Suicide is the fourth leading cause of death in American soldiers. Since the beginning of the “war on terror,” the Army has lost more than 580 soldiers to suicide, the equivalent of an entire infantry battalion. Military suicides in 2008 were 13% higher than in 2006. In addition, nearly 6,500 veterans take their own lives in a year (Human Events 6/16/08).
The record high number of suicides was the subject of a Senate hearing on March 18, 2009. Most of the victims seemed to have been suffering from post-traumatic stress disorder (PTSD) (Democracy Now 2/20/09).
It is estimated that about 20,000 troops in Iraq and Afghanistan were taking selective serotonin reuptake inhibitor (SSRI) antidepressants and/or sleeping pills such as Ambien—including 70% of those who attempted suicide. While the Army states that “failed relationships” are the primary cause of suicides, some think the drugs contribute, and criticize the “pharmacologic imperative” said to dominate in military psychiatry (Mark Thompson, “America’s Medicated Army,” Time 6/5/08).
A problem that is likely related is the traumatic brain injury (TBI) reportedly suffered by as many as 360,000 U.S. troops (AP 3/5/09). TBI can result from blast injuries, even in the absence of direct impact trauma (Bhattacharjee Y. Shell shock revisited: solving the puzzle of blast trauma. Science 2008;3198:406-408), for example, from improvised explosive devices (IEDs).
The prevalence of PTSD increased linearly with the number of firefights experienced during deployment: from 4.5% with no firefights, 9.3% with one or two, 12.7% with three to five, and 19.3% for more than five (P<.001) (Hoge CW et al. N Engl J Med 2004;351:13-22).
The rapid compression/decompression accompanying a blast wave can produce showers of air emboli in the carotid artery, detected by Doppler up to 30 minutes after the injury. On this basis, hyperbaric oxygenation has been recommended for treatment, and has had favorable results in 16 out of 16 cases, even long delayed. The military, however, is not yet using this treatment (Army Times 3/3/09).
A research protocol for hyperbaric oxygenation has been approved, and enrollment of veterans with TBI is slated to begin in about 3 weeks. (See testimony before House Armed Services Committee, May 14, 2009 by Walter Jones).
Additional information:
