Post-Intensive Care Syndrome (PICS) - Let's talk

Have you heard of Post-Intensive Care Syndrome? Sometimes it’s called post ICU syndrome or PICS. PICS is defined as new or worse health problems after critical illness. These problems can affect your mind, body, thoughts, and/or feelings.

On Connect we would like to bring together people who have been affected by critical illness, and hopefully lighten the burden you bear. Patients and family members welcome.

Grab a cup of tea, or beverage of your choice, and let’s chat. Why not start by introducing yourself?

@chattykathy

I have thought about the question from Annie; I think the staff could have done a better job by talking about the transfer with me and getting me comfortable with the idea that I would be moved out of ICU, same floor but another room until next day. I was moved late at night and did not have same people working with me. It was strange. They needed my room for another patient who was critical and coming back from transplant surgery which I understood totally, but I needed more preparedness. It was a trust thing. When a person is blind and cannot see faces and see body language, it takes one aback at first to get use to the fact.

My husband was called back to the hospital that night to help calm my jitters and get me settled in the new room. After an hour or 2 I was OK with the idea.

I think the next day I was transferred back to the transplant floor with people I knew since I had been there previously for 3 weeks prior to surgery. Sometimes, a person needs a little extra help in getting use to things since they have been bombarded with info and trying to get it all straight. Do any of you feel the same way? I know all people are different in how they accept and process new ideas or is this a “blind” thing. It is just so overwhelming at times.

As I have had time to look back on my experiences in the hospitalizations over those particular years, I could not have had better care from all who were involved. At times, I was difficult because I was confused and could not comprehend some of the things that were going on. I hope this makes sense to everyone as I am trying not to ramble.

AS I stated before, my journey was long and complicated by the fact I was so sick prior with encephalopathy. After transplant, as the liver started filtering the toxins, my color came back and some of the confusion cleared but it took time for all of this to happen. I am sure those of you who have had liver transplant have experience the same process.

Another thing that was difficult was to know that others who I had met through the hospitality house were going home just a few days after transplant and I was stuck in the hospital. There were a lot of factors that played into my mental status at the time. Only now, while looking back, it all seems surreal.

All for now.

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@contentandwell, you mention having planned on keeping a journal. Was this something suggested to you by a care provider or was that something you had just planned on on your own?

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@chattykathy

I have thought about the question from Annie; I think the staff could have done a better job by talking about the transfer with me and getting me comfortable with the idea that I would be moved out of ICU, same floor but another room until next day. I was moved late at night and did not have same people working with me. It was strange. They needed my room for another patient who was critical and coming back from transplant surgery which I understood totally, but I needed more preparedness. It was a trust thing. When a person is blind and cannot see faces and see body language, it takes one aback at first to get use to the fact.

My husband was called back to the hospital that night to help calm my jitters and get me settled in the new room. After an hour or 2 I was OK with the idea.

I think the next day I was transferred back to the transplant floor with people I knew since I had been there previously for 3 weeks prior to surgery. Sometimes, a person needs a little extra help in getting use to things since they have been bombarded with info and trying to get it all straight. Do any of you feel the same way? I know all people are different in how they accept and process new ideas or is this a “blind” thing. It is just so overwhelming at times.

As I have had time to look back on my experiences in the hospitalizations over those particular years, I could not have had better care from all who were involved. At times, I was difficult because I was confused and could not comprehend some of the things that were going on. I hope this makes sense to everyone as I am trying not to ramble.

AS I stated before, my journey was long and complicated by the fact I was so sick prior with encephalopathy. After transplant, as the liver started filtering the toxins, my color came back and some of the confusion cleared but it took time for all of this to happen. I am sure those of you who have had liver transplant have experience the same process.

Another thing that was difficult was to know that others who I had met through the hospitality house were going home just a few days after transplant and I was stuck in the hospital. There were a lot of factors that played into my mental status at the time. Only now, while looking back, it all seems surreal.

All for now.

Jump to this post

@contentandwell, I think that each transplant center is different, just like each patient is different. I have talked with some transplant recipients at home, and I have been surprised at how patient follow-up care is provided and scheduled – or nor scheduled. But I guess all is good because we are here and we are able to talk about it together.
Rosemary

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@chattykathy

I have thought about the question from Annie; I think the staff could have done a better job by talking about the transfer with me and getting me comfortable with the idea that I would be moved out of ICU, same floor but another room until next day. I was moved late at night and did not have same people working with me. It was strange. They needed my room for another patient who was critical and coming back from transplant surgery which I understood totally, but I needed more preparedness. It was a trust thing. When a person is blind and cannot see faces and see body language, it takes one aback at first to get use to the fact.

My husband was called back to the hospital that night to help calm my jitters and get me settled in the new room. After an hour or 2 I was OK with the idea.

I think the next day I was transferred back to the transplant floor with people I knew since I had been there previously for 3 weeks prior to surgery. Sometimes, a person needs a little extra help in getting use to things since they have been bombarded with info and trying to get it all straight. Do any of you feel the same way? I know all people are different in how they accept and process new ideas or is this a “blind” thing. It is just so overwhelming at times.

As I have had time to look back on my experiences in the hospitalizations over those particular years, I could not have had better care from all who were involved. At times, I was difficult because I was confused and could not comprehend some of the things that were going on. I hope this makes sense to everyone as I am trying not to ramble.

AS I stated before, my journey was long and complicated by the fact I was so sick prior with encephalopathy. After transplant, as the liver started filtering the toxins, my color came back and some of the confusion cleared but it took time for all of this to happen. I am sure those of you who have had liver transplant have experience the same process.

Another thing that was difficult was to know that others who I had met through the hospitality house were going home just a few days after transplant and I was stuck in the hospital. There were a lot of factors that played into my mental status at the time. Only now, while looking back, it all seems surreal.

All for now.

Jump to this post

@andreab, I kept a journal of sorts. It started as a record of my many tests and procedures and eventually evolved into a journal. I saw one in a sitting rooms at the Gift of Life House and that is where I got the idea. It has many gaps, but I went back after my transplant when I was stronger, and added some of the missing parts. I am glad I did it.
My husband kept all of the emails that he sent back home to a growing list of family and friends. He also kept all of the replies. He has printed them and we have put them into 2 binders! They cover a time span of 8 months. They tell our story, and they show our support and prayers that kept us going.
These are two things that we will cherish forever.
I used to encourage people to begin a journal when listed for a transplant. I will begin to do that again. Thanks for this reminder!
Rosemary

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@chattykathy

I have thought about the question from Annie; I think the staff could have done a better job by talking about the transfer with me and getting me comfortable with the idea that I would be moved out of ICU, same floor but another room until next day. I was moved late at night and did not have same people working with me. It was strange. They needed my room for another patient who was critical and coming back from transplant surgery which I understood totally, but I needed more preparedness. It was a trust thing. When a person is blind and cannot see faces and see body language, it takes one aback at first to get use to the fact.

My husband was called back to the hospital that night to help calm my jitters and get me settled in the new room. After an hour or 2 I was OK with the idea.

I think the next day I was transferred back to the transplant floor with people I knew since I had been there previously for 3 weeks prior to surgery. Sometimes, a person needs a little extra help in getting use to things since they have been bombarded with info and trying to get it all straight. Do any of you feel the same way? I know all people are different in how they accept and process new ideas or is this a “blind” thing. It is just so overwhelming at times.

As I have had time to look back on my experiences in the hospitalizations over those particular years, I could not have had better care from all who were involved. At times, I was difficult because I was confused and could not comprehend some of the things that were going on. I hope this makes sense to everyone as I am trying not to ramble.

AS I stated before, my journey was long and complicated by the fact I was so sick prior with encephalopathy. After transplant, as the liver started filtering the toxins, my color came back and some of the confusion cleared but it took time for all of this to happen. I am sure those of you who have had liver transplant have experience the same process.

Another thing that was difficult was to know that others who I had met through the hospitality house were going home just a few days after transplant and I was stuck in the hospital. There were a lot of factors that played into my mental status at the time. Only now, while looking back, it all seems surreal.

All for now.

Jump to this post

@rosemarya, this is true, they are all different. I am amazed that my center seems to be one of the few that strongly suggests, almost insists, that you wear a mask on an airplane. I will of course but I wish I didn’t have to. If it is true that viruses can get through the masks then what’s the point? I did already purchase some and they are supposed to have an embedded anti-viral so hopefully that will help.
JK

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@chattykathy

I have thought about the question from Annie; I think the staff could have done a better job by talking about the transfer with me and getting me comfortable with the idea that I would be moved out of ICU, same floor but another room until next day. I was moved late at night and did not have same people working with me. It was strange. They needed my room for another patient who was critical and coming back from transplant surgery which I understood totally, but I needed more preparedness. It was a trust thing. When a person is blind and cannot see faces and see body language, it takes one aback at first to get use to the fact.

My husband was called back to the hospital that night to help calm my jitters and get me settled in the new room. After an hour or 2 I was OK with the idea.

I think the next day I was transferred back to the transplant floor with people I knew since I had been there previously for 3 weeks prior to surgery. Sometimes, a person needs a little extra help in getting use to things since they have been bombarded with info and trying to get it all straight. Do any of you feel the same way? I know all people are different in how they accept and process new ideas or is this a “blind” thing. It is just so overwhelming at times.

As I have had time to look back on my experiences in the hospitalizations over those particular years, I could not have had better care from all who were involved. At times, I was difficult because I was confused and could not comprehend some of the things that were going on. I hope this makes sense to everyone as I am trying not to ramble.

AS I stated before, my journey was long and complicated by the fact I was so sick prior with encephalopathy. After transplant, as the liver started filtering the toxins, my color came back and some of the confusion cleared but it took time for all of this to happen. I am sure those of you who have had liver transplant have experience the same process.

Another thing that was difficult was to know that others who I had met through the hospitality house were going home just a few days after transplant and I was stuck in the hospital. There were a lot of factors that played into my mental status at the time. Only now, while looking back, it all seems surreal.

All for now.

Jump to this post

@andreab No one suggested a journal, I just wanted to so I could have a record of everything. I kick myself that I didn’t have it with me so most of my coherent memory was lost in my drugged up state.
JK

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@alyric

This is a brief overview of what brought me to Mayo Clinic Hospital. May 1, 2016 I was flown from another hospital emergently to St. Mary’s Hospital in Rochester after a traumatic intubation at another outlying facility, after I attempted to die by overdosing with hundred & hundreds of pills (April 29, 2016). This resulted in a tracheal tear. (I was in 3 hospitals in under 36 hours). The tear was over 2″ in length. It was found no one had lived from an injury such as mine. I was admitted to CICU because the ET tube was 1/2 in the trachea & 1/2 outside of it allowing subcutaneous air surrounding the organs & compressing the organs, but my heart was having the most problems at that time. I had a tracheotomy done to place a trach in & allow the air to slowly escape. At that time an ET tube was inserted through the trach & mouth so each lung could be ventilated. The Surgeon who accepted me researched procedures & found there was none documented. She & her team came up with one & surgery was May 3, 2016. An incision was made just under the right scapula, above the 4th & 5th ribs under the axillae to the breast crease. The 4th rib was removed & the 4th & 5th rib muscles were drawn through a window to rebuild the trachea. My lungs couldn’t oxygenate my blood so was put on ECMO. I remember nothing except a few small things from the day I overdosed. I have a few snippets of memories, brief seconds of lucidity, but remember the dreams and nightmares so very vividly. I can even still feel them & the emotions they elicited. It’s almost impossible to explain them to anyone. When I was allowed to come out of sedation I couldn’t lift my head, arms, or legs. I was terrified. I was on ECMO approximately 2 weeks & the ventilator for 2 1/2 weeks; I was decannulated May 27th just before being transported to another Mayo facility for swing bed rehab.

It’s been a year of firsts for me. Being able to think clearly, make good decisions, not living in the black hole of depression & building a life worth living are all things I’m doing for the first time in 15 years.

It is my heartfelt desire to meet the team of professionals who saved my life & thank them for their part in returning life to me. I want them to know they didn’t put “Humpty Dumpty together” so I could kill myself. I want them to know I have not thought about hurting myself or ending my life. I need to do this to start the next chapter of my life & close this one. Have any of you done this? I went back to St. Mary’s & met & thanked some of my nurses; it was so cathartic to do this. They remembered me, we cried together.

I have some more questions to ask but maybe I will find the answers as I continue to read everyone’s posts. Thanks for allowing me to talk. I don’t have anyone to share with who would understand my thoughts & feelings.

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@alyric, thank you so much for taking time and telling us about your journey with critical illness and your experiences since. Your perspective on this side of all of it is very powerful. The desire to reconnect with your care team is so normal, and I know from my professional experience that this can be healing not only for the patients but also for the healthcare providers. I also wonder, if anyone else such as @rsinger22 , @baceman , @mouse355 has had this desire or has reconnected with their healthcare team in anyway and if so what were your experiences with that?

