Coping with having nearly died

[pinkterrazzopot]

I have a friend who is recovering from a very serious acute illness that very nearly killed him. He, his family and doctors all expected him to die.

Thankfully he has made a great physical recovery but he is really struggling with the mental side, trying to process what has happened. He seems to be particularly struggling since returning home.l from hospital.

I'm wondering if anyone has been through similar and has any advice-books to read etc? I know he won't talk to a counsellor, how ever much that may help...he just won't. But he might read a book or take some advice-he does want to talk about it but I'm kind of struggling to know what to say because I can't really relate to the situation.

Any thoughts gratefully received!

Was he in ICU? There may be an ICU Steps group nearby that can offer support. There is a website too.
Having been in a similar situation, I found it hard to adjust after hospital as you don’t have someone checking on you all the time (just that reassurance that expertise is on hand).

icusteps.org/support Is the website

Thanks so much @Wildernesstips yes he was. I get the impression he may be resistant to something organised like this, but I will suggest it nonetheless-I'm certain it would do him good if he gave it a try

I think he struggling with not being checked on as you say, it must've been a massive adjustment

I had a horrible experience where I almost died. My GP, lovely woman who had known me for a very long time, was fairly firm about referring me for counselling.

I am glad she did. That was all I was offered though but it did help.

When I left ICU I was given a leaflet on the ways it can affect you and coping strategies. Did he receive this? It helped me and my family. I was also offered a debrief but chose not to. I've been in ICU three times but the first two times I wasn't expected to survive. Every one is different. I do have an NHS clinical psychologist but that is because I have a phobia of hospitals now and unfortunately need to go there far too often. I don't think she helps with my very real fears but it gives me a place to voice them and acknowledge just why I'm so scared.

I think how he feels about the situation will be influenced by how his life will be affected in the future. The less issues he will face, the easier it will be to move on and get back into the swing of usual life, which is probably what he will be wanting to do.

I;m not really sure what to offer as advice because i don't know the details but i believe that there's only so much you can do to help people with psychological issues like depression etc. knowing that someone cares and will be there when needed is a good thing.
If he's depressed and isolating himself then get him out for a bit and share a positive experience to shed a bit of light on things and break the negativity. It's a small thing but it helps.

If he's got very little issues to face in the future then it's more a case of celebration that he will be fine and moving on, looking to the future.

Hope that helps

I recommend reading Staring at the Sun by Irvin Yalom, an existential psychotherapist - about death anxiety and how to live with the knowledge of our mortality.

I very nearly died a few years ago, massive blood loss, emergency surgery required, many blood transfusions, crash team present, etc. Immediately afterwards I was feeling very poorly and then I was just grateful to be alive, but after a few weeks i had sudden feelings of anxiety from the blue. A friend who's in mental health thought it was post traumatic stress. I didn't act on it in any formal way, didn't see my gp or anything. I did request my medical notes from the hospital regarding the whole incident and read through these, this gave me some clarity and a sense of understanding about what happened. Then I tried to reason with the fact I'd survived and was healthy, living, and it actually ended up giving me a fresh way of thinking. Decided to stop fearing some of the things I'd previously feared, such as flying, tried to worry less about the small things, and grasp life with both hands where I could. Since then I can think about that time as though it happened to someone else without it giving me any feelings of anxiety at all, just feelings of gratefulness that I am still here. I realise not everyone can turn things around in their minds, but hopefully your friend can focus on the here and now rather than what was.

CBT helped me. Not an illness but lost an enormous amount of blood giving birth to ds1. Initially I was ok, glad to be alive and recovering physically but I felt quite numb and not myself. Then a few weeks later I started having flashbacks, anxiety, was on high alert all the time. It was horrible but I had 12 sessions of cbt and fully recovered. Hope your friend is ok.

CBT helped me too. GP was utterly useless ('But you're fine now, get on with your life!') but managed to self refer through the NHS's SLaM system. To be honest I wasn't sure if it was something I wanted to do either but the self-referring (and waiting time) sort of eased me in to it and made it feel like it was 'just something I might do' until I was actually at the first appointment. I think I had 12 appointments in total (once a week) and It's made very clear that you can stop the process at any time if you want to as well. I know it's difficult to persuade someone though. Hope you find some help OP.

Thanks so much everyone. It sounds like CBT is probably the way to go...now I just need to persuade him to do it

ICU Steps is a fantastic organisation - I agree with a PP that they might well be helpful.

Some ICUs have a follow up clinic for patients who’ve been discharged. Ideally (although not always due to resources) they have support from a psychologist who’s experienced in treating people who are critical illness survivors. It might be worth finding out if the ICU where your friend was treated has one of these. I know you said he’s unlikely to want to actually talk to someone but if it’s linked to staff he already knows then maybe that would swing it for him?

The Blink of an Eye - how I died and started living by Rikke Schmidt Kjaergaard is very good. She had meningitis, sepsis and multiorgan failure. This book is an account of her illness and recovery. It’s very well written and positive.

Above all, it is very very normal to feel like your friend does after something like this.

It sounds like he really trusts you to talk to which is excellent. Sometimes we don’t need to “know what to say” - you’re not going to change what’s happened, but just by being there and by being supportive you’re clearly doing a good job!

The poor man. My friend almost died during Labour, very rare complications. She was diagnosed with PTSD eventually and had nhs counselling within weeks

It won't be for everyone but a good book 'dying to be me' by Anita Moorjani

He wont be ready for these books yet. It is too soon.

I definitely second referral to the ICU distress clinic if there is one there. It is extremely common to experience symptoms of PTSD and psychosis after the trauma of ICU but with support people can recover .

After my climbing accident, where I resigned myself just before I came off, I suffered from a lot of contradictory emotions: gratitude that I wasn't dead, fear because I nearly was, annoyance that I now had to get on with stuff. SSRIs were useful, on top of the CBT I was already doing. People tell you to keep busy, which is a twatty thing to say when you're immobile.

Has he been put on a course of anti depressants? I have experience with a long stay in ITU and the person who left was automatically given 6 months of anti ds because they knew returning to the real world would be difficult.

My relative saw a psychologist once and had a couple of debrief sessions with the ITU team. It's a marathon to recovery and not a sprint.

A Leg To Stand On by Oliver Sacks is very good on the psychology of recovery.