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The History and Treatment of PTSD

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Shattered Memories


PTSD Has Been Around For Centuries

Post-Traumatic Stress Syndrome (PTSD) is usually associated with veterans returning from war. However, PTSD can affect virtually anyone that has suffered severe trauma.

Symptoms of PTSD have been recorded by doctors for centuries, and was first identified by military doctors in Switzerland in 1678. German doctors around the same time identified it as homesickness. Spanish doctors named it estar roto which means, “to be broken”.

Some PTSD Symptoms Are Not Visible

A PTSD diagnosis means that a person has experienced symptoms for more than a few months, and does not feel better.

According to the National Center for PTSD, there are four types of symptoms:

1. Flashback: this is reliving the event in the form of nightmares or recurring memories.

2. Avoidance: a person may not want to talk about the event, and may avoid situations or individuals that may trigger the traumatic memory.

3. Guilt, Shame or Lack of Trust: a person may deal with Survivor's Guilt from not bringing everyone in their unit back home. It may be difficult to participate in activities that were previously a part of everyday life.

4. Hyperarousal: a person with PTSD may be on constant lookout for danger. They have have trouble sleeping and may startle easily. Reliance on drugs and alcohol and other forms of recklessness may be evident.

Traumatic Brain Injury: A Silent Killer

Men and women serving in war zones often return with invisible injuries and the symptoms may not be immediately apparent. Traumatic Brain Injury (TBI) is frequently incorrectly diagnosed or overlooked because there is no visible wound. However, when a soldier or Marine survives an explosion from an Improvised Explosive Device (IED), it is very possible that they received a brain injury from the blast. An explosive blast can travel invisibly through the brain and cause complex injuries. This complexity can interfere with the ability to concentrate. It can also cause headaches, mood swings and depression.

If a TBI is correctly identified, the soldier is prescribed a period of rest which allows the brain time to rest and heal. However, each person will heal differently and treatment should not be limited to one standard. In all likelihood, the service member would rather be with his or her unit than sitting in medical, doing nothing. However, sending a service member that has not fully recovered, back to the battlefield can put them at future risk for suicide.

Post-Deployment Health Assessments (PDHA) is designed to give the service member an opportunity to answer questions about receiving a head injury while deployed. I personally know people that received TBI on the battlefield that would not disclose symptoms in a PDHA because they were afraid it would affect their career, or their ability to rightfully own guns when they exited the military. A PDHA may be part of the equation to help identify service members with PTSD, but it is not the solution.

We lose 22 veterans every day because they have not received adequate treatment. It is the untreated, misdiagnosed, misunderstood and ignored veteran that ends his or her life by suicide. We must do a better job of recognizing the injury when it occurs, and provide effective, professional treatment for our wounded warriors.

The Siege of Gibraltar

Hand to hand combat.

Hand to hand combat.

PTSD Symptoms in the 18th Century

In 1727 during the siege of Gibraltar, some soldiers are recorded as attempting to commit suicide, while others were successful. Recorded symptoms included a state of extreme physical fatigue and the distraction which caused soldiers to lose focus or accomplish the simplest of tasks.

The American Civil War: Soldiers Heart

Military doctors took note of symptoms during the American Civil War in the 1860's and called it Soldiers Heart.

Symptoms included:

- Attempted suicide

- Heart palpitations

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- Physical collapse from emotion, not during battle but later after they got home

- Paralysis

- Nostalgia (missing home)

- Tremors

Doctors were so alarmed that they requested the War Department to screen recruits that might be susceptible to a mental breakdown. They did not have the skill, knowledge or medicine to treat men with Soldiers Heart. Once diagnosed, these men were sent home for the families to deal with. Many of them wandered aimlessly and died of exposure or starvation.

Trapped in Battle of Little Big Horn

The Battle of Little Bighorn: Battle Shock Syndrome

The Battle of the Little Bighorn took place in Montana in 1876. It is reported that some of the troops under the charge of Major Reno were paralyzed with fear during the Battle of Little Big Horn. The Indians thought they were cowards – too afraid to fight, and did not kill them.

