Brief history of post-traumatic stress disorder - Military News | News From Afghanistan, Iraq And Around The World - Military Times

Brief history of post-traumatic stress disorder

In the Civil War, when soldiers came back angry, sad or agitated after fighting brothers and cousins on the battlefield, doctors said they had “soldier’s heart.”

In World War I, in what might have served as the first diagnosis of traumatic stress combined with traumatic brain injury, doctors used the term “shell shock” for soldiers rattled by artillery barrages.

In World War II, troops who lived through Normandy or Iwo Jima were said to have “battle fatigue” or “gross stress reaction.”

And those who fought in Southeast Asia suffered “post-Vietnam syndrome.”

It all means the same thing — and the symptoms have been known for centuries. But not until 1980 did post-traumatic stress disorder become an official diagnosis, when the American Psychiatric Association added it to the Diagnostic Manual of Mental Disorders.

Dr. Frank Ochberg, who helped write the medical definition, said the diagnosis came after doctors saw the same symptom clusters over and over and realized that diagnoses of general anxiety and depression didn’t quite capture it.

The new diagnosis also included a cause: Victims had experienced a traumatic event that left them fearing for their lives or feeling utterly helpless.

Jonathan Shay, a psychiatrist at the Boston Veterans Affairs Outpatient Clinic, took that diagnosis, as well as 20 years of working with Vietnam veterans, and walked the story backward to find that the history of PTSD stretches far back into history.

In his book, “Achilles in Vietnam: Combat Trauma and the Undoing of Character,” Shay links the experiences of Vietnam veterans dealing with PTSD to the legendary Greek warrior and finds many parallels. Vietnam veterans often felt betrayed by their leaders, just as Achilles did when his king, Agamemnon, slept with Achilles’ slave woman, whom he won as a battle prize.

The veterans had an “us versus them” mentality against anyone outside their unit, as Achilles did. They felt helpless when they lost a loved one, as Achilles did when Patroclus died in battle. And they began to feel like pawns in a game played by politicians, as Achilles felt about the gods.

Shay notes that Achilles felt numb and helpless, refused to eat or bathe, felt a bloodthirsty need for revenge, tried to commit suicide and mutilated a respected opponent — symptoms of PTSD, a “moral injury” in Shay’s words.

But he sees Achilles’ story as a potential source of hope in terms of the lessons it offers: that combat veterans should not be isolated or marginalized, that their experiences need to be shared with the communities that sent them to war — and that the communities need to welcome those troops home.

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Check out our series on PTSD