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PTSD Patients Feel Too Commonly Say “I Want to Die”

Sarah Ratliff
cannabis represented by woman helping man who may be saying "i want to die"

Studies find that PTSD patients consuming cannabis are less likely to be suicidal.

Unfortunately, “I want to die” is an all too common phrase on the minds of those suffering from PTSD. A recent research review from Yale University, published in The Primary Care Companion for CNS Disorders, has promising news for these patients. The report shows that “many of the published studies suggest a decrease in PTSD symptoms with marijuana use.”

What Is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can occur after living through a traumatic event. PTSD affects many facets of a person’s daily life, leading some sufferers to become so dissociated that they completely lose sense of self. The condition can even effect those who experience trauma second hand, for example, by listening to someone else’s trauma. The onset of symptoms can be immediately or even decades later.

Some of the groups most commonly diagnosed with PTSD are victims of sexual or physical assault, survivors of natural disasters, first responders, and combat veterans. Those diagnosed will often experience symptoms such as extreme anxiety, flashbacks, and repeatedly “reliving” the trauma. The list continues to include nightmares and trouble sleeping, even hypervigilance, which makes it extremely difficult for patients to relax. Hypervigilance includes the constant discomfort of always being on guard, expecting betrayal by others, and overanalyzing situations. This issue alone contributes to many PTSD sufferers having suicidal ideation. This is the distinct feeling of “I want to die.”

vateran speaking to psychiatrist, may be saying "I want to die"

PTSD Research Suggests Dysfunctional Endocannabinoid System

Recent research suggests that the development of PTSD may be the result of a damaged or deficient endocannabinoid system (ECS). A study, published in Psychoneuroendocrinology (2013), found that of the people exposed to the trauma of the 911 attacks (at ground zero), those with low circulating endocannabinoids were most likely to develop PTSD. Those with a healthy endocannabinoid system tended to sort out the trauma in a healthy manner.

The ECS has receptors throughout the central nervous system. It regulates hormones and contributes to mental health. These help the body maintain overall balance and homeostasis. While there are alternate ways to strengthen the ECS, cannabis is proven to contribute to a healthy ECS supporting good mental health and relieving symptoms of PTSD in particular.

Veterans are at a higher risk for PTSD than the general population. Shame is a major factor in suicidal ideation. Women are twice as likely to have PTSD, and also more likely to exhibit symptoms for a longer duration than men. The age at which a person experiences trauma affects the likelihood of symptoms as well.

What Makes a Person Say “I Want to Die”?

It’s important to understand that a person saying, “I’m depressed” is not the same as saying, “I want to die.” Both require attention and medical treatment, but suicidal ideation should be handled as a legitimate medical emergency.

People who are suicidal typically want to die because they need their pain to end, be it physical or emotional. Suffering from PTSD typically means there is no break from feeling disconnected from loved ones, repeatedly picturing traumatic events, living with rage or inappropriate responses to triggers, and harboring no hope for the future. Adding on lack of sleep due to nightmares is a recipe for a mental health crisis.

Combat veterans often suffer from PTSD.  The number of veterans who die by suicide upon returning home from war is at epidemic levels. In fact, twenty veterans die by suicide each day. Survivor’s guilt, or the trauma of being in combat multiple times, are both contributing factors.

veterans, who are far more likely to say "I want to die" than average people

Treatment Options for PTSD

A large percentage of PTSD patients do not feel that currently available treatments are effective. Trauma-based cognitive behavioral therapy and medication are most commonly prescribed. Another additional treatment is Eye Movement Desensitization and Reprocessing (EMDR).

Patients can attend group or individual therapy, but there doesn’t seem to be an over-arching treatment plan that has success. Pharmaceuticals tend to cover over the symptoms and numb the patient to the point of feeling even further removed from life and feelings. This can leave PTSD patients feeling even more hopeless.

PTSD is an Individual Issue

The truth is that PTSD is not a ‘one size fits all’ diagnosis. It is a complex mental health condition requiring consistent and flexible care. While therapy may work for some, one study found that weekly group therapy sessions were not beneficial to Vietnam veterans in particular. This could be due to the unique challenges these vets faced in reintegrating into society. Especially in doing so after fighting a brutal and socially unaccepted war. Veterans are not inclined to share their experiences, likely because of the shame they harbor, and the judgement faced. As a result, Vietnam vets enrolled in the group therapy largely dropped out before the completion of the thirty weeks. Those that completed the program had minimal progressive benefit and healing compared to the control group.

Another group of trauma-survivors that are difficult to treat are those who acquired PTSD from sexual assault. The personal nature of this type of violence makes each case very unique. So too do the varying but often personal relationships (stranger, family, partner) between victim and perpetrator.

In short, PTSD is not a condition where the same treatment is equally effective for all patients. As a result, novel treatments are continually sought to provide relief.

girl using cannabis perhaps to avoid saying "I want to die"

How Cannabis Can Help PTSD

In order to maintain good mental health, maintaining the ECS is important. Consuming cannabis may lend to the process of improving the condition of the ECS as it is neuroprotective. Further, cannabis acts upon the endocannabinoid system by binding to receptors and providing the cannabinoids that a deficient ECS needs in order to function. Cannabis can establish a balance in a consumer’s mental health, and ease PTSD symptoms, including depression, so that PTSD patients don’t want to die. Fortunately, cannabis also does not cause the myriad of side effects potentially experienced when taking pharmaceuticals for PTSD.

When consumed for relief of conditions, such as anxiety and depression, cannabis acts upon the endocannabinoid system by binding to receptors and providing the cannabinoids the deficient ECS needs to function as it should. Cannabis can establish a balance in a consumer’s mental health and ease PTSD symptoms, including depression, so that PTSD patients don’t want to die.

PTSD patients with a higher PTSD score tend to consume more cannabis than those with a lower PTSD score, in order to facilitate general coping as well as to help them sleep. Cannabis also does not cause the myriad side effects potentially experienced when taking pharmaceuticals.

Challenges for Veterans

An estimated eleven to twenty percent of veterans experience PTSD. There are even higher rates for homeless veterans. Twenty-three percent of women in the military report sexual assault, with a further fifty-five percent of women and thirty-eight percent of men reporting sexual harassment.

In addition to the stigma attached to mental health conditions as a barrier to seeking treatment, four out of ten veterans are dissatisfied with the medical treatment they receive from the Veterans Administration (VA). As a result, American Veterans (AMVETS) are working to seek better treatment options and outcomes. Veterans often have a hard time accessing medical cannabis for PTSD. The VA has outdated information regarding cannabis studies, which creates a barrier to access.

Thankfully, cannabis legalization is gaining momentum across the United States, and the world. With cannabis as an available treatment option, fewer veterans will come home with the thought, “I want to die.”

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Sarah Ratliff
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