Veterans with PTSD: substance abuse and suicide incidents

Veterans with PTSD and the Incidents of Substance Abuse and Suicide

PTSD and TBI are regular consequences of war. They have distinct symptoms, treatment modalities, and long-term effects. PTSD has been accepted in various forms throughout military history. It is an anxiety disorder, with symptoms of changeable severity, which can occur following experiences, such as military battle, in which grave physical injury occurred or was threatened. People who experience from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged. TBI happens when a sudden physical trauma causes damage to the brain. Improvised explosive devices (IEDs) can cause TBI, sometimes in the absence of obvious external signs of injury. Symptoms of TBI can be mild, moderate, or severe, depending on the extent of the brain injury. When symptoms of TBI or PTSD are mild, they may go undiagnosed, or be confused with conditions with similar symptoms, such as other mental illnesses, including depression, or substance use disorders. Either PTSD or TBI may also occur with depression or substance abuse. Some veterans suffer from both a TBI and PTSD (Sundararaman, Panangala and Lister, 2008).

Suicide rates in the military and especially among veterans are on the rise. Military Sexual Trauma (MST) persists at epidemic proportions, and under-diagnosed traumatic brain injury (TBI) ensures a future of pain for veterans and their families. It is thought that homelessness and incarceration lie in wait for many of the returning troops. The Department of Defense guarantees that new research initiatives will be funded to find out how to address the rising suicide rates in the military. Studies continue to examine the causes and treatment of MST, TBI, PTSD, and all the substances used to self-medicate the many symptoms that come with each (Hall, 2008).

There were 177 accounts of active-duty Army suicides from January 1 through September 30, 2009. During 2008, there were 129 confirmed suicides. This rising suicide rate, coupled with an under-reported occurrence of substance abuse which is a by-product of self-medicating the symptoms of PTSD, is indicative of a culture that discourages ongoing and effective utilization of mental health services. There is a culture inside the military that continues to harass those who try to take advantage of mental health services (Hall, 2008).

Because of its continuing and transient nature, chronic suicidal ideation (CSI) compared to active suicidal thinking is often not an indication for hospitalization. This can be a difficult factor in treatment of veterans with PTSD. For many who have experienced considerable trauma in their past and continue to cognitively and emotionally re-experience the trauma (i.e. chronic PTSD), CSI is a persistent concern. CSI is distinguished from acute and active suicidal ideation as being constant, transient, intermittent thoughts of ending one's life. Acute suicidal ideation explains a patient who is in imminent danger of killing themselves, and is an indication for emergency hospitalization. On the other hand, passive suicidal ideation is the wish for oneself to die, without active plans to facilitate the process. Since danger is not objectively pending, these individuals are left to deal with their suicidal thoughts by drawing on their own intra- and interpersonal resources (Sivak, n.d.).