The good news? Treatment can help prevent it.
Suicidal thoughts may be common in veterans with PTSD, or post-traumatic stress disorder. Still, not all veterans have PTSD, and not all veterans with PTSD experience suicidal thoughts. So what are the risk factors for suicidal thoughts in veterans?
PTSD leads to negative thinking patterns in the brain. This can then progress to suicidal thoughts, according to Collin Reiff, MD, psychiatrist at NYU Langone Health.
“[PTSD] can increase feelings of shame [and] feelings of guilt,” says Dr. Reiff. “Then there’s the whole part of feeling like, ‘What’s the point of even continuing to live my life? This horrible thing has happened to me. I don’t know how to make meaning of it.’”
In many cases, some veterans with PTSD have negative thoughts about themselves. This can lead them to thinking that they don’t deserve to get better or to have a good life. As a result, feelings of hopelessness are common and may lead to suicidal thoughts. Learn more about how military service may affect mental health here.
The Effects of Alcohol on Suicidal Thoughts
Veterans with PTSD who do not receive treatment are particularly at risk for suicidal thoughts. That’s because they’re more likely to turn to negative coping strategies. “They may try to self-medicate with substances such as alcohol. They may use stimulants, they may use cannabis,” says Dr. Reiff.
Substance use and misuse is very common among people with mental illnesses, including PTSD. While substance use may soothe PTSD symptoms temporarily, they may worsen problems in the long run. In fact, substance use may increase one’s risk of suicidal thoughts and suicide attempts.
“The danger … is that alcohol is a stimulant in low doses, and a depressant in high doses,” says Dr. Reiff. “That can disinhibit the individual and lead to impulsive activity.”
If someone is already having suicidal thoughts, and then they experience impulsivity from alcohol, they are more likely to have a suicide attempt. Statistically, suicide accounts for 20 percent of deaths related to alcohol, according to the U.S. Department of Health and Human Services.
Thoughts About Death
“Another thing to consider is that our veterans … may have at times accepted that there’s a high probability that [they’re] going to die,” says Dr. Reiff. “In a certain regard, death may not be as foreign to them.”
Some veterans may come home with an intrusive thought that they weren’t “supposed” to survive their military service. According to U.S. army veteran Anthony Aiello, some of his suicidal thoughts stemmed from an idea that he was “meant to have died in the war.”
“That’s something else that tons of veterans go through—this feeling that they shouldn’t have survived the war [because] they just weren’t meant to survive,” says Aiello.
The Communal Effect of Suicide
The prevalence of suicide within the veteran community can be devastating. “The veterans rely on each other. They went out to war together,” says Dr. Reiff. “It’s important for them to have that subgroup of individuals and members who appreciate one another, who have a shared identity, so they enable each other to push forward and to make progress.”
It’s damaging on its own to lose one member of the group. They might be a friend or an important member of one’s support system. To make it worse, it may have a rippling effect on the community.
“It’s devastating when one of the members of that subgroup is lost because it communicates to the other members within the subgroup that ‘I wasn’t able to overcome this burden, and you might not be able to overcome this,’” says Dr. Reiff. “It wears away at the community, this shared identity, and it’s almost as if they’re losing the war after the war.”
Get more information about suicide prevention here:
Collin Reiff, MD, is an addiction psychiatrist at NYU Langone Health and a clinical assistant professor at NYU Grossman School of Medicine.
00:00:02.100 --> 00:00:04.666
PTSD can lead to suicidal thoughts
00:00:04.667 --> 00:00:08.299
because it causes negative alterations in cognition.
00:00:08.300 --> 00:00:13.999
(somber piano music)
00:00:14.000 --> 00:00:16.832
It can increase feelings of shame,
00:00:16.833 --> 00:00:20.899
feelings of guilt, so there's that part of it.
00:00:20.900 --> 00:00:23.932
Then there's the whole part of
00:00:23.933 --> 00:00:25.666
00:00:25.667 --> 00:00:28.366
what's the point of even continuing to live my life?
00:00:28.367 --> 00:00:30.599
This horrible thing has happened to me.
00:00:30.600 --> 00:00:32.332
I don't know how to make meaning of it.
