COVID-19 pandemic increases risk of suicides in veterans wtih post-traumatic stress disorder

The U.S. military veteran population is known to have abnormally high rates of suicide, so health officials have been concerned that the COVID-19 pandemic might elevate risk of psychiatric disorders, particularly among those suffering from post-traumatic stress and related disorders.

A recent national study of more than 3,000 veterans participating in the National Health and Resilience in Veterans Study did find that 12.8% reported post-traumatic stress disorder (PTSD) symptoms related to COVID-19 and 8% said they had contemplated suicide during the pandemic.

However, the same survey, published April 8 in JAMA Network Open, revealed another, startling finding. A full 43.3% of respondents -- more than three times the number of those reporting COVID-related PTSD symptoms and five times the number of those who had contemplated suicide -- said that they have experienced positive psychological benefits during the pandemic. These veterans reported greater appreciation of life, closer interpersonal relationships, and an increased sense of personal strength.

"Yes, there have certainly been many negative mental health consequences of the pandemic, but we are also seeing that a considerable proportion of people may experience positive psychological changes," said Robert Pietrzak, director of the Translational Psychiatric Epidemiology Laboratory of the U.S. Department of Veterans Affairs' National Center for PTSD, associate professor of psychiatry and public health at Yale, and lead author of the paper.

"This suggests that the experience of stress and trauma related to the pandemic can lead to positive personal growth."

Over the past decade, Pietrzak and Steven Southwick, the Glenn H. Greenberg Professor Emeritus of Psychiatry at Yale and senior author of the new paper, have been studying veterans who experience what is known as "post-traumatic growth" following a traumatic experience.

Scientists have long been fascinated with the concept of resilience -- how people who endure trauma find a way to bounce back. The concept of post-traumatic growth posits that while trauma can increase risk for mental disorders such as PTSD, it may also spur positive personal growth.

For the latest findings, Pietrzak and Southwick initially asked veterans about their psychological health between November of 2019 and March 2020. The advent of the pandemic motivated them to follow up that survey with another, of the same group, a year later. In this second survey, they asked questions about PTSD symptoms and possible positive psychological changes related to the pandemic.

Of the 3,078 veterans who responded to both surveys, 43.3% reported that the pandemic led to positive psychological changes in their lives. Among veterans who screened positive for COVID-related PTSD symptoms, more than 70% reported experiencing these changes.

Post-traumatic growth is a process that often happens naturally and is stimulated by reflective processing about a traumatic event. Sometimes you need to be sufficiently shaken by an experience and even experience symptoms of PTSD to begin to process it at a deeper level and ultimately be able to grow from it."

Robert Pietrzak, Director, Translational Psychiatric Epidemiology Laboratory, U.S. Department of Veterans Affairs' National Center for PTSD

Greater post-traumatic growth -- particularly an increased appreciation of life and improved interpersonal relationships -- was also associated with a 40% lower likelihood of contemplating suicide during the pandemic. This finding suggests that psychological interventions to promote post-traumatic growth may be a helpful measure to prevent suicide among veterans.

While the scientific study of post-traumatic growth is relatively new, the concept is not. Ancient religious and spiritual traditions, philosophers, and scholars have long expressed the potentially transformative power of suffering.

"The saying 'Grow through what you go through' captures the essence of post-traumatic growth," Pietrzak said.

He and his colleagues plan to continue to follow their cohort of veterans over time to examine the longer-term course of post-traumatic growth and whether it may help promote resilience to subsequent traumatic events.

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