Could There be a Physical Reason for the Military Suicide Epidemic?

Could There be a Physical Reason for the Military Suicide Epidemic?
Posted by Moran Banai [1] on May 11 [2] 2012

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The U.S. Army released its monthly suicide numbers [4] yesterday and the news is once again tragic: 27 soldiers may have taken their lives in April, one less than the 2012 high of 28 in March. Each suicide is its own tragedy, but the fact that the numbers continue to stay high, even as the Army has made fighting this suicide epidemic a top priority, raises many questions. One question is whether there is a physical reason for at least some of these deaths – and what that would mean for treating an epidemic that is hitting service members and veterans hard.

Last week Junior Seau joined a growing list of seemingly healthy retired football players who committed suicide, raising the potential prospect that he suffered from chronic traumatic encephalopathy (CET). CET is a disease that causes degeneration in the brain and can lead to behavioral changes, moodiness, difficulties learning and remembering and sometimes, suicide. The disease is caused by repeated blows to the head – a problem that afflicts not only professional sports players, but also service members fighting in two wars whose signature weapons are explosive devices.

Currently, the only way to diagnose CET is through a brain autopsy, though scientists are searching for ways to diagnose it earlier. So far, only a few veterans have been diagnosed with CET, and only one case has been peer-reviewed for a journal. But Nicholas Kristof recently reported [5] that more studies are in process.  Not all soldiers and veterans who commit suicide have deployed, but these initial findings raise the possibility that there is a physical reason for at least some of the suicides in the Army – and even more so among veterans, who have a much higher suicide rate.

Psychiatrists are asking the same question about Post-Traumatic Stress Disorder (PTSD), an invisible injury that in extreme cases can lead to suicide. The American Psychiatric Association (APA) met this week to debate and revise its diagnostic guide that serves as the primary tool for recognizing and treating mental health issues. One of the big debates at this year’s meeting was what to do about PTSD. The military was lobbying for it to be changed to Post-Traumatic Stress or “PTS” - no “D” for Disorder - to destigmatize the diagnosis among service members. Others suggested that what troops suffer is often different because its cause is different; there is an external influence on troops that essentially causes injury, one that changes the brain. The APA may end up with a compromise of Post-Traumatic Stress Injury (PTSI), to acknowledge this distinction, though such hasn’t yet been finalized.

Invisible injuries are the most common wounds of the Iraq and Afghanistan wars. As the APA sets out to potentially redefine PTSD, it is possible that yet another wound is going unseen among our service members and veterans – a physical injury to the brain that may be playing a role in the military and veteran suicide epidemic.  Just as PTSI might need to be treated differently if it has a physical component, we may need to rethink our approach to fighting the suicide epidemic to take into account the impact of CET, a physical injury that we cannot yet diagnose before death.

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