Veterans Day is a time to honor those who served in the U.S. military and to recommit to safe and effective treatments for those with mental health issues.

The newly released annual report on veteran suicides from the U.S. Department of Veterans Affairs (VA) shows that while the number of suicides decreased modestly in 2019 and 2020, the rate of veteran suicides per 100,000 population has remained stubbornly high for decades and is still substantially greater than the rate for non-veterans. The suicide rate is also much higher among veterans who received VA health services compared to those who did not.

In every year from 2001 through 2020, the suicide rate of veterans exceeded the rate for non-veteran U.S. adults, and the rate rose faster for veterans than for non-veterans during that time. In 2020, the rate for veterans’ suicides was 57.3% higher than that of non-veteran adults.

It is noteworthy that in each year from 2001 to 2020, the suicide rate of those veterans who had recently received services through the Veterans Health Administration (VHA) exceeded the rate for veterans who had not. In 2020, the rate of suicide for veterans who used VHA services was 43.4% higher than the suicide rate of other veterans.

Of those veterans who had recently used VA health services before taking their lives in 2020, 58% had been given psychiatric diagnoses, with 35.2% of them diagnosed with depression, 25.6% diagnosed with anxiety, and 24.4% diagnosed with posttraumatic stress disorder (PTSD).

While we do not know what psychotropic drugs, if any, these veterans had been taking prior to committing suicide, these disorders are typically treated with antidepressants, which carry the known risks of deepening depression and suicidal thoughts and actions. The FDA website lists “suicidal thinking” as one of the “serious risks” of antidepressants.

In answer to a FOIA request by the Citizens Commission on Human Rights International, the VHA revealed that of the 9 million U.S. veterans enrolled with the VHA for health care services in 2019, 4.2 million – nearly half – were prescribed psychiatric drugs, with 1.75 million prescribed antidepressants.

The risk of suicidal thoughts and actions from taking antidepressants is well-known. In 2004, the FDA ordered antidepressant labels to carry a black box warning concerning the increased risk of suicidal thinking and actions in children and teens. The warning was extended in 2007 to include young adults aged 18 to 24, an age range that includes many active-duty military and veterans.

Once you medicate [them], it’s much harder to work with them because [their] brain functioning is chemically and physiologically changed by the medications.”
— Colonel Bart Billings, retired military psychologist with 34 years service

Though the FDA has not yet extended the black-box warning to all adults, evidence indicates it should. In a 2016 study published in the Journal of the Royal Society of Medicine, a team of researchers at the Nordic Cochrane Centre reviewed clinical trials in which healthy adults with no history of depression or other mental disorders were given antidepressants. The researchers concluded that “antidepressants double the occurrence of events in adult healthy volunteers that can lead to suicide and violence.” Consider, then, how antidepressants could affect those already struggling with depression, anxiety, traumatic stress, or other mental health issues.

The key rationale for prescribing antidepressants – to fix a supposed lack of serotonin or other brain chemicals presumed to be the cause of depression – has been called into question by research published in Molecular Psychiatry in July.  The review of reviews, led by Joanna Moncrieff, M.D., a British psychiatrist and academic at University College London, concluded that, after decades of brain research, there is still no scientific evidence to support the theory that a low level of serotonin causes depression.

“Our comprehensive review of the major strands of research on serotonin shows there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity,” the researchers wrote. “It also calls into question the basis for the use of antidepressants.”

A 2018 study published in Psychotherapy and Psychosomatics found that taking antidepressants led to worse depression symptoms years later. Subjects in the study were assessed for depression symptoms over a 30-year period. The researchers found that those who used antidepressants at any time during the study had an 81% greater chance of having more severe depression symptoms at the end of the study.

Colonel Bart Billings, a retired military psychologist with 34 years of service who founded the International Combat Stress Conference, has stated that in all his years of practice with military personnel and veterans diagnosed with “post-traumatic stress disorder,” he never once had to prescribe a mind-altering psychiatric drug.

In a 2014 interview, he explained that 99% of those who go into combat experience “post-traumatic stress, a normal reaction to being in an abnormal environment.” But, he says, “if you give them time to normalize themselves…, then the post-traumatic stress dissipates, and they get back to living their normal lives.”

“I explain to the psychiatrists and psychologists,” he continues, “that you really shouldn’t be medicating them because they have a normal brain, and once you medicate [them], what happens is it’s much, much harder to work with them because now you’re working with someone whose brain functioning is chemically, physiologically changed by the medications.”

Veterans deserve safe and effective treatment for their mental health issues. They have a right to the full disclosure of the increased risk of suicidal thoughts and actions when taking or discontinuing antidepressants. Without this vital information, veterans cannot make fully informed decisions about their mental health treatment.

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or any other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.