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January/February 2010

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More on Suicide and PTSD

BY TOM BERGER

According to a December 14 article in Congressional Quarterly, at least 349 men and women on active duty and in the reserves took their lives in 2009. This figure is more than those killed in enemy action in Afghanistan (259) and Iraq (76) combined. Meanwhile, “an average of about 50 people who had been discharged after fighting in Afghanistan and Iraq committed suicide each year between 2002 and 2006,” according to the VA.

The Army’s November 2009 suicide data show that twelve soldiers “are suspected of taking their own lives,” bringing the total to 147 in 2009. That was the highest since the Army began keeping records in 1980. In 2008, the Army reported 140 suicides.

Although Army officials continue to deny any links between repeated deployments and suicide, evidence to the contrary is growing. Only about a third of Army suicides occur in the war zones; another third occur among individuals who have never deployed. The remaining third are among those who have deployed, many of them returning home with mental health problems.

Army officials also acknowledge that substance abuse, including prescription drugs, fueled by repeated combat tours, as well as a shortage of mental health professionals in the military, contribute to the mental health problems that can lead to suicide. The percentage of soldiers in Afghanistan taking anti-depressants and other mental health drugs nearly triples—from 3.5 percent to 9.8 percent—between first and third deployments. 

Gen. Peter Chiarelli told the House Armed Services Committee on December 10 that “the greatest debilitating injury of soldiers returning from Iraq and Afghanistan is post-traumatic stress. Soldiers who are suffering from post-traumatic stress are six times more likely to commit suicide than those that are not.”

In addition, Time magazine reported in December that, under pressure from the families of military suicide victims, “the President’s staff is reviewing a long-standing but unwritten policy that bars him from sending condolence letters to the families of military personnel who have killed themselves.”

According to an article published in the December 8 Army Times, two new studies seem to provide more evidence that post-traumatic stress disorder is a chemical change in the brain caused by trauma. The studies also indicate that it might be possible to diagnose, treat, and predict susceptibility to it based on brain scans or blood tests. 

In one study, Christine Marx of the Duke University Medical Center and Durham VA Medical Center investigated why PTSD, depression, and pain often occur together. Researchers already knew that people with PTSD show changes in their neurosteroids, which are brain chemicals thought to play a role in how the body responds to stress.

Previous animal studies indicated that blood neurosteroid levels correlated to brain neurosteroid levels, so Marx measured the blood neurosteroid levels of 90 male Iraq and Afghanistan War veterans. She found that the neurosteroid levels correlated to symptom severity in PTSD, depression, and pain issues. 

Marx is researching treatment for people with traumatic brain injuries using the same kind of brain chemical. Early results indicated that increasing a person’s neurosteroid level decreases PTSD symptoms. 

A second study by Alexander Neumeister of Yale University School of Medicine found that veterans diagnosed with PTSD along with another syndrome—such as depression, alcohol abuse, substance abuse, or suicidal ideation—had different brain images on a CT scan than did those who had been diagnosed only with PTSD. 

These differences “can have huge implications for treatment,” he said in a statement issued by the American College of Neuropsychopharmacology, which released the two studies during its annual meeting in December. 

For example, Neumeister said, treating someone with antidepressants addresses only the depression diagnosis—not the PTSD or the substance abuse issues. All of these issues need to be addressed. 

Additionally, he said, service members claim they fear being perceived as weak or cowardly, or that their military careers will be hurt if they seek help for mental health issues. “Once veterans see this is a neurobiological disorder in which their brains act differently in terms of circuitry and chemical function, oftentimes it motivates them to seek treatment,” he said.

 

 

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