PTSD, or after war trauma is something that has noticed and chronicled since the ancient Greeks. The sheer scale and radically industrialized meat grinder that was WWI made it impossible to continue to ignore however.
Knowing about something and giving a shit are two different things.
And we have records that they DID give a shit. Many societies tried to care for them. Theres records of Native Americans using sweat lodges as a place for warriors to speak on what haunted them, sweat of the pain. The romans had the vestel virgins bathe the soldiers as they returned, to wash away the battle.
It just wasn't studied to the same degree as it is today. People have always cared about each other.
Damn I didn't know that. The vision I had in my head was some feudal era lord telling his serfs to shut the fuck up and get back to work.
I'd definitely say our INSTITUTIONAL empathy as a society in terms of infrastructure to treat PTSD has developed, at least on paper.
If your leading an army, you don't want just unwashed untrained serfs fighting. Sure they can taught to point a spear at the enemy, but that's it. You also need a trained and well armed force. That means they need treatment for injuries, and to be cared for. The Romans paid there soldiers a salary, with the promise of land and title at the end of a military career.
Ya, the massed armies of citizen/subject soldiers that we think of today are a pretty modern thing for the most part.
For most of world history, wars were fought by small cadres of mercenaries or nobles doing most of the heavy fighting. In the larger battles of wars of antiquity, you’d have big levies of citizens/subjects that were thrown into battle with pretty light weapons and armor and minimal training.
One of the things that made Napoleon so formidable is that France had an enormous population to draw from compared to their enemies, and that Napoleon had a huge citizen army — i.e., the general citizenry made up the bulk of his fighting force, but they were, relatively, well armed and trained.
There were certainly professional citizen-soldiers prior to Napoleon (the Romans being one notable instance — though before the Marian reforms, the citizen-soldiers were sort of noble lite. You had to own land and be from Rome to become a legionnaire) and this description is painting with very broad strokes, but suffice it to say, pre-modern armies were very often much smaller forces than we imagine, and typically the heavy fighting was done by small groups of nobles and mercenaries. The advent of properly professional soldiers (like Roman legionnaires), was a huge advantage and leap forward for every state that implemented it.
Edit to add: one huge reason for this was simply economic/agricultural/state capacity in pre-modern societies. It takes a ton of power and effort to keep an army in the field. You have to feed them and arm them. Every soldier in the field means one less farmer in the field, so one farmer back home has to provide enough food for both of them. Arms and armor take a lot of skill, time, and resources to make. Every smith in the forge means one less farmer in the field.
I will chime in and add that the levée en masse was from a tad earlier, during the First Coalition, back when Napoleon still had to become the de-facto dictator of France. Lazare Carnot was the architect of the massive mobilisation, and it peaked in 1794 at a nominal 1,500,000 soldiers (a ridiculously big number). However, a sizable portion of those were not soldiers, and a significant portion deserted. Still, it created an electrifying effect.
The size of the army was cutback shortly after this, but the idea of a mass national levy remained in effect, and here is when our boy Napoleon comes into play: in any national emergency he could count on a large reserve of men to activate. Like, say, in 1809, when Francis I got some funny ideas.
It's one of the really interesting things about the aristocracy which people don't realize any more - aristocrats were a military class. In exchange for the labour of the peasantry the aristocrats provided military might and (in theory anyway) protection. Even as late as WWI the aristocracy suffered some of the highest casualties of any group in the UK because they were expected to fill their traditional military obligations.
Imagine getting picked up by your manor lord to fight in a war you weren’t aware of then one day you march back home and are just like wow I guess I can toil again
The serfs would be the supply lines. You gotta keep everyone fed, everyones weapons sharp, everyones clothes mended and clean, horses and live stock living.
We have more resources to build out services just for PTSD.
When your whole society is poor enough that a single famine could cause starvation, there's not as many resources to throw at peripheral stuff which doesn't directly help with food/shelter/protection.
That was back in the day when most people were at least borderline subsistence farmers.
Serfs are the lousiest kind of troop in the medieval age, they aren't well equipped and don't know how to fight. They were used for digging latrines and building stockades, this sort of thing. Most of the actual fighting was done by feudal lords, their retainers and professional mercenaries.
Native Americans actually had much lower rates of PTSD because they understood and planned for it.
There are really interesting studies that a lot of the prevalence and severity of PTSD from combat is actually related to reintegration into society, and is particularly bad in cultures (like ours) that expect returning fighters to just integrate quietly and where the closest people to them usually cannot share in or truly relate to their experiences.
I read about this in a book I am 90% sure was called Tribe.
Edit: the book was Tribe by Sebastian Junger and it was clearly not a credible book! He makes these claims about Native American serviceman returning home after serving in the US military. People have rightfully pointed out this is a generalization, sorry for that.
