University

03/08/2010

For veterans, suicides and anti-depressants rise together

Since 2001, there have been 2,100 suicides in the military, triple the number of troops that have died in Afghanistan and half of all US deaths in Iraq. 

In 2007, a story in the San Diego Union Tribune showed that more Marines died at Camp Pendleton from suicide, homicide, and motorcycle accidents than Marines deployed from Camp Pendleton who died in combat.  In 2008, the New York Times reported that over 1,000 suicide attempts a month were reported in veterans seen at VA facilities. 

These shocking statistics are matched by another one:  from 2002 – 2008 the number of anti-depressants and anti-psychotics prescribed to military personnel and their families has nearly doubled.  One social worker who completed two tours of duty in Iraq and Afghanistan estimated that 90 percent of the US combatants have used psychiatric medication:  she claims she was specifically told to support the medication of the troops.  A VA psychiatrist has openly admitted that he prescribes psychiatric medicine to 98 percent of the patients he’s treated.

Is there a relationship between the vast use of anti-depressants to treat Post-Traumatic Stress Disorder (PTSD) and the astoundingly high rates of veteran suicides? 

That’s the question asked by Bart Billings, a clinical psychologist, retired soldier, and Saybrook graduate, at Congressional hearings in late February. 

Billings, who founded and directs the world’s longest running conference on combat stress, has concerns that the US military has a de facto policy of drugging soldiers first and asking questions later. 

“I have personally seen military personnel as patients, who explained that they were given anti-depressants on the battlefield to simply try to stop smoking,” he told a House of Representatives committee on Feb. 24.  But it’s not just the overuse of anti-depressants that concerns him:  it’s their use as a panacea for PTSD.

As he told Congress:

Stop and think about the fact that military personnel, who carry a weapon 24 hours a day, seven days a week, for a year deployment, can be given a medication that has a black box warning, indicating a potential side effect can be suicide as well as aggressive, angry, and violent behavior that can lead to homicide.  If a medical practitioner prescribed this type of medication in the civilian community, to a patient who constantly carried a loaded weapon (had a permit to do so) and had extensive training on how to use this weapon, they could likely be charged with malpractice and possibly lose their license to practice medicine.  If there was a suicide or homicide by this patient, directly related to this prescription, then the practitioner could be criminally charged.”

Any exact link between the mass taking of anti-depressants and military suicides (and homicides) will require further study to ferret out – but the question should be moot.  Because as Billing’s notes, anti-depressants are a bad treatment for PTSD in the first place.

“I have not observed significant long-term studies that have ever shown any psychiatric medication to be effective in treating PTSD, for which significant prescriptions in the military are written,” he said.  “My overall observations and clinical experience leads me to state, emphatically, that integrative treatment approaches in treating combat stress and related problems is more effective in the long run, than prescribing drugs, both as a force multiplier and a money saver.”

These approaches – such as individual counseling, biofeedback, guided imagery, hypnosis, and much more – have little or no side-effects, and there is compelling research that shows them to be effective in both the short and long terms.  “This is more than can be said currently of psychiatric medication,” he notes. 

Billings estimates that the cost for the anti-depressants the military uses exceeds $2 billion annually – more than enough to pay for all the mental health professionals needed to support our troops with meaningful treatments. 

Many high ranking members of the Pentagon have been enthusiastic about switching priorities … but so far, the funding hasn’t followed.

The result may be more soldiers told to pop ineffective pills to deal with debilitating PTSD – and an increased risk of violent, self-destructive behavior.   

In the meantime, Billings’ conference, the International Military and Civilian Combat Stress Conference, enters its 18th year from April 29 - May 2, and has trained thousands of military and civilian leaders and mental health providers on better approaches.

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