Relating to War
Post traumatic stress disorder has existed as long as there has been trauma. Although PTSD is not limited to war experience, it was battle that brought it to public attention. During early war periods, post traumatic stress disorder was referred to by many names such as "shell shock," "exhaustion" and "battle fatigue."
Throughout history, there have been accounts of soldiers fleeing the battlefield, having emotional breakdowns and suffering the symptoms of post traumatic stress disorder. In 1678, Swiss military physicians were among the first to identify and group behaviors of PTSD (although it was not called this).
During the American Civil War, military physicians attributed many emotionally disabling behaviors to stress and fear of battle. Military physicians were at a loss to treat the soldiers so many were sent home with no supervision. The symptoms of battle related stress were dismissed as lack of discipline and cowardice.
In 1905, during their war with the Japanese, the Russian army was the first to connect mental collapse with the stress of war and accept it as a legitimate condition.
World War I produced many psychiatric casualties and during this period, symptoms of PTSD were still viewed as a weakness in character. Some soldiers fled the battlefield as they were so traumatized by the mass slaughter. Such was the ignorance of the time about the mental effects of war that some of these soldiers were accused of being cowards and executed.
During the Korean War, combat stress became a clear factor of psychological breakdown. Following the end of combat, it was observed that symptoms were re-emerging in veterans who had experienced the anxiety during the war. Symptoms of intense anxiety, aggression and depression had also developed in veterans who had not experienced symptoms during combat.
A large number of veterans were affected following the Vietnam War. PTSD was largely disregarded for decades. After much research, study, and suffering on the part of war veterans it began to be recognized as a legitimate condition.
Trauma Related to Other Events
Although post traumatic stress disorder came into the public eye through war veterans, it was later realized that the condition was not solely experienced by those engaged in military battle. Events such as sexual assault, physical abuse, car accidents, plane crashes and natural disasters like an earthquake could result in post traumatic stress disorder.
Before the full impact of PTSD became known, this type of stress was often viewed as a weakness by others. Once it was understood that the symptoms of post traumatic stress disorder was the mind’s attempt to process the traumatic event, the reality of the disorder was gradually recognized. And the proper help and treatments could be given.
Classification as a Disorder
The history of PTSD has seen several transformations from the designated terminology of its title to the criteria necessary for diagnosis, before finding its place among mental disorders. Post traumatic stress disorder was first classified as a disorder in 1980 in the Diagnostic and Statistical Manual of Mental Disorders.
The DSM was developed by the American Psychiatric Association and is used by mental health professionals in the diagnosis of patients. Post traumatic stress disorder has evolved many times in the periodic revisions of the DSM. The DSM has also revised the definition of trauma in relation to PTSD.
In the DSM-III, trauma was seen as an event beyond the range of normal that would be distressing for anyone who experienced it. In the DSM-IV, trauma is viewed as an event that can cause serious injury, harm or death but not necessarily beyond the range of normal.
The DSM-IV was revised in 2000 and redefined trauma to include events that cause intense fear, helplessness and horror. The revision also states that exposure to a traumatic event can also cause post traumatic stress disorder.
Although much progress has been made in understanding PTSD, it remains uncertain whether there are differences in brain structure or chemistry in people that develop post traumatic stress disorder. While some individuals recover from PTSD, it becomes a lifelong condition for others.
Post traumatic stress disorder that lasts longer than three months is considered chronic. People with PTSD may also suffer from depression, substance abuse or other anxiety disorders. They may withdraw from situations that may trigger stress, anxiety or flashbacks of the original trauma.
For instance, a person suffering from PTSD following a car accident may avoid driving or even traveling in a car. Post traumatic stress disorder may worsen if not treated. Current treatment for PTSD includes drug therapy, stress management and cognitive behavior therapy. A psychotherapist can help patients with PTSD learn how to cope with fear and anxiety.
University of Maryland Medical Center
Post Traumatic Stress Disorder
PTSD Causes and History
The History of Post-Traumatic Stress Disorder (PTSD)
The Evolution of Post Traumatic Stress Disorder
A Short History of PTSD
Picture credit – Image by Martin St-Amant released into the public domain under Creative Commons License
Understanding Post Traumatic Stress Disorder