Why didn't we hear about PTSD prior to the 1980's? Because it didn't exist? No, 1980 was simply the year it was added to the Diagnostic Statistical Manual (DSM-III). But this set of symptoms was observed far before then.
The first mention of symptoms correlated with PTSD dates back three thousand years ago. Ancient Egyptian Hieroglyphics depicted the emotions and fears soldiers felt while in combat. The Greek historian Herodotus wrote, in 480 B.C, of a Spartan soldier who was "taken off the front lines due to his trembling and later took his own life in shame."
In 1688, PTSD was termed Nostalgia by French physician Johannes Hofer, who described as having three stages: 1) “heightened excitement and imagination,” 2) “period of fever and prominent gastrointestinal symptoms,” and 3) “frustration and depression.” Symptoms of PTSD were called Soldier’s Heart and Da Costa Syndrome during the Civil War.
PTSD gained recognition during WWI, which had some of the worst casualties in history as a result of weaponry that redefined warfare. The psychological effects of this war were seen in returning veterans as involuntary tics and shaking uncontrollably and named Shell Shock or War Neuroses. The term was replaced by Combat Fatigue and later, Combat Stress Reaction during WWII due to the longer tours and extensive time soldiers spent on the battlefields. Gen George S. Patton and others did not believe it was real.
Still, the negative consequences these terms carried kept soldiers and vets quiet or treated poorly. It’s no wonder we didn’t hear about these conditions. In parts of Europe in the 1700’s, anyone suffering from nostalgia was discharged, Russian troops were buried alive if they succumbed to Nostalgia. Civil War soldier were publicly shamed. Many ended up self-medicating with morphine. Prior to the 20th century, doctors treated symptoms with medicine, targeting heart issues and pain, as they thought the symptoms were linked to head trauma. After WWI, they began using ECT, hypnosis, and hydrotherapy which proved ineffective. Many vets were treated through the mid to late 20th century with tranquilizers, pain, and heart meds.
How were vets able to return to their normal life, jobs, etc.? Many didn't. The veteran community stepped in and provided aid to them. Groups such as The Grand Army of the Republic were founded by veterans of the Civil War to provide support and assistance. VFW began in 1899 after the Spanish American War. American Legion followed in 1919. The early Veteran's Administration was formed from a group of smaller state and federal programs in 1921. In WWII there was a new movement of building military unit relationships and support to prevent stress and promote recovery. Talk therapy, first documented by French physicians in the 1800’s, was used by a few practitioners, called Narrative Therapy by contemporary psychiatrists and psychologists.
But through most of the 20th century, the stigma continued to prove too much for most vets to overcome. They were told to go home, resume life, and Do. Not. Talk. about what you experienced with family, anyone. They felt alone. They joined VFW, American Legion, and formed more groups, such as AMVETS in 1943, and motorcycle clubs such as Hell's Angels, to have a place where it was ok to talk. Or they isolated. They developed drinking and drug addictions. They beat their spouse or kids, left their families, they got in fights, went to jail, they committed suicide. How do you get help or relief for a problem if you're not allowed to have a problem? And more poignantly, as a Vietnam vet, how do you ask for help when you return home from a war that many Americans opposed?
Finally, formal research began. Vietnam vets and holocaust survivors were involved in research to clarify the link between war trauma and post-military life. More effective medications were developed. The VA continued to study and develop treatment programs which have brought us where we are today. One specific treatment, Eye Movement Desensitization and Reprocessing (EMDR) was found as or more effective than 200mg of Zoloft in the treatment of PTSD. And no side effects. Screening and treatment programs were implemented in each branch of the military to assist vets after a tour of duty, discharge, etc. Symptoms were identified and treatment was offered to more active duty and discharging vets increasing our awareness of the amount of individuals with the diagnosis. Are there more vets with PTSD now than there were in prior wars and conflicts? No, we simply began identifying, counting, and treating them. And the diagnosis was more publicly discussed.
I feel both heartbroken for the generations of men and women who suffered without support, and relieved and hopeful for the new attitudes, new treatments, and support that our vets can now access to rebuild their lives, their families. I hope that you can take something you read and use it to increase your understanding of PTSD, for your own benefit and for others. Information is powerful and can help us shift our preconceived beliefs to fact based understanding. Many things you hear about PTSD are untrue, and generated by hearsay or inaccurate movies. For instance, several studies have shown that those with PTSD, especially vets and first responders, are highly likely to hurt themselves, and not others, due to inability to manage symptoms, which is contrary to popular belief. I urge you to learn more and check your own beliefs before accepting them as true, and think twice before judging or comparing someone’s circumstance to another who probably hid their pain through alcohol, pills, workaholism, anger, or isolation.
There are even opportunities to help, contact the local lodge of any group mentioned above or the Northeast Ohio USO to find out about donating funds, or volunteering time, or participating in fundraisers. Consider hiring vets if you’re a business owner. And if you have someone you love or are close to is diagnosed with PTSD, whatever the cause, you can utilize therapy to learn and understand more, assist them in their recovery, and be a support to them. Spouses and family members of service connected vets can take advantage of programs through their local VA office. And here at The Behavioral Wellness Group, we have several therapists at our practice who can assist you.
Alicia R. Thomas, M.Ed., LPCC-S.