by Karen R. Effrem, MD
As Memorial Day approaches, it is incredibly important that we pause from our rhetorical and political battles on the education front to remember, honor, and teach the next generation the stories of our military men and women. These soldiers, sailors, airmen, marines, and coast guardsmen fought and died to secure the heritage and blessings of our liberties. We are rapidly losing those who fought tyranny in World War II and the Korean conflict to age. The veterans of Vietnam are in middle age and are dealing both with the horrors of war and the poor treatment they received on their return due to the country’s conflict about our involvement there.
Tragically, in addition to those who made the ultimate sacrifice in battle, far too many military members that served in Iraq and Afghanistan are dying due to suicide and, in addition to physical wounds, are suffering from the ravages of Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). The care they should be receiving is too often inadequate, ineffective and, in the area of mental health, downright dangerous.
This horrible psychiatric care that our brave veterans are receiving was brought into sharp focus for me this week as a veteran I care about very much, whom I will call David, attempted to take his life. After driving a tank in Iraq, where he witnessed the death and injury of comrades and civilians alike, his transition back to civilian life has been rough. In addition to significant hearing loss, he has struggled with flashbacks, nightmares, headaches, a previous suicide attempt, and debilitating anxiety resulting in difficulty keeping a job. Although he seems to have found his niche in the health care field and is married with two young children, his stress increased significantly when he started working the night shift, going to school to further his education and training, and after the birth of his second child.
Instead of asking about David’s low success rate with psychiatric drugs in the past, and before a physical work-up for his headaches was completed, a psychiatrist started him on two different medications that are known to cause suicidal thoughts and actual episodes of self-harm. So it was hardly a surprise when, a few weeks later, David was hospitalized for attempted suicide. During his three days in the hospital, he was offered or given four other medications that can also cause suicidal thoughts or actions as well as many other dangerous, if not fatal, side effects — including new or worsening aggression or hostility that has a well documented link to murderous rages (see here, here, here, and here).
Thankfully, David did not experience any of these terrible additional side effects and will be weaning off the medications and pursuing other non-chemical means of help for his problems. He has been invited to a retreat for veterans paid for by a family foundation that provides support via cognitive behavioral therapy, equine and art therapy, acupuncture, and fellowship with other veterans.
As bad as David’s experience was with psychiatric medications, sadly, it pales in comparison to that of other veterans. According to a letter by Dr. Joseph Tarantolo, a Washington, D.C., psychiatrist who helps patients come off of psychiatric medications, one of his veteran patients came to him on nine different psychiatric medications at the same time, and had been prescribed more than forty of these drugs over seven years with terrible consequences. According to the letter:
When he arrived at my office on August 17, 2017, he was on high doses of nine different drugs all of which have had profound adverse reaction impact. Before arriving at the VA for medical care in 2010, his vision was perfect, now impaired. Before arriving at the VA he had normal GI functioning, now impaired. Before arriving at the VA, he had normal sexual functioning, now impaired. Before arriving at the VA, although in psychological turmoil, he had excellent cognitive function and could emotionally feel authentically, now, “I fake feeling. I know I’m supposed to feel but I can’t.” And he nods off in the middle of substantive discussion.
These drugs are being used as bandages for a broken leg. It is easier and cheaper, at least in the short-term, to use medications cover over the psychological pain experienced by our veterans. As Dr. Tarantolo explains:
Why all the drugs? Thousands upon thousands of veterans are going through this. I believe the difficult answer to this question is that the VA has been infiltrated with self-defeating, and what I consider odious ideas about what it means to have suffered the damage of war battle. Pathologizing these returning warriors rather than accepting, hearing, understanding, and supporting their terror-filled experiences drives them further into misery, e.g., as soon as the idea of “suicide” is mentioned almost invariably the VA physician reaches for the prescription pad. And as the veteran experiences the first adverse reaction, the second drug is added, then the third, the fourth, etc. In time there is utter confusion about what is “real” and what is drug-induced. The chance then of finding a remedy becomes less and less.
This situation is appallingly unacceptable and must be changed. Dr. Tarantolo, psychologist Dr. Paula Caplan (author of When Johnny and Jane Come Marching Home), and others are absolutely correct that we need to stop pathologizing and drugging these heroes, and begin listening to them, respecting them, and supporting their transition back to civilian life.
A fabulous way to celebrate Memorial Day is to remember and honor the fallen by taking your children to a Memorial Day ceremony, read them General Order 11 from the post-Civil War era that was the basis of Memorial Day, and help protect those who have returned from war from becoming additional casualties. Here are some practical ways you can help:
May God bless our veterans that have served, fought, and died to give us our liberties and education for a free nation.