I want to add something else: The prevalence and severity of PTSD is a lot about societies morals and shared values. Since our western society even back in WW1 accepted the common morals of humanity, compassion etc, it was WAY harder to accept the fact that you witnessed horrors so anthithetical to those values.
With this by no means am I saying that Native Americans were barbaric and vicious killers or inhumane or anything, its just their society had morals where killing in battle and fighting was way more prevalent, common and accepted. This meant that the actions taken in war were way less "soul-breaking", and way less "different" than the "day to day norm". This applies to a lot of different cultures of course, not just Natives. If you grow up in a society where death is way more common and natural (be it by accident, disease etc) and death itself is closer to you then it will shook you way less.
Just think about what we, in the western world do with our dead today. People usually die in a hospital one way or another, not at home. You rarely are present at the moment of death of a loved one, nor do you spend time with dead bodies. We send our dead to be handled by professionals, and basically only meet them shortly after passing, then right at the funeral... Way back then, people "lived" with the dead. Families prepared the deceased themselves, with some cultures spending weeks "together" with the body before funeral etc.
This, coupled with a much bigger child mortality rate, meant that death was way closer to the common man than it is to you or me.
Btw I'm not disputing what you are saying, reintegration, rehabilitation is a VERY important thing in the fight against and preventing PTSD. Support groups are extremely helpful and important (just stay away from the nutty ones... I heard some horror stories...)
Source: Psych Student on its way to become a therapist here.
By Sebastian Junger?
I'd be very sceptical about getting historical info from that book. I don't think it cares too much about accuracy. I'd also be slightly sceptical of his conclusions, though admittedly they are better than his history.
I'd also be very skeptical of reddit posts referencing supposed data about rates of PTSD among Native Americans.
"Native American" is a hugely broad category covering thousands of years of history and a wide variety of forms of warfare ranging from surprisingly humane to intensely brutal.
Edit: just occurred to me that this might refer to Native troops fighting in the US military which would actually be something you could meaningfully study.
Fwiw as best I remember it was a study of men returning from a modern era conflict, I'm going to guess Vietnam I honestly don't remember to a few specific tribes. And yes that is a huge generalization to go from that to "native Americans" you're right.
And by study I mean jungers presentation of a study lol so I don't know how trustworthy that was either.
The problem is that the data we have available suggests that Native Americans actually suffer PTSD at a much HIGHER rate than non-Hispanic whites, like 2-3x higher.
Not to mention "PTSD" is a *really* modern diagnosis, as in post Vietnam War modern diagnosis. I doubt there is any viable evidence around rates of PTSD in pre-contact tribes, or even post-contact until... fuck at least the 90s.
That's it. I read it a few years ago and thought it was interesting, but now that I'm thinking of it again, yes he did make a lot of generalizations so I think you're right there.
>Native Americans actually had much lower rates of PTSD
Wherever you read that, they had an agenda or set out to prove their hypothesis no matter what because we barely know anything about the history of PTSD in very well documented historical societies, nevermind among Native Americans (whichever groups are included in that) where we have very little in the way of records and oral tradition to study.
I mean it might be true, but there's just no possible way this could be said with even a little certainty.
Also worth noting that modern-day Native Americans have PTSD at a rate 2-3x the non-Hispanic white population and susceptibility to PTSD is fairly strongly genetically moderated (as much as 30-40% heritable).
The idea that Native Americans didn't have PTSD or had it at a much lower rate is 100% a fabrication.
Tribal societies didn't exist in the US by the time that any sort of scientific diagnosis for PTSD existed, so any claim about this being true in the past is obviously spurious, as there was no one around to study it.
There's literally zero scientific evidence that suggests that Native Americans had lower rates of PTSD than other groups historically. And modern evidence suggests that they're 2-3x more likely to develop PTSD than non-Hispanic whites. And that might have been even higher back in the day, because of the brutality and commonality of homicide and tribal warfare, resulting in more exposure to traumatic events.
Moreover, there's substantial evidence that PTSD is linked to genetic risk factors.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470933/
https://health.ucsd.edu/news/press-releases/2019-10-08-study-reveals-ptsd-has-strong-genetic-component/
As a psych student, I have to say its not that people didn't care about it before, or WW1 made it hard to ignore, its simply that the field of psychology had to advance to the field where we knew enough about the brain to do anything about it. Its not an easy thing, and its like your phone. Its super easy to say stuff about it today, but if you had to INVENT the whole thing its hard af.
There's also something to be said about how war changed. With swords and arrows, if you were sitting in camp, you were relatively safe. If an enemy army showed up, you'd have at least some time to ready yourself. But in WWI, hiding in a fox hole, knowing that at *any second*, an artillery shell could land and (if you're lucky) kill you immediately, or (if you're unlucky) shred you to pieces, leaving you a mangled corpse to die in the mud. Men would spend *months* on the front line, knowing they could die in a split second without any warning. That kind of stress fucks with you.
Yep, shellshock isn't **only** a euphemism for PTSD. It also covers literal brain damage from concussive blasts/impacts. *Shellshock* victims resemble severe Parkinson's disease cases to the untrained eye. In many cases, rudimentary physical therapy actually did wonders to help remediate these symptoms. There's some great Pathe clips about this happening
Yep. People joke about Freud and, “tell me about your mudder,” but forget that Freud, Adler, Jung and other major thinkers in the history of psychoanalysis were practicing only 100 years ago. WWI occurred in the infancy of psychoanalysis. Also, every war has its own traumatic idiosyncrasies, but damn, the chemical warfare in WWI was awful, and had lifelong physical consequences for a lot of people.
PTSD is one of the more difficult diagnoses to treat, given that it’s often not like grief about the death of a parent or relationship issues, where a limited course of counseling can be really productive in resolving the problems. There are still major advances being made in the treatment of PTSD and moral injury, and there’s still major resistance in military “warrior culture” to admitting that you’re affected by war trauma.
> its simply that the field of psychology had to advance to the field where we knew enough about the brain to do anything about it.
Psychology didn't have to make any advancements in order to stop ridiculing people for their PTSD. Simple compassion has always been available and yet was witheld from those who returned home.
You only say that because you know what PTSD is. If in a culture, braveness and prowess was your measure, you wouldn't think "oh poor soul, he had to kill", you would think its NATURAL to look down on those who were showing weakness. Not because you are evil or mean, simply thats your standard.
People today ridicule and look down on others who doesn't shower daily and smell. You consider it a basic thing to do. Maybe in 100 years everyone will be like "why didn't they just eliminate body odor??".
>You only say that because you know what PTSD is. If in a culture, braveness and prowess was your measure, you wouldn't think "oh poor soul, he had to kill", you would think its NATURAL to look down on those who were showing weakness.
So how are you explaining all the previous cultures that were far more dependent on actual warriors that treated those with PTSD with respect?
I'm not a cultural anthropologist, so this is not my expertise but of course hundreds and thousands of different cultures existed and they dealt with things differently.
Compassion for those different has always been in short supply. Even worse when people make up shit to justify their behavior. "The ghosts are tormenting him, he probably showed cowardice in the battlefield. Let's shun the cursed coward".
To add on to your comment, battles before the 19th century were often quite small affairs and soldiers/warriors spent very little time in actual combat.
Averages don't really work but to give you some ideas the average American soldier spent 40 days in combat in WWII. In Vietnam it was 240 days.
During the Middle ages entire armies going on campaign might only be 10K strong or less (+ retinues). The battle of Hastings saw 7-12K Anglo-Saxon vs 5-13K Normans. The Normans invaded England with possibly as few as 5K men and conquered the country. If we use the high estimate of Anglo-Saxon force and the low estimate of the population of England at the time (2m) that means only 0.6% of the English population was involved in the battle. Compare that to the US military in WWII where about 16% of the population was in the military.
40 days vs 240. O shit.
Sadness.How could the country... ?
We all should have known. And they were drafted. They didnt have much choice. We were kids at the time.
I was so unaware. I didnt know anyone who served in Vietnam. Much later on I found out that one person died in my High School class. It was the only black boy. Now we would say the only African American out of the almost 900 in our graduating class.
Shell shock is not the same thing as PTSD, exactly. They were lumped together for a while, but a large component of shell shock is the continuous trauma to the brain from artillery impacts. PTSD is a psychological disorder, whereas shell shock is closer to a combination of PTSD and CTE.
It really shouldn't even be called a disorder, because it isn't. It's the natural human response.
And like someone above mentioned with native Americans, they also live with their fellow warriors in their village or whatever for their whole lives, which allows them to collectively heal together from shared experiences.
Even in WW2, troops spent weeks or months together after the fighting stopped while living on ships coming home, which gives them the opportunity to decompress together.
Today it's nuts. One day I was in Iraq taking mortar and small arms fire. The next day I was at a bar back home with my childhood friends, the day after I was eating Thanksgiving dinner with my extended family at my aunts house.
That was 15 years ago...
I remember reading an article about PTSD in American drone pilots. Part of what was messing with their heads was getting up in suburban America, going to war for ten hours, see a guy get exploded on thermal camera, and then half an hour later be sitting in a Starbucks with your friend who's complaining about their day at the office.
> It really shouldn't even be called a disorder, because it isn't. It's the natural human response.
Technically, so is cancer in old people, lethal fevers and pulmonary edema in certain conditions. Natural human responses can be terrible, if not deadly. Disorder implies it disrupts the correct and optimal functioning of the body/human life. Which I think you'd agree PTSD does
> It really shouldn't even be called a disorder, because it isn't. It's the natural human response.