Sending Soldiers Back to the Front Lines

In 1905 Russian doctors began to treat ‘forward soldiers’ that showed symptoms of mental collapse. By treating them early, they were able to return some of the soldiers to the front lines. However, fewer than 20% of soldiers ever returned to the front lines.

Heavy Artillery Gave Soldiers the Advantage of Distance


World War 1: Shell Shock and Combat Neurosis

There was so much time between the Battle of Little Big Horn and the start of WWI, that doctors were once again starting from ground zero with PTSD symptoms. Troops under General John J. Pershing in Mexico began to exhibit symptoms of mental illness. Doctors assumed this was due to new war technologies which included large-caliber weapons. They believed that concussion of the artillery was disrupting the brain, and called it Shell Shock.

As World War I came to a close, psychiatrists were treating soldiers for PTSD symptoms. However, they thought this only happened to men that had weak characters, and did not suspect there may have been physiological changes or damage to the brain. Doctors took note that not everyone that saw combat or was physically injured suffered from ‘battle fatigue, or ‘combat exhaustion’. This new term moved away from the pathology of psychosis and ‘combat neurosis’.

Caught on video

Below are two videos that were recorded during World War I by physicians that were treating men that had seen and experienced the horrors of war. The videos are some of the earliest recorded evidence of the conditions men suffered from PTSD.

World War 1 Neurosis: PTSD Symptoms

World War 1: Shell Shock

Recognized Symptoms of PTSD in the 21st Century

Veterans returning from the battlefield may experience one or more of the following symptoms; anger, depression, fear, irritability, anxiety, panic, loss of trust, withdrawal and isolation, hyper-vigilance, nightmares, reoccurring flashbacks, insomnia, fatigue, pounding heart, migraines, difficulty concentrating, paranoia, sleepwalking, suicidal thoughts, anti-social behavior and poor self esteem.

They May Have Suspicions and Phobias:

  • Email
  • Stores
  • Phones
  • Unfamiliar people
  • Cars and other vehicles
  • Crowds

Danger on the Battlefield

Being on the battlefield can cause long-term anxiety.

Being on the battlefield can cause long-term anxiety.

War is Hell For Everyone

American men and women have bravely served through even more wars, including; WWII, Vietnam, Korea, Iraq and Afghanistan wars. The 21st century has not seen much improvement in treating our war wounded. If that were the case then the suicide rate among veterans would be significantly lower. The addiction rate among veterans would be lower. And, traditional families with returning veterans would function better. PTSD doesn't just affect the warrior. The symptoms may increase once the veteran separates from the military. The family is left to deal with symptoms they don't understand, are not trained to deal with, and the terror associated with the symptoms. War is hell for veterans and their families.

PTSD and the Veterans Administration

The Veterans Administration (VA) is overwhelmed by the increasing number of veterans that seek treatment from war-time trauma. They need staff that is trained in identifying symptoms of PTSD and can provide effective treatment. In 2014 a whistle blower at a Phoenix facility exposed the corruption and outrageous dysfunction at the VA. Many facilities across the country manipulated waiting lists in order to hide the time that veterans actually waited on for care. It is likely that thousands of veterans died, or committed suicide while waiting to receive care from the VA. Two years after this scandal, the VA Inspector General reported the following:

"On the benefits side, while the number of backlogged disability claims has come down, the wait for first-time applicants remains, on average, 389 days; it’s over 770 days in Baltimore and 630 days in Boston. Meanwhile, the backlog for appealed claims has skyrocketed to over 255,000 — and most of the veterans on that list have been waiting upwards of three years."

The report stated that the VA must be "restructured and reformed."

President Obama promised, "I will not stand for it. There will be consequences."

