Dr. Daniella David Interview
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1. What do you believe are the reasons veterans want to commit suicide? There are a good number of factors that contribute to this very serious problem: a. Untreated mental illness – depression, bipolar disorder, PTSD b. Feelings of guilt about acts of commission or omission – death of fellow soldiers, civilian casualties c. Problems with anger, anxiety and impulse control, possibly associated with depression or PTSD d. Substance abuse difficulties e. Family, marital and interpersonal difficulties upon return from war – feeling alienated, not fitting in 2. What makes your type of therapy unique or special for veterans? We provide evidence-based psychiatric and psychological treatment interventions: a. Medication treatment with medications that have been shown to be effective for PTSD in scientific studies. b. Counseling by Psychologists and other therapists who have been trained in the specific types of interventions that have been shown to be effective in veterans with PTSD and/or depression (such as cognitive therapy, exposure therapy). c. Treatment is provided in a supportive environment, typically in group sessions with other veterans who have been through similar experiences. d. Family and couple education and counseling are also available. e. Referral to specialized services such as vocational rehabilitation, recreational therapy and others. 3. In your opinion, what is the best way to treat depressed veterans? With a combined treatment approach, as described above: Individual and group counseling, medication management, family involvement. 4. During what war was the number of veterans' suicides at its peak? I don’t think that we know that for sure, as many veterans commit suicide after the war, and that data is not always tracked. We know that for the Vietnam War, the number of veterans who died from suicide was higher than the number of veterans killed in the war. 5. What age group of veterans is at a greater risk for suicide? Gender? There are two peaks for suicide – young adults 18-24 and older adults >65 yrs old. Male veterans generally make more lethal attempts and are
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This is an expert interview I did with Dr. Daniella David, a phsychologist at the Miami Veterans' Affairs Hospital in Florida.
Transcript of Dr. Daniella David Interview
1. What do you believe are the reasons veterans want to commit suicide? There are a good number of factors that contribute to this very serious problem: a. Untreated mental illness – depression, bipolar disorder, PTSDb. Feelings of guilt about acts of commission or omission – death of fellow soldiers, civilian casualtiesc. Problems with anger, anxiety and impulse control, possibly associated with depression or PTSDd. Substance abuse difficultiese. Family, marital and interpersonal difficulties upon return from war – feeling alienated, not fitting in
2. What makes your type of therapy unique or special for veterans? We provide evidence-based psychiatric and psychological treatment interventions:a. Medication treatment with medications that have been shown to be effective for PTSD in scientific studies.b. Counseling by Psychologists and other therapists who have been trained in the specific types of interventions that have been shown to be effective in veterans with PTSD and/or depression (such as cognitive therapy, exposure therapy).c. Treatment is provided in a supportive environment, typically in group sessions with other veterans who have been through similar experiences.d. Family and couple education and counseling are also available.e. Referral to specialized services such as vocational rehabilitation, recreational therapy and others.
3. In your opinion, what is the best way to treat depressed veterans? With a combined treatment approach, as described above: Individual and group counseling, medication management, family involvement.
4. During what war was the number of veterans' suicides at its peak? I don’t think that we know that for sure, as many veterans commit suicide after the war, and that data is not always tracked. We know that for the Vietnam War, the number of veterans who died from suicide was higher than the number of veterans killed in the war.
5. What age group of veterans is at a greater risk for suicide? Gender? There are two peaks for suicide – young adults 18-24 and older adults >65 yrs old. Male veterans generally make more lethal attempts and are more likely to commit suicide. Older Caucasian males are at highest risk in the general population, especially if they have alcohol/substance abuse problems, or chronic medical or psychiatric problems.
6. What can a soldier do personally to avoid depression and risk for suicide? Education is the key. Need to educate soldiers about combat stress, stress and anxiety reaction, depressive symptoms and how to identify them. Need to educate the general population in order to help family members and other professionals (family doctors, pastors, teachers) identify these symptoms in returning soldiers.Need to help the military de-stigmatize mental illness in order to facilitate soldiers asking for help.A lot of efforts and initiative are already in place.
7. Do you think that your young Gulf War patients or older WWII patients do better in therapy? Why? I don’t think there is a group difference. In general, it’s probably better if therapy and treatment start earlier in the course of illness, rather than later. However, a lot has to do with the individual’s motivation in therapy. I have treated WWII veterans who were highly motivated and did great, and I
have treated recently returning veterans from Iraq who were a lot less motivated. So it’s also somewhat up to the individual.
8. When a soldier is going into war, what can he/she do to mentally prepare for the stress and effects of war?Learn about stress reactions, and identify positive coping skills (being with friends, listening to music, practicing meditation/relaxation).See also answer to question 6.
9. What else is being done to expell this issue as much as possible?We provide education and information about resources at soldiers’ returning debriefing sessions, so they’ll know where to find us if they need us.We also have a presence in the media, spreading the word about early intervention. And we engage in a lot of outreach efforts to returning soldiers, veterans and their families, colleges, churches, schools and community providers.