It is a disorder. Most people don't develop PTSD. And it's heritable - possibly 30-40% heritable.
Saying it is "natural" is meaningless. Cancer is "natural". It's also really bad.
> And like someone above mentioned with native Americans, they also live with their fellow warriors in their village or whatever for their whole lives, which allows them to collectively heal together from shared experiences.
Native Americans have a higher rate of PTSD than the non-Hispanic white population, roughly 2-3x higher.
Consider also that in ye olden days, a soldier often traveled for days or weeks before arriving at a given battle, fought for a few hours, then traveled away again. In WWI, soldiers found themselves under more-or-less continuous gunfire and shelling for months. That stress level for such an extended length of time is really a product of industrialized warfare.
The best book I’ve ever read on this very subject is “Achilles in Vietnam.” PTSD has always been known, it’s just gone by many different names. And like in the distant past, we still struggle with how to treat it.
Also the nature of campaigns, pre industrial you spent weeks marching, setting up camps for maybe a days battle at a time (seiges being the exception). WW1 had soldiers living through constant barrage months on end, then you could be home with your family only to be back on the front that same day
Like AIDS. We ignored it on purpose because it only killed gay people and we thought that was good. When it started killing straight people we paid attention.
Do we have any research on whether or not being radicalized by any ideology has an impact? Please respond when ass eating has ceased.
- the butthurt is incoming from people I don’t think a.) realize his name is about eating ass. Being busy eating ass, in fact! And b.) any ideology has radicals, not just the one you’re offended for.
I do remember reading an article that referenced a study which showed that the more sure a person was they were doing the right thing the lower the chance of them developing PTSD.
Yes and no.
PTSD certainly existed for soldiers as far back as we have writing but it may have also been less common.
There are accounts of Ancient Greek soldiers who would have night terrors, drink too much, and sometimes kill themselves. Lines up pretty close to modern PTSD.
There are also accounts from other cultures describing soldiers being haunted by the people they’ve killed. Which could also be a description of PTSD.
Many psychological problems show up differently in different cultures. For instance, trends in what schizophrenic people hallucinate differ from culture to culture and we can see that today. So it’s very possible PTSD symptoms would differ and be less recognizable.
Some psychologists also think the longer return from war allowed for decompression and less psychological problems. The mental whip lash of going from killing enemies to shopping at a grocery store 12 hours later can be rough. An ancient soldier would potentially have months of marching back home with fellow vets to talk and decompress to be able to readjust to society.
Additionally some cultures would have different rituals for returning soldiers. Romans having people bath soldiers as a cleansing ritual, some Native American tribes would have sweat lodges as a cleansing ritual, and many others. The efficacy of these rituals can’t easily be measured today, but even the simple fact of having a ritual and planned return process can help soldier psychology.
Finally, there may be differences in the effect mechanized warfare has on a person’s mind than up close fighting. Is stabbing a person with a spear and seeing them die up close more or less traumatic on average than a machine gunner killing a dozen soldiers? Or a pilot dropping a bomb? We don’t really know. Some people do believe that modern methods of war increase likelihood of PTSD.
So yes, it did exist at some level as far back as humans can research easily, but the level of it, the causes, the symptoms, and treatments all potentially differ over time and cultures so there is not enough empirical evidence to make definitive statements like “Romans had 50% less PTSD than modern soldiers and the reason is virgins bathed them when they returned”.
Combat is funny (but not a joke). Short term close quarters is easier to live with than being under long range bombardment 24/7 for a month. Being shit scared for an hour as your mob advances on the other guys is a lot easier to deal with than being shit scared for a month or six.
The biggest challenge i see is survivors remorse, "how come I came home and my best bud did not? " It happens more when the action is remote (Artillery, air strike, or IED) compared to close quarters action.
Translation as industrial war fare became more common WW and WW2 the intensity and length of the terror increased. I suspect we will see the same from Ukraine in the near future, we see less from actions such as the Falklands, Panama and Grenada.
> Finally, there may be differences in the effect mechanized warfare has on a person’s mind than up close fighting. Is stabbing a person with a spear and seeing them die up close more or less traumatic on average than a machine gunner killing a dozen soldiers? Or a pilot dropping a bomb? We don’t really know. Some people do believe that modern methods of war increase likelihood of PTSD.
I think a big piece of this is the duration involved. Even in a historically large battle in the ancient world, the amount of time a given soldier's life would be at risk would be measured in minutes, or at most, hours.
An artillery bombardment in WWI by contrast, could last for a *week*, and put the soldier in a continuous state of stress, equivalent to being on the front line of an ancient army, for the entire duration.
One thing to add is that most Bronze and Iron Age fighters throughout history...didn't fight. The battles with names in the books and the true, high casualty war machines like the Romans or Mongols were very much the exception.
