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U.S. Army veteran Skip, left, uses an iPad to speak to his family with the help of nurse manager Laurie Nicol, center, and recreation therapist Kristen Weber at Holyoke Soldiers Home in Holyoke, Mass., where he was in isolation due to COVID-19, April 20, 2020. Using technology to connect with others during coronavirus lockdowns and quarantines is thought to be one reason why suicidal thoughts among veterans fell during the pandemic, says a study published Aug. 25, 2021.
U.S. Army veteran Skip, left, uses an iPad to speak to his family with the help of nurse manager Laurie Nicol, center, and recreation therapist Kristen Weber at Holyoke Soldiers Home in Holyoke, Mass., where he was in isolation due to COVID-19, April 20, 2020. Using technology to connect with others during coronavirus lockdowns and quarantines is thought to be one reason why suicidal thoughts among veterans fell during the pandemic, says a study published Aug. 25, 2021. (Samuel Keenan/U.S. National Guard)

Veterans who have had COVID-19 were more than twice as likely to contemplate suicide during the coronavirus pandemic as those who never had the illness, a study published Wednesday found.

Overall, however, veterans were less likely to have suicidal thoughts during the pandemic than they were before it, said the study, which was published in JAMA Psychiatry.

The study was “one of the first … to find an independent link between COVID-19 infection and suicidal ideation,” said lead author Brandon Nichter, a Defense Department clinical psychologist.

Suicidal thoughts after COVID-19 infection could be driven by physical issues, such as inflammation of the brain or changes to the body’s immune response, which scientists believe may be caused by the virus, the study said. Social factors, including increased feelings of isolation and loneliness, or financial stress felt during the pandemic could also be factors.

Veterans whose primary health care source was a Veterans Affairs hospital were more likely to say they had thought about suicide.

Among the nearly 3,100 veterans who took part in the study, the prevalence of suicidal thoughts fell from 10.6% prior to the pandemic to 7.8% 10 months into it, bucking predictions that coronavirus lockdowns and limits on travel and gatherings could leave veterans feeling lonelier and increase suicidal behaviors among them, the study said.

Veterans are considered a high-risk group for loneliness and tend to have more mental illness, such as post traumatic stress disorder, and previous suicide attempts than other groups — all of which increase suicidal thoughts.

The drop was seen mainly among veterans ages 18 to 64, possibly because they are better at using “virtual technologies (e.g., FaceTime, Zoom) to solicit support during the pandemic,” said one of the study’s authors, Dr. Robert Pietrzak, director of the main lab involved with the research at the U.S. Department of Veterans Affairs’ National Center for PTSD.

But even among veterans over 65, who “were already at high risk for loneliness,” suicide ideation declined during the pandemic, the study said.

That could be because veterans’ lifetime exposure to trauma, including in combat, is greater than other groups’ and “may have helped ‘inoculate’ them to be better able to endure periods of prolonged stress,” Pietrzak said in an email.

It may also be linked “to a ‘pulling together’ phenomenon that has previously been observed in natural disasters and periods of war,” he said. “Societies (tend to) pull together during times of national crisis, which may have helped to promote social connectedness and mitigate risk of suicide ideation during the pandemic.”

The veterans surveyed may have underreported suicidal behavior because of the stigma attached to it, the researchers warned, adding that they want to follow individuals with COVID-19 infection over time to study the long-term impact of the illness on suicidal ideation, depression and PTSD in veterans.

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