Hopelessness about life is the ultimate reason many people take their own lives. Among the military, as in civilian life, suicide often results when individuals feel isolated, abandoned, and without hope. Our military and veterans need to know that we Americans appreciate their sacrifices and the horrors they have endured, and that we want to extend them help. But what kind of help should it be?
Hopelessness itself is tangled up with a host of negative or self-defeating emotions, such as guilt, shame and anxiety. Although often rooted in childhood, these self-destructive feelings can be amplified by repeated deployments into war zones with the resulting mental and emotional exhaustion. Ruptured relationships with loved ones are inevitable and devastating during these excessive deployments. When soldiers fight within civilian populations, they can be deeply affected not only by the death of their friends, but also by the death of innocent civilians. Restrictive rules of engagement add to the stress.
There is yet another potential contributor to suicide that is given far too little attention: psychiatric drug-induced suicide. A large percentage of soldiers are being sent into combat with several months' supplies of multiple psychiatric drugs to be taken and even renewed without supervision. On their return, with the slightest excuse, the military continues or initiates polydrug treatment.
At the present time, several classes of psychiatric drugs carry a black box warning about suicidality. Black box warnings are the highest level of warning imposed by the FDA on drug labels or package inserts. In my clinical experience, and confirmed by the scientific literature, nearly all psychoactive drugs can contribute to suicide, including alcohol and marijuana, and prescription drugs like antidepressants, stimulants, tranquilizers, sleeping pills, mood stabilizers and antipsychotics. Any chemical that clouds the consciousness, weakens frontal lobe function, depresses or stimulates the brain can lead to despair and hopelessness or the loosening of inhibitions against suicide.
I have done a series of easily available blogs on Huffington Post about the massive psychiatric drugging of our troops and veterans. I have documented the dangers of drugs in numerous books and scientific articles, including Medication Madness: The Role of Psychiatry Drugs in Cases of Violence, Suicide and Crime and in Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families.
Not only do most psychiatric drugs potentially increase the risk of suicide in some patients, as well as many other serious risks, no psychiatric drug has been shown to reduce the rate of suicide in controlled clinical trials. As a result, the FDA has not approved any psychiatric medications for the treatment of suicidality. On this basis, there is no clinical, scientific or common sense reason for giving psychiatric drugs in the vain hope of preventing suicide. A 2013 epidemiological study found that most suicidal behavior among adolescents starts after they have entered treatment.
The growing number of suicides in the military correlates with the escalating use of antidepressants and drug cocktails. In 2010 the Veterans Affairs Committee of the U.S. Congress held a hearing that featured my scientific presentation on this growing problem. Returning military and veterans are being continued on wholly irrational combinations of multiple psychiatric drugs which could be contributing to suicide, violence and sudden "unexplained" death from cardiac arrhythmia and depression of the central nervous system. Douglas Kennedy on Fox News has done an admirable three-part series about the drugging of veterans.
What really helps suicidal people in the military or in civilian life? The psychological and spiritual restoration of hope.
Often in my clinical experience a carefully planned withdrawal from psychiatric drugs will bring suicidal feelings to an end. Some of the earliest clinical reports regarding Prozac-induced suicide, including Martin Teicher and his Harvard colleagues in the American Journal of Psychiatry in 1990 (pp. 207-210) showed that intense suicidal feelings typically abated after "as little as 3 days to as long as 3 months after discontinuation."
Without medication, hope can be revived in many ways from discovering "a reason to live" to finding new love or turning to God. Simply put, any aspect of life and living that can restore hope can help a person overcome suicidal feelings.
As a psychiatrist and psychotherapist, two principles are confirmed in my practice on a daily basis. First, offering psychiatric medications to individuals often undermines their trust in their own personal capacity to triumph over suicidality and often chemically worsens their condition. Second, establishing a meaningful relationship with the suicidal person is the most significant way of disarming suicidal impulses. The best way for a therapist, or anyone else, to help a suicidal person is by building a relationship that is caring and offers hope. As a part of my series called "Simple Truths about Psychiatry," I have recently posted my video about how to help people who feel suicidal without resort to drugs.
When suicidal feelings are not drug-induced, people are helped by understanding that they would not have such despairing and self-destructive feelings about life if they did not harbor secret wishes for a much better life. They will benefit from knowing that the more intense their suicidal feelings, the more intense their thwarted desire to live a much better life. They can be helped by an encouraging conversation about all the things they once wanted to live for -- all the unfulfilled hopes and desires from becoming guilt-free to expressing their creativity and finding true love. This is not unrealistic or pie-in-the-sky. The most desperately suicidal people can find within themselves an even stronger impulse to live and to love life.
This post is part of a special Huffington Post series, "Invisible Casualties," in which we shine a spotlight on suicide-prevention efforts within the military. Every weekday in September, we'll feature a different blog post by someone who is either an expert in the field, who has been affected by a suicide, or who has contemplated suicide. To see all the posts in the series, as well as original reporting, audio and video, click here.
If you or someone you know would like to contribute to our series, send an email to firstname.lastname@example.org.
And please, if you or someone you know needs help, call the national crisis line for the military and veterans, 1-800-273-8255, or send a text to 838255.