00:00:32.333 --> 00:00:34.166
Oftentimes that happens to people who have
00:00:34.167 --> 00:00:35.566
00:00:35.567 --> 00:00:37.666
I don't deserve to have a good life.
00:00:37.667 --> 00:00:39.466
I may never get better.
00:00:39.467 --> 00:00:42.899
And so what can happen is they can start to feel hopeless
00:00:42.900 --> 00:00:46.899
about their current situation and the future.
00:00:46.900 --> 00:00:50.066
An individual sufferer with the symptoms of PTSD,
00:00:50.067 --> 00:00:51.566
if they're not in treatment,
00:00:51.567 --> 00:00:53.166
they may try to self-medicate
00:00:53.167 --> 00:00:54.899
with substances such as alcohol.
00:00:54.900 --> 00:00:57.199
They may use stimulants, they may use cannabis.
00:00:57.200 --> 00:00:59.999
The danger of that, specifically with alcohol,
00:01:00.000 --> 00:01:02.966
is that alcohol is a stimulant in low doses
00:01:02.967 --> 00:01:04.932
and a depressant in high doses.
00:01:04.933 --> 00:01:08.566
That can disinhibit the individual
and lead to impulsive activity.
00:01:08.567 --> 00:01:11.666
Another thing to consider is that our veterans
00:01:11.667 --> 00:01:15.166
that have served may have already
00:01:15.167 --> 00:01:19.299
more or less dealt with the idea that I'm gonna die,
00:01:19.300 --> 00:01:22.132
and they may have at times accepted
there's a high probability
00:01:22.133 --> 00:01:25.232
that I'm gonna die in this situation,
00:01:25.233 --> 00:01:27.799
so in a certain regard,
00:01:27.800 --> 00:01:30.499
death may not be as foreign to them.
00:01:30.500 --> 00:01:32.532
I had this idea that I was
00:01:32.533 --> 00:01:35.966
meant to have died in the war.
00:01:35.967 --> 00:01:38.766
That's something else that tons of veterans go through.
00:01:38.767 --> 00:01:42.032
This feeling that they shouldn't have survived the war,
00:01:42.033 --> 00:01:44.266
not because their friends died,
00:01:44.267 --> 00:01:46.166
but they just weren't meant to survive.
00:01:46.167 --> 00:01:49.399
Not only that, it removes a veteran
from the community.
00:01:49.400 --> 00:01:51.999
And the veterans rely on each other.
00:01:52.000 --> 00:01:54.366
They went out to war together.
00:01:54.367 --> 00:01:57.966
Oftentimes civilians have a hard time relating
00:01:57.967 --> 00:02:00.966
or really understanding what our veterans do,
00:02:00.967 --> 00:02:03.199
and they do a lot,
00:02:03.200 --> 00:02:05.632
so it's important for them to have that subgroup
00:02:05.633 --> 00:02:08.666
of individuals and members
00:02:08.667 --> 00:02:11.066
who appreciate one another,
00:02:11.067 --> 00:02:13.932
who have a shared identity,
00:02:13.933 --> 00:02:16.299
so they enable each other
00:02:16.300 --> 00:02:18.732
to push forward and to make progress.
00:02:18.733 --> 00:02:21.699
It's devastating when one of the members
00:02:21.700 --> 00:02:24.732
of that subgroup is lost because it communicates
00:02:24.733 --> 00:02:26.532
to the other members within the subgroup
00:02:26.533 --> 00:02:29.832
that I wasn't able to overcome this burden,
00:02:29.833 --> 00:02:31.899
and you might not be able to overcome this.
00:02:31.900 --> 00:02:35.466
It wears away at the community,
00:02:35.467 --> 00:02:36.932
this shared identity,
00:02:36.933 --> 00:02:43.166
and it's almost as if they're losing the war after the war.
00:02:43.167 --> 00:02:45.500
- Does alcohol and other drug abuse increase the risk for suicide? Washington, DC: U.S. Department of Health and Human Services, 2008. (Accessed on August 27, 2020)
- Mental health: suicide prevention. Washington, DC: U.S. Department of Veterans Affairs. (Accessed on August 27, 2020)
- Post-traumatic stress disorder. Bethesda, MD: National Institute of Mental Health. (Accessed on August 27, 2020)