Traumatic Brain Injury Can Lead to Issues With Suicide
As our military members return from Iraq and Afghanistan an increase in suicide is also being witnessed. While they are fighting for our freedom, they are also suffering Traumatic Brain Injuries that can make PTSD symptoms worse for them.
Traumatic Brain Injury Can be Connected as an Additional Risk of Suicide
There is an increase of incidence of combat-related traumatic brain injury. This study feels that it is because with improved body armor explosive injuries that once were fatal are now survived. But the same advances have not been seen with head protection. And the fibers of the central nervous system can be damaged by a concussive force and not show up on gross examination. Clinicians should be aware that there may be an increased risk of suicide and take this factor into account when treating TBI patients. In addition, patients with TBI should be periodically evaluated as they are at continued risk for suicide (Reeves & Laizer, 2012).
Prior research has shown that PTSD (posttraumatic stress disorder) and mild TBI independently increase suicide risk. This study gathered veterans and military personnel from Operation Enduring Freedom and Operation Iraqi Freedom who had PTSD alone or with a history of TBI. Suicide rates among US active-duty soldiers reached a record high in 2009 and 2010. This caused suicide to be ranked third for the cause of death among those fighting the War on Terror.
Veterans have been found to be twice as likely as non-veterans to die by suicide. TBIs among civilians have a direct link to suicides as well. The study showed veterans with PTSD and history of TBI display a comparable risk of suicide. They also found TBI tended to cause more severe PTSD symptoms. And a direct relation was found the with an increase in PTSD severity and increase risk of suicide (Barnes, Walter, & Chard, 2012).
Traumatic Brain Injury is thought to be one factor in the rising number of suicides among military personnel and veterans. Suicide is currently the second leading cause of death among the military. TBI has also been associated with a significant increase in suicidal thoughts, attempts, and deaths. It is of concern among military due to the increased risk of concussive injuries secondary to explosions or other military training and combat-related factors.
As of this study, research is limited to the potential effects of cumulative head injuries on suicide. This study was conducted in Iraq at one of the military hospitals. Patients who had acute moderate or severe TBI were immediately evacuated from Iraq. The study found a correlation between the number of TBI and thoughts/attempts at suicide. TBI increase impulsivity and emotional distress (Bryan & Clemans, 2013).
Traumatic Brain Injury is considered the signature injury of Iraq/Afghan conflicts. The Defense and Veterans Brain Injury Center has reported nearly 350,000 with a diagnosis of TBI in US military since 2000. Over one-third of veterans have a history of mild TBI also have depression, suicidal thoughts, attempts and death by suicide. Additional outcomes in mild TBI include cognitive impairment, alcohol misuse and binge drinking, pain disorders and unemployment. TBI has been linked to suicide lower quality of life and mood and anxiety disorders among civilians.
This study found the most common cause of injury was blast or explosions by rocket-propelled grenades, landmines, IED or grenades. This was followed closely by objects hitting the head ir head hitting an object like vehicular accidents or crash. It was seen that a probable 87.3% of injuries with moderate-severe TBI at 12.7%. The study also showed that many veterans who reported multiple head injuries were associated with higher rates of PTSD, depression, suicidal thoughts, back pain or any pain. Current findings add knowledge to understanding TBI and its influence on depression and suicide (Lindquist, Love & Elbogen, 2017).
Increased suicide rates for the concussions and fracture group by a factor of 2:1. There has been an under-recording as non-specific intra-cranial lesions. Also, there is a concert according to this study that there has been an underreporting of suicides possibly due to social and religious reasons. This study showed a risk of suicide continues for at least 15 years of this study follow-up. Age at injury increased with the severity of diagnosis. The median times from injury to suicide were about three to three and a half years. And they didn’t differ significantly. The possibility exists, however, cases of suicide after TBI could be from an unsuccessful attempt at ending their life (Teasdale & Engberg, 2001).
Both males and females with a TBI experience life-altering changes that directly impact their quality of life and productivity. It is felt that the extent to which depression emerges post-TBI is a direct result of structural and neurochemical changes that occur in the brain. Following the injury versus during due to the associated barriers in TBI recovery attributed to suffering TBI. Previous studies have shown TBI depression happens from altered connectivity in a lot of networks in the brain (Lavoie et al, 2017).
A history of self-harm, suicide, and death was seen directly associated with TBI in higher rates than the rest of the population.
Barnes, S.M., Walter, K.H., Chard, K.M. (2012). Does a History of Mild Traumatic Brain Injury Increase Suicide Risk in Veterans with PTSD. Rehabilitation Psychology, 57(1). American Psychological Association. Doi:10.1037/a0027007
Bryan, C.J. & Clemans, T.A. (2013).Repetitive Traumatic Brain Injury, Psychological Symptoms and Suicide Risk in Clinical Sample of Deployed Military Personnel. JAMA Psychology, 70(7). Doi:10.1001/jamapsychiatry.2013.1093
Lavoie, S. Sechrist, S. Quach,N. Ehsanian, R. Duong, T. Gotlib, I.H. and Isaac, L. (2017). Depression in Men and Women One Year Following TBI: A TBI Model Systems Study. Frontiers in Psychology, 8(634). Doi:10.3389/psyg.2017.00634
Lindquist, L.K., Love, H.C. & Elbogen, E.B. (2017). Journal of Neuropsychiatry Clinical Neuroscience. Doi:10.1176/appi.neuopsch.16050100
Reeves, R.R. & Laizer, J.T. (2012). Traumatic Brain Injury and Suicide. Journal of Psychosocial Nursing. Doi:10.3928/02793695-20120702-02
Teasdale, T.W. & Engberg, A. W.. (2001). Suicide After Traumatic Brain Injury: Population Study. Journal of Neurology, Neurosurgery, and Psychiatry. Doi:10.1136/jnnp.71.4.436