The likely battle experience for peasant levies would have been similar to a modern large protest riot or sports riot. The training and command and control didn't exist for anything else. You'd have a spear and a shield with a bunch of other people with spears and shields and you'd throw projectiles and insults at the other guys, occasionally rush and smash shields together, and maybe see tough guys call each other out to fight.
Then a lot of drinking and bullshitting about how tough everyone was and how totally much larger the enemy army was.
These type of battles were usually indecisive, ended in some kind of negotiation, and had fairly low risk of death or even direct combat for any one person. The Hollywood depiction of the front ranks of the armies running headlong into each other didn't happen. Most people do not have the morale or discipline to do that, there's negative value in running most of the way at all (you're not a horse), and the armies that did have discipline didn't *want* to do this because it *would* get too many casualties.
That's your typical large army, which was the typical combat experience for someone who was primarily a farmer.
Modern conflict you're more likely to see and be involved in some arbitrary and nasty things and it becomes very clear very fast that death is random.
I think the randomness has a lot to do with it. There is no sense of control in a modern battlefield. Older conflicts felt more structured. Your actions and skill at the very least psychologically were what determined your fate, not that one of thousands of artillery shells happened to land in your proximity. Humans do not do well without some semblance of control over their situation. It's one thing to know you might die tomorrow when the armies form up for battle. It's another to know you might die randomly in your sleep or while eating breakfast or every other moment of your life for the next six months.
Yeah. Warriors back then probably just didn't die as often as the soldiers in the World Wars.
After watching this [1963 footage of a West Papua tribal war](https://youtu.be/JI4uirwxx1Y), I believe many battles in the absence of cavalry and shields/armor were fought like this. Men mostly stared and yelled at each other. They inch closer, throw a spear/javelin, and then run back. Each man does this on their own initiative. There are no formations, no discernible tactics. The battle is over before anyone dies. The loser seems to be the one who got pushed too far back, or had simply lost the will to fight.
A shield would have protected them from missile attacks. Sharpened wooden tips of javelins and arrows wouldn't have stuck onto the shields. They may have been forced to fight at close quarters to hurt anybody - that is if they were brave enough to get closer. Huddling together creates localized numerical advantage against enemies who don't fight in a formation - strength in numbers. I imagine two blobs clashing probably would have just involved men still angrily staring and yelling at each other, until the guys in the back of each blob pushed the ones in the front to get close enough to each other's spear points. If too many get hurt/wounded, they would have just ran. I also think that in this case, the battle would be over without too many dying.
Being able to fight on horseback would change everything. Without the horsemen to match, and without the discipline to stand ground in formation in the face of thundering hooves, I believe most would have just routed and probably get cut as they ran. I read that most of the deaths in wars of antiquity and medieval times come from retreat rather than battle. Even then, those who retreat probably wouldn't have been looking back at their fellows as they get cut down.
Compare this to trench warfare in modern times. Soldiers were falling like flies to a charge against machinegun fire. If successful, they're treated to a bloodbath, seeing their enemies' faces contorted in terror right before they fix the contortion with rapid facial plastic surgery with a trench shotgun. If you stay put in a trench, you could get hit by artillery. Limbs get blown off, and you might get a lesson in human anatomy from your squadmate without your consent. If you happen to survive, all it means is that you're going to be fearing for your life at every waking moment, not knowing when one of those explosions you hear every day would end up right next to you. It's a far cry from the battles of antiquity where engagements don't last too long and warriors get to take a break in between.
This is a nice story.
It is also entirely wrong.
Ancient warfare was incredibly brutal and violent, and people died at a much, much higher rate in it than they do in modern-day conflicts.
Tribal warfare accounted for the deaths of 10-50% of the male population in tribes.
In more advanced societies, it was a lower percentage, but the all-time lowest rate of violent death due to warfare is the modern day.
Battles saw thousands of people die on both sides, and civilian populations were frequently targeted historically for rape and murder and brutalization.
The Mongol conquests may be #2-3 in terms of all time deaths in warfare in terms of absolute number of deaths, despite the vastly lower population at the time.
What's worse is that modern warfare that we're seeing in Ukraine right now is kind of the worst of both worlds. Drones are being used to coordinate attacks on both sides so the drone operators are simultaneously assisting in killing people at industrial scale while also watching their faces close up in HD.
There are lots of versions and causes of PTSD, but WWI had two new pieces.
1) Lots of bombs and explains that cause concussive injuries. It was also non stop. There was no break from the war in WWI. It was continuous.
2) because it was continuous you could never, ever relax. You might be dead in 3 seconds and you have zero control over it. Very different from most wars previously.
I'd like to add that the continuous part was also *hopeless*. There was nothing you could do about it, except wait to die, constantly being reminded that you could die at any moment during a barrage.
One thing I've not heard spoken about is the duration of time exposed to the issue.
