Sepsis doesn't cause one specific illness but leads to a range of serious mental health issues, primarily Post-Traumatic Stress Disorder (PTSD), Depression, and Anxiety, often grouped under Post-Sepsis Syndrome (PSS), along with significant cognitive decline (brain fog, memory loss). These conditions stem from the body's extreme inflammatory response affecting the brain (Sepsis-Associated Encephalopathy) and the traumatic experience of critical illness, leading to lasting psychological and cognitive damage.
The high incidence of long-term brain damage caused by sepsis, including cognitive decline, anxiety, and depression and the occurrence of post-traumatic stress disorder, constitutes a substantial health burden in sepsis survivors.
The pathophysiology of sepsis-associated encephalopathy involves direct cellular damage to the brain, mitochondrial and endothelial dysfunction and disturbances in neurotransmission.
The overactive immune response during sepsis can also damage the brain, resulting in delirium and causing one in five survivors to suffer from poor memory, shorter attention span, and slower mental processing.
Around 40% of people who develop sepsis are estimated to experience physical, cognitive, and/or psychological after effects. For most people, these effects will last a few months, but others can face a long road to recovery and develop Post Sepsis Syndrome (PSS).
In particular, sepsis is associated with a 3-fold increase in the prevalence of cognitive impairment (1, 2), which mainly involves declarative memory, working memory, processing speed, and executive function.
Clinically, sepsis-induced brain dysfunction is characterized by focal neurological deficits, cognitive impairments, depression, attention decline, mood disorders, and movement-coordination problems, as well as reduced rationality, awareness, comprehension, intelligence, mental processing, and social interaction.
In some cases, symptoms of more severe sepsis or septic shock (when your blood pressure drops to a dangerously low level) develop. These can include: feeling dizzy or faint. a change in mental state – like confusion or disorientation.
These changes in the blood–brain barrier might lead to a major symptom of sepsis, sepsis-associated encephalopathy, which manifests as confusion with a rapid decline in cognitive functions, especially memory, or coma.
Out of all the mental disorders including depression, anxiety, schizophrenia, and bipolar disorder, which do you think is the deadliest? A review of nearly fifty years of research confirms that Anorexia Nervosa has the highest mortality rate of all mental illnesses (Arcelus, Mitchel, Wales, & Nelson, 2011).
According to psychology, there are specific personality types that are notoriously difficult to live with. These can include the passive-aggressive communicator, the relentless critic, or the energy-draining pessimist. However, recognizing these traits is the first step toward managing the stress they cause.
These severe and persistent mental illnesses include schizophrenia, bipolar disorder, other severe forms of depression, panic disorder, and obsessive-compulsive disorder.
The sepsis survivors described that the psychological and cognitive impairments with remaining fatigue, lack of concentration, loss of short-term memory, pondering and depression was the worst.
Post-ICU patients with severe sepsis or septic shock have a high prevalence of PTSD symptoms, and these symptoms appear to persist over time. Even after one year, more than one-third of the patients had PTSD symptoms.
Typically, the psychiatric disorder of sepsis survivors manifests as depression, anxiety, and post-traumatic stress disorder (PTSD), all of which can have a profound influence on their daily life as well as their ability to return to work following recovery [5, 6].
The six main symptoms of sepsis are: Shortness of breath. Fever, chills, shivering, or feeling very cold. High heart rate or low blood pressure.
The evidence behind the “golden hour” protocol
The main finding was that patients who received antibiotics within the first hour of sepsis recognition had a 79.9% chance of survival. It was also found that with every additional hour, the chance of survival decreased by 7.6%.
The neurological impairment associated with SAD can persist for months or even longer, after the initial septic episode has subsided which may impair the rehabilitation potential of sepsis survivors.
Sepsis – potential consequences and brain injury
If sepsis is not identified and treated quickly, it can lead to shock, multiple organ failure, including brain injury and sometimes death. It can also cause ischaemic damage to limbs and extremities, leading to the need for limb amputation.
Hepatitis and sepsis are among the infections that may increase the risk of substance-induced psychosis.
Post-Sepsis Syndrome can affect up to 50% of sepsis survivors especially if you were admitted to the intensive care unit. Symptoms include: Sleeping irregularities: insomnia, difficulty falling or staying asleep; nightmares, hallucinations. Confusion / inability to concentrate.
Administrative prevalence and incidence of mental disorders. In the twelve months post-sepsis, 54.8 % of patients were diagnosed with any MHI (Table 2). Depression was particularly common, affecting 32.2 % of patients, while anxiety disorders and PTSD were found in 8.9 % and 0.6 % of patients, respectively.
Signs of MCI include losing things often, forgetting to go to important events or appointments, and having more trouble coming up with words than other people of the same age. It's common for family and friends to notice these changes.
(2020). Their study found that as the severity of sepsis increased from mild to severe, the risk of dementia increased from 1.20- to 5.04-fold. Similarly, another study (Chou et al., 2018) also showed an increase in the risk of dementia as the severity of sepsis increased.