Virtually nothing has changed at the VA, even after a nation-wide scandal. A few people resigned or were fired, but the deception and manipulation continues while our veterans continue to wait for treatment.

Non-Profit Organizations Do Their Best To Help Heal Our Heroes

There are many fine organizations that have been created since the Iraq and Afghanistan wars began, that are able to provide veterans with non-prescriptive options for dealing with PTSD. One of the organizations I am personally aware of since it's inception is the Battle Buddy Foundation. Battle Buddy trains dogs to recognize triggers and symptoms of PTSD in their owners and to interject themselves in order to decrease the symptoms and help the veteran calm down. These dogs are highly trained and provided to veterans at no cost.

Another organization I have been involved with from 2012 - 2019 is Wellness 4 Warriors. This organization was founded by the mother of a United States Marine. She was concerned about the way our veterans are treated by the VA, and by the types of drugs being prescribed to them. She raises funds to help improve the home environment of veterans in the form of; clean air, clean water, sleep systems, magnets and other non-prescriptive items that can improve a veteran's health.

There are many different ways for people to get involved with non-profit organizations that work to benefit the physical and mental wellness of veterans in their communities. These organizations need people that can write well, create graphics, manage social media and other digital assets.

The Soldiers Cross

The Soldiers Cross is a tribute to a fallen soldier or Marine and is made from the boots, rifle and helmet.

The Soldiers Cross is a tribute to a fallen soldier or Marine and is made from the boots, rifle and helmet.

The Real Cost of PTSD

PTSD is not a mental defect, it is a reaction and response to emotional or physical trauma. While the reaction to trauma may be understood, the person experiencing those memories is gravely misunderstood.

1 in 5 veterans from the Iraq and Afghanistan wars are affected by PTSD and 1 in 3 abuse drugs or alcohol. We have lost more veterans to suicide than were killed during Operation Iraqi Freedom (OIF) in Iraq, or Operation Enduring Freedom (OEF) in Afghanistan.

We are currently losing over 8,000 veterans every year to suicide. The cost to families and communities is too high, and it is time for our government to take better care of those that sign up to protect and serve America.

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2013 Michelle Orelup


Michelle Orelup (author) from Las Vegas, NV on September 27, 2013:

I have a couple of friends that served in the military that have been diagnosed with PTSD. It is treatable, but isn't something that goes away. A lot of people think that PTSD is used as an excuse for behavior but they have no idea the real cause. Thanks so much for commenting.

Majidsiko from Kenya on September 27, 2013:

PTSD is very real. Have a number of people this week after the Nairobi attacks, its terrible and scare you for life if not dealt with correctly.

Michelle Orelup (author) from Las Vegas, NV on September 03, 2013:

Unfortunately we haven't made very much progress in the last 400 years to find the right way to treat the symptoms either during war, or after they return home to their families. Thanks for commenting.

CraftytotheCore on September 03, 2013:

Very interesting Hub! I had no idea PTSD had been recognized since the 1600s!

Michelle Orelup (author) from Las Vegas, NV on September 02, 2013:

I appreciate your comment. I think that there are a lot of things that are misunderstood about PTSD and from war to war there seems to be no solution to the trauma or emotional toll that soldiers experience.

LKMore01 on September 02, 2013:

Educational, informative, sympathetic and very well constructed article, lifelovemystery. Awareness and understanding is critical.

Michelle Orelup (author) from Las Vegas, NV on September 02, 2013:

You are so right. The price they pay is too high, and it is just as hard on their families. Thank you for sharing.

Peggy Woods from Houston, Texas on September 02, 2013:

Yes, our veterans deserve so much more. It is so sad that so many of our young men and women have to serve in these seemingly endless wars. The price they pay is a high one. They should be honored for their service and helped in any way possible so that they can resume a more normal lifestyle after their service is over. Both of my grandfathers, my father and both of my brothers were in the service spanning the decades between World War I to World War II and Vietnam. Sharing this post with my followers, tweeting and also pinning it.

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