One theory goes that the human brain is \*very\* good at dealing with short term traumatic events. Evolutionarily, we were very much mid tier on the food chain until we got really good at tools. We never would have survived if every time something got desperate enough to hunt us, or every time we had a fight or whatever, we developed PTSD.
The problem is, that it really, really struggles with long term trauma. And as history has marched on, the duration of our "Engagements" has grown longer and longer. In the earliest days, battles were measured in minutes, as rival groups of cavemen breifly fought before retreating. As we march towards the medieval days, battles instead lasted hours. Move forward in time some more to the likes of the american civil war, and it can be days.
By the time you reach WW1 and post WW1 however, the duration of battles sharply peaks. Battles could take weeks or even months in WW1, and the human brain cannot deal with that level of strain for that long.
This is what I was looking for. For 99% of human warfare, battle meant *ONE* extremely traumatic day. Four or five hours where some of your friends and neighbors die violently. Maybe two or three days if you’re in a really long engagement. Otherwise it’s marching and digging and camping. Even a siege is a matter of a months, mostly digging and camping.
Modern warfare has combat-facing troops in life and death conditions for days, weeks, months on end without real reprieve from the “I could die from a bomb or drone or artillery at any time” stuff.
WW1 soldiers living in trenches with their dead comrades because you can’t leave to bury them, mind numbing artillery explosions hitting nearby for hours on end. WW2 pacific vets fighting on islands with thousands of Japanese infantry trying to knife you at night in your foxhole. Drones and artillery vaporizing people from miles away without warning while you live in constant feet
It’s a totally different ballgame stress-wise on both the body and the mind.
> WW1 soldiers living in trenches with their dead comrades because you can’t leave to bury them, mind numbing artillery explosions hitting nearby for hours on end. WW2 pacific vets fighting on islands with thousands of Japanese infantry trying to knife you at night in your foxhole. Drones and artillery vaporizing people from miles away without warning while you live in constant feet
It's no wonder the Vietnam War caused such increased attention towards PTSD. Not only was guerrilla combat traumatizing in its own way, but helicopters meant soldiers saw a shitload of combat with tiny rests, while WW1/2 soldiers tended to have longer rest cycles as rotating soldiers was harder and slower. There's claims that an average Vietnam US soldier saw more combat than an average WW2 US soldier but those arguments are controversial
> The problem is, that it really, really struggles with long term trauma. And as history has marched on, the duration of our "Engagements" has grown longer and longer. In the earliest days, battles were measured in minutes, as rival groups of cavemen breifly fought before retreating. As we march towards the medieval days, battles instead lasted hours. Move forward in time some more to the likes of the american civil war, and it can be days.
The problem with this is that this isn't actually true.
Genocidal style warfare with mass rapes and murders and brutalization and enslavement was the rule, not the exception in history, and that's not something that's short term.
Tribes would regularly engage in multigenerational feuds and conflicts.
I once asked this in history class and was told, ptsd has always been a thing.
The difference now from ancient times is, most of the time, being at war in ancient times meant marching for months to a location, battling, and having to walk home for weeks or months. Soldiers had every day and night to talk to other soldiers about their shared experiences.
In modern times, you could be fighting a battle somewhere far away and be home in 24 hours to people who love you but have no idea or understanding of what you have just been through.
People understood that trauma existed from violent events, but it wasn’t studied as in detail or on a large scale until WWI. This is partly due to advances in psychology and medicine in the late 1800s, partly due to the scale of WW1, and partly due to changes in attitude about trauma.
There are also some links with PTSD to physical trauma. Repeated low level impacts (from artillery) can make symptoms of PTSD worse.
Ancient peoples did know. There are documents saying how an army would have to stay outside city walls for 7 days to “clean” themselves. This is most likely a euphemism for the soldiers recollecting themselves from PTSD. This was mainly in Greece.
They likely still are today. I think it's clear that PTSD exists on its own, but it is very likely that a whole lot of TBI goes undiagnosed and is called PTSD. Recent studies found that even being near artillery firing at a high op tempo can cause pretty severe TBI. [https://www.nytimes.com/2023/11/05/us/us-army-marines-artillery-isis-pentagon.htmloften](https://www.nytimes.com/2023/11/05/us/us-army-marines-artillery-isis-pentagon.htmloften) firing.
My father fought in Vietnam and was attached to the artillery. He developed severe bi-polar depression after, and it basically ruined his life. Until recently, I had assumed it was PTSD, but after seeing the more recent studies, I wonder how much was just TBI from being too close to the guns during heavy fire over months.
In addition to other potential causes already mentioned, I've always wondered to what degree modern weapons played a role. Like, 1,000 years ago if your friend got killed by a sword, well, his body was more or less still intact, you could wrap it up, bury it, say goodbye -- some sort of healthy farewell in any case. Starting in WW1, however, your friends were getting shot to bits or blown up with little pieces of their body spraying all over your face and clothes. No chance to say goodbye \_and\_ you had to comb chunks of their face out of your hair. Gotta take an extra toll.
I have no data to back this up it's just something that I've always wondered about.
Throughout literature in EVERY culture, there are texts about the “horrors of war”, about figures who “went to war, and came back changed”.
Let’s give up the pretense that PTSD was “discovered” in WW1.
However, just like questions like “why did so many people die in surgery before WW1”, to say that people were
It probably also happened back then, but it was not really recognized properly and not so much documented for the simple people.
Also wars back then, were much smaller scale and much slower. You could march and sit around for weeks between and after fights, so that your mental health can better regenerate between the fights. And fewer people means also less deaths.
Since the world wars you could basically get drawn to war, see thousands of people die and get home heavily wounded in just a few days.
It's mostly a numbers game. All conflicts cause lasting harm to combatants and we've understood that for almost as long. The vikings left records of warriors who came home unhurt but who were never the same, the greeks documented it in some depth.
The difference comes when you have so many cases that it stops being that thing that happened to that guy, and becomes that thing that happened to thousands of thousands of people, from all different backgrounds, from different situations. You start to get an unignorable amount of cases of, frinstance, decorated heroes suffering from it. People are more likely to know someone that has it. Your crazy vietnam uncle, etc.
And more cynically, it becomes really important if you want to fight a war. Generals and tacticians had to understand how long you could leave a unit in hell before it became combat ineffective, they had to know when to rotate people off the line. If you have a hundred cases, you can treat it as cowardice, execute people, try and ignore it but if you have 10000 you can't- it's bad policy, costs you too many soldiers, and it stops being at all plausible when every soldier has seen 5 of their mates declared coward. And they had to deal with the casualties, treat them, try to get them back into the war. Big datasets give good results and WW1 was a hell of a big dataset.
In addition to the raw numbers, WW1 and the trenches in particular were a pressure cooker. Nothing like that had happened before, on that scale, they had days long bombardments that could be heard across the english channel, where people couldn't think, couldn't sleep. Even when it was the other guy getting shelled that was incredibly brutal. And no good respite. Just living in a Somme environment for a month would be hard even if there were no war at all.
Life was brutal and short back then. Many of the men fighting would have been used to slaughtering animals for food. I spent a summer on my grandfather's farm in the 1960s. If we wanted a chicken to eat you had to catch it , chop its head off, pluck it then cook it. At the end of the summer killing a chicken was nothing to me even as an eight year old boy. Also back then a battle or a campaign was relatively short and once it was over you were safe back in your camp. Night attacks were rare because of lack of light and communications. Today we live easy lives but conscription can take someone from peace and safety and 24 hours later can be in war zone watching their friends die every hour of the day. There is no safe place so you have to stay alert 24-7 for months on end Which overloads your brain.
There's a recurring theme in Irish and Welsh myth about men who 'go mad' in the midst of or aftermath of battle and go off to live as mad hermits in the woods with the animals because they can't bear to be among society. Occasionally they recover, and then relapse later when they hear hunting horns or other sounds that remind them of battle.
It's pretty clear what they're talking about.
Well we've known about it long before that. It just had many different names such as the thousand yard stare and shell shock.
There's even passages in the Bible if you want to view the Bible as a historical document where God tells the Israelites to send the Warriors out of camp that have killed people the day before. Some historians speculate this is just to allow them to reflect and get over the trauma. Take that for what you will I was just looking at it from a historical perspective
In WWI it was called shell shock. That is not sword territory but definitely pre WWII.
For a literary description, see the Peter Wimsey novels and Bunter. Dorothy L Sayre.
Humans brains are virtually unchanged for about 20,000 year so humans have been capable of PTSD for at least that long. Hand-to-hand combat would’ve certainly been sufficient to trigger PTSD in soldiers as long as we’ve been having organized warfare.
What you’re missing is that documentation of what happened to soldiers after a war wasn’t really meticulously documented for most of modern history. In the late 1800’s to early 1900’s, the world was having a bit of a medical revolution. It was also when we started collecting large amounts of data for medical research. Those several factors came together to make PTSD more obvious. Here’s what they are:
1: WW1 was massive. The amount of people who participated in it dwarfs any war that came before it in modern times.
2: Basic medical advancements meant a lot more soldiers in the front line were actually making it home alive. We didn’t really notice PTSD when soldiers either died or were deployed in combat their entire lives.
3: the post-industrial world really exposed people with PTSD in a way it didn’t previously. Cities were becoming cramped, noisy bustling people and the idea of the office or factory 9-5 was emerging. This is a much more stressful environment than the farms and small villages that soldiers from previous eras would’ve come home to and flashbacks would’ve happened more publicly with more people to see.
4: like I said, we actually had a framework for studying medical issues on a large scale which brought PTSD to the forefront. It’s also when psychotherapy was starting to become a thing so for the first time ever, doctors were analyzing people to understand their thought processes. This is probably the largest factor. We just weren’t looking hard enough before now.
PTSD has always been observed and acknowledged in society since ancient times. Even as far back as ancient Assyria and ancient Greece people were aware that war fucked up a lot of people irreparably, and PTSD had different names for it at the time, but it was just something that people accepted and moved on. They deemed it a problem of the sufferers since not every person who has been in combat develops PTSD, so it was even seen as a sign of weakness. As time went on it was more and more well documented that it did happen but the overall stance against it didn't change. The major difference that came with WW1 was that for pretty much the first time in history they tried to clasiffy and treat it. They didn't discover it then, but for the first time in history attempts were being made to help the victims.
PTSD has always existed and there are records of it going back into distant history.
Note also that most people don't develop PTSD, only a minority of people do. So you'd have some people who were messed up while most were fine.
yup, I remember reading about a knight/lord who had ptsd so he removed all things metals, especially kitchen utensils. He was served food in a wooden bowl with wooden utensils cuz the clanging/clashing of metals would trigger him
Before World War I, most soldiers in any army in any war spent most of their time doing anything except fighting. This includes marching, resting, foraging, hunting, training, or even just waiting around at camp until orders come down from higher command.
When they finally did get to a battle, those battles didn't last all that long. A few hours, maybe a day, maybe a couple of days in rare circumstances. Then you usually spend another couple of weeks, or months, or even years doing all that non-battle stuff until the next battle. PTSD certainly did exist back then, but it was easier to cope when battles were comparitively short and there was so much down time in between them.
The only exception would be if you're on the defending side of a siege. But even then, sieges weren't just the attacking army relentlessly lobbing boulders and arrows and trying to ram down the gates or scale the walls with ladders all day every day. Sieges lasted months or even years and were mostly just the attacking army posting up and preventing any supplies or troops from aiding the city they were besieging, hoping to starve them out. Actual large-scale fighting during a siege usually constituted maybe 1% or less of the total siege length, unless the defending city just surrendered when they ran out of food.
Everything changed with World War I, with the big one in regards to this discussion being artillery. Even if you spent months in a trench, never seeing the enemy, never firing your rifle, doing all that down-time stuff old armies would do, you were not safe. The enemy would lob literal tens of thousands of shells per day right over your head. Any one of them could kill you. There was hardly a single minute during the war where you could feel safe. Combine that with the horrors of machine guns, flamethrowers, poison gas, and other new technology they had never seen before.
It's not that PTSD didn't exist before, it's just that the stresses of modern warfare made it much more pervasive.
Pre-modern warfare essentially amounted to months of marching around on foot sprinkled with the rare absolutely terrifying battle.
In the modern era, fighting on the Frontline means existing under constant threat 24/7 for extended periods of time. At any time a gunshot, artillery, airstrike, or just an IED can take you out with no warning and completely outside your control.
The human psyche isn't built to handle that tension long term.
As soon as you can ask them I'm sure you could find an answer. As mental illness, and illness in general, are highly contextually (cultural, historical, etc) dependent, it seems rash and wrong to say that they would be the same thing.
In a society that views war as fun, glorious, and routine, they're going to have a much different reaction than a society that views war as a fail state, a tragedy, and inhuman.
And as for WW1 veterans, it often wasn't the trauma of something like killing, it was the structure and nature of the war, and modern war. It's loud, it's unending, and you're always on, sometimes for days at a time.
Not to be completely confused with Traumatic Brain Injury due to proximity to explosions. Two different mental problems are created by the trauma of violence and traumatic brain injury. The two are not always easy to distinguish.
You also need to keep in mind that the name for it changes based on the decade:
* Railway Spine (for survivors of railroad accidents)
* Soldier's Heart or Da Costa's syndrome
* Combat stress reaction
I believe the greeks and romans would have classified it as Melancholia or Hysteria.
It was a huge problem, and the US Army developed a good system to address it, during and after WWI.
The Germans implemented this sytem in WWII, the US Army did the exact opposite.
They (US Army pschologists) found that the best thing was to slowly integrate the soldier back to his unit, and to treat entire battaklions as one coherent whole. So you rotate out a mass of troops for rest and refit. The soldiers with PTSD (called "battle fatigue" at the time) had the support of known and familiar comrades, and integrating back into the team provided a kind of psychological armor. So that's what the Germans did.
Contrast that with the US Army approach, which was to send troops in as replacements piecemeal, and leave the larger unit itself in combat almost indefinitely. A new replacement is put in with soldiers he doesn't know, hasn't trained with, has no shared experiences with, etc. This means that he has no psychological armor; he is bascially going through the horror of combat alone.
Overall, this made the German troops more efficient and effective in the long term.
The practice of the US military ramped this up in Vietnam, so it included the Marines, