD, Johns Hopkins Medicine
A man in his 50s came to the intensive care unit (ICU) with a life-threatening respiratory illness. After three months of critical care, including intubation, VV-ECMO cannulation, and tracheostomy, he survived, completed acute rehab, and returned home. While undeniably a success story, months later, he still struggled with fatigue, pain, stiffness, brain fog, depression, anxiety, grief, and upsetting memories. The crisis had passed, but the path forward felt unclear. Unfortunately, this experience is more common than many clinicians realize.
Life after the ICU
Post-Intensive Care Syndrome (PICS) describes physical, cognitive, and psychological challenges that can emerge after critical illness, lasting from weeks to years. Patients may experience generalized weakness, fatigue, decreased mobility, pain, sleep disturbances, cognitive difficulties, sexual dysfunction, and challenges returning to employment or previous roles.
The psychological effects can be equally significant. Research has shown that nearly half of post-ICU patients experience psychological disorders at three months post-discharge. Anxiety, depression, and post-traumatic stress symptoms are common, often affecting recovery long after the acute illness has resolved. Families can be affected as well, by emotional distress, complicated grief, and the ongoing demands of caregiving.
Supporting the whole person
Clinicians across every specialty can recognize and address PICS symptoms by approaching each patient with curiosity and compassion. Symptoms can be invisible, misunderstood, or attributed to other causes, and patients may not connect their challenges to a past ICU stay. Simply asking patients about their post-ICU experience can be validating, normalizing, and a bridge to needed support.
In addition to standard rehabilitation therapies, behavioral health approaches such as mindfulness-based stress reduction, cognitive behavioral therapy, and acceptance and commitment therapy may also help patients process their experiences and develop effective coping strategies. These interventions can strengthen understanding of the mind-body connection, help patients regain a sense of control and autonomy, and help them reconnect with purpose and meaning—even when recovery doesn’t look as expected.
Practical tips for all clinicians:
1. Ask about prior ICU stays and major hospitalizations when evaluating new symptoms.
2. Listen and watch for signs of fatigue, weakness, pain, sleep disruption, anxiety, depression, PTSD symptoms, cognitive changes, and work-related challenges that may affect recovery.
3. Consider the impact on family members and caregivers, not just the patient.
4. Validate symptoms even when they don’t meet formal diagnostic criteria.
5. Encourage healthy sleep, nutrition, activity pacing, physical activity, and engagement in meaningful activities.
6. Connect patients with rehabilitation therapies, behavioral health, support groups, and/or community resources when appropriate.
7. Remember that listening, acknowledging, and understanding a patient’s story may be one of the most therapeutic interventions we provide.
Every encounter is an opportunity to see beyond a diagnosis to support the person living through recovery.
This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.