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@alyric The story you have shared regarding you and your husband is quite remarkable! Thank you. I’m sure it will inspire others as they read it. Best wishes to you both! Teresa

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Hi all,
It’s been a while since a message was posted to this discussion. I thought I’d pop in and see who you are all doing. The weather is finally getting warmer where I live. Although the cooler temperatures prolonged the spring flowers for which I was grateful. What has made you grateful lately?

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I’m having a desperate time of it right now. Well, actually all the time, not just right now. I was in the ICU in 2014, on a respirator for eight days, I think. I had vivid hallucinations while I was on it. When I was coming out from under the anesthesia, my brother wasn’t there that day and I believed for over 24 hours of terrified semi-wakefulness that I was being held prisoner somewhere. I make jokes about it now, but it was no joke then.

When I started recovering, I couldn’t walk. I’m right handed, and my right hand wouldn’t function. I lost so much muscle, my thigh looked like it had a cute little waist.

I couldn’t remember the date, or even the year, for several days while I was recovering.

What’s causing the desperation now is the shape my brain is in. I’ve had significant memory loss. I had neuropsychological testing done twice, in 2015 and just this spring in 2017. Both tests showed mild cognitive impairment. I am working part-time, and the only reason I can do that job is because it’s twelve hours a week and very flexible. The depression monster and its friend the anxiety monster are constant companions for me. My brain won’t work for me anymore, but adding to the problem is that…

I
look
so
normal.

I know that I am disabled. I know that I ought to be on disability. But Iook so nicely normal, and I sound normal much of the time. I need help, and I know it. But getting help is almost impossible. I’m supposed to be seeing either a… what’s it called? Occupational therapist. And a speech therapist too. But how am I supposed to do that when my insurance sent me a letter saying that all but one of the therapies was denied? I’m supposed to call them back and see if they were approved. Then I can maybe do something if they’re not approved. But I can’t remember to call them back most of the time. And even if I did, the mental fatigue is making me want to crawl back into bed, fall asleep, and just not wake up. No, I’m not suicidal; I mean literally, I don’t want to wake up. I just want to sleep, where I don’t have to deal with all this overwhelming stuff.

I need help with disability stuff, but since I look normal, or maybe because social workers don’t have time for people who look normal on the outside, or something, nobody is offering to help me. I don’t even know who to ask anymore.

Are there specialists somewhere to help people like this? My life has been pretty much ruined, and yet I’m supposed to just get myself together and get myself a full-time job so I won’t be worrying about living on $600 per month or less.

I feel like I’m being pulled under. I have a very few friends, but they’re not close enough to help. I share a house with my brother, but he has his own set of problems. (We come from a family with at least one depression monster, or one anxiety monster, or one PTSD monster, and often multiple monsters, which complicates anything that comes our way.)

Help?

REPLY
@spottedcat83

I’m having a desperate time of it right now. Well, actually all the time, not just right now. I was in the ICU in 2014, on a respirator for eight days, I think. I had vivid hallucinations while I was on it. When I was coming out from under the anesthesia, my brother wasn’t there that day and I believed for over 24 hours of terrified semi-wakefulness that I was being held prisoner somewhere. I make jokes about it now, but it was no joke then.

When I started recovering, I couldn’t walk. I’m right handed, and my right hand wouldn’t function. I lost so much muscle, my thigh looked like it had a cute little waist.

I couldn’t remember the date, or even the year, for several days while I was recovering.

What’s causing the desperation now is the shape my brain is in. I’ve had significant memory loss. I had neuropsychological testing done twice, in 2015 and just this spring in 2017. Both tests showed mild cognitive impairment. I am working part-time, and the only reason I can do that job is because it’s twelve hours a week and very flexible. The depression monster and its friend the anxiety monster are constant companions for me. My brain won’t work for me anymore, but adding to the problem is that…

I
look
so
normal.

I know that I am disabled. I know that I ought to be on disability. But Iook so nicely normal, and I sound normal much of the time. I need help, and I know it. But getting help is almost impossible. I’m supposed to be seeing either a… what’s it called? Occupational therapist. And a speech therapist too. But how am I supposed to do that when my insurance sent me a letter saying that all but one of the therapies was denied? I’m supposed to call them back and see if they were approved. Then I can maybe do something if they’re not approved. But I can’t remember to call them back most of the time. And even if I did, the mental fatigue is making me want to crawl back into bed, fall asleep, and just not wake up. No, I’m not suicidal; I mean literally, I don’t want to wake up. I just want to sleep, where I don’t have to deal with all this overwhelming stuff.

I need help with disability stuff, but since I look normal, or maybe because social workers don’t have time for people who look normal on the outside, or something, nobody is offering to help me. I don’t even know who to ask anymore.

Are there specialists somewhere to help people like this? My life has been pretty much ruined, and yet I’m supposed to just get myself together and get myself a full-time job so I won’t be worrying about living on $600 per month or less.

I feel like I’m being pulled under. I have a very few friends, but they’re not close enough to help. I share a house with my brother, but he has his own set of problems. (We come from a family with at least one depression monster, or one anxiety monster, or one PTSD monster, and often multiple monsters, which complicates anything that comes our way.)

Help?

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You are not alone. There are specialists who are part of a post icu and recovery clinics across the country who may be able to help.

You are correct you have experienced a trauma and you are both trying to process that experience, heal your self and recover your cognitive brain function. But the medical insurance system is not good at checking underneath the hood of a seemingly normal and healed body. Check out the thrive website and learn more.

By posting and sharing your story and asking for help you are doing the important work
Keep it up

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@spottedcat83 Hello and welcome to Mayo Connect. It sounds as if you have been through an incredible trauma and your frustration with your current situation is very understandable. You do not mention where you live, however, in Michigan we have Hope Network which is a Rehabilitation facility that specializes in neurocognitive rehab. This type of rehab would be very helpful to you. Perhaps you could use your computer and google the term, “neruocognitive rehab” in your locale and see what facilities might be available near you and then see if they can help you. If you are comfortable sharing more, let us know how you ended up in ICU. Was it the result of an accident or stroke? We look forward to getting to know you better. Teresa

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@spottedcat83 and @elhirsh, I would like to add my welcome to Teresa’s- I think this will be a great place for you to connect with others who have also experienced something similar to what you have been through. In my experience, part of the “healing journey” is to keep sharing and connecting.

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@chattykathy

I would also like to mention that with all the weight loss after the transplant, I did not feel normal. Everyone told me the weight loss was great, but I lost too much too fast. I still had the “sick” look about me.

I was hurting in the right side when I got up and down but thought it was just the routine of healing and so on. This pain was pain from the bile duct. I underwent CT scan but nothing was found by local radiologist. So I continued on until my next checkup at Mayo and that is when bile duct problem was found.

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@contentandwell JK, Very practical approach to your situation! Teresa

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@spottedcat83

I’m having a desperate time of it right now. Well, actually all the time, not just right now. I was in the ICU in 2014, on a respirator for eight days, I think. I had vivid hallucinations while I was on it. When I was coming out from under the anesthesia, my brother wasn’t there that day and I believed for over 24 hours of terrified semi-wakefulness that I was being held prisoner somewhere. I make jokes about it now, but it was no joke then.

When I started recovering, I couldn’t walk. I’m right handed, and my right hand wouldn’t function. I lost so much muscle, my thigh looked like it had a cute little waist.

I couldn’t remember the date, or even the year, for several days while I was recovering.

What’s causing the desperation now is the shape my brain is in. I’ve had significant memory loss. I had neuropsychological testing done twice, in 2015 and just this spring in 2017. Both tests showed mild cognitive impairment. I am working part-time, and the only reason I can do that job is because it’s twelve hours a week and very flexible. The depression monster and its friend the anxiety monster are constant companions for me. My brain won’t work for me anymore, but adding to the problem is that…

I
look
so
normal.

I know that I am disabled. I know that I ought to be on disability. But Iook so nicely normal, and I sound normal much of the time. I need help, and I know it. But getting help is almost impossible. I’m supposed to be seeing either a… what’s it called? Occupational therapist. And a speech therapist too. But how am I supposed to do that when my insurance sent me a letter saying that all but one of the therapies was denied? I’m supposed to call them back and see if they were approved. Then I can maybe do something if they’re not approved. But I can’t remember to call them back most of the time. And even if I did, the mental fatigue is making me want to crawl back into bed, fall asleep, and just not wake up. No, I’m not suicidal; I mean literally, I don’t want to wake up. I just want to sleep, where I don’t have to deal with all this overwhelming stuff.

I need help with disability stuff, but since I look normal, or maybe because social workers don’t have time for people who look normal on the outside, or something, nobody is offering to help me. I don’t even know who to ask anymore.

Are there specialists somewhere to help people like this? My life has been pretty much ruined, and yet I’m supposed to just get myself together and get myself a full-time job so I won’t be worrying about living on $600 per month or less.

I feel like I’m being pulled under. I have a very few friends, but they’re not close enough to help. I share a house with my brother, but he has his own set of problems. (We come from a family with at least one depression monster, or one anxiety monster, or one PTSD monster, and often multiple monsters, which complicates anything that comes our way.)

Help?

Jump to this post

@spottedcat83, I am so happy you found this space that you can meet others who share such similar stories and feelings. I think one of the biggest emotional reliefs that many people find in forums like face to face or online support groups is that they are not alone in what they are experiencing. And you certainly are not! However, this doesn’t do anything really to help the very real barriers that you are experiencing with your attempts to access and obtain real care for the problems you are facing. I wonder, have you reached out to your primary care provider about these issues? You might find it helpful to visit the following websites to learn more about Post Intensive Care Syndrome, and then bring this new knowledge with you to an appointment:
https://connect.mayoclinic.org/page/pics/
http://www.myicucare.org/Thrive/Pages/default.aspx

I also want to let you know about a face to face support group that we offer here in Rochester MN if you are local. We meet the third Monday of every month. Our next meeting is tomorrow from 2-3pm! Here is a link to more information about this group:
https://connect.mayoclinic.org/page/pics/tab/resource-81/

Liked by Jamie Olson, otosjd

REPLY
@spottedcat83

I’m having a desperate time of it right now. Well, actually all the time, not just right now. I was in the ICU in 2014, on a respirator for eight days, I think. I had vivid hallucinations while I was on it. When I was coming out from under the anesthesia, my brother wasn’t there that day and I believed for over 24 hours of terrified semi-wakefulness that I was being held prisoner somewhere. I make jokes about it now, but it was no joke then.

When I started recovering, I couldn’t walk. I’m right handed, and my right hand wouldn’t function. I lost so much muscle, my thigh looked like it had a cute little waist.

I couldn’t remember the date, or even the year, for several days while I was recovering.

What’s causing the desperation now is the shape my brain is in. I’ve had significant memory loss. I had neuropsychological testing done twice, in 2015 and just this spring in 2017. Both tests showed mild cognitive impairment. I am working part-time, and the only reason I can do that job is because it’s twelve hours a week and very flexible. The depression monster and its friend the anxiety monster are constant companions for me. My brain won’t work for me anymore, but adding to the problem is that…

I
look
so
normal.

I know that I am disabled. I know that I ought to be on disability. But Iook so nicely normal, and I sound normal much of the time. I need help, and I know it. But getting help is almost impossible. I’m supposed to be seeing either a… what’s it called? Occupational therapist. And a speech therapist too. But how am I supposed to do that when my insurance sent me a letter saying that all but one of the therapies was denied? I’m supposed to call them back and see if they were approved. Then I can maybe do something if they’re not approved. But I can’t remember to call them back most of the time. And even if I did, the mental fatigue is making me want to crawl back into bed, fall asleep, and just not wake up. No, I’m not suicidal; I mean literally, I don’t want to wake up. I just want to sleep, where I don’t have to deal with all this overwhelming stuff.

I need help with disability stuff, but since I look normal, or maybe because social workers don’t have time for people who look normal on the outside, or something, nobody is offering to help me. I don’t even know who to ask anymore.

Are there specialists somewhere to help people like this? My life has been pretty much ruined, and yet I’m supposed to just get myself together and get myself a full-time job so I won’t be worrying about living on $600 per month or less.

I feel like I’m being pulled under. I have a very few friends, but they’re not close enough to help. I share a house with my brother, but he has his own set of problems. (We come from a family with at least one depression monster, or one anxiety monster, or one PTSD monster, and often multiple monsters, which complicates anything that comes our way.)

Help?

Jump to this post

Thank you! I live in the Seattle area, so I can’t make it to your group, but maybe I can find something closer to home.

🙂

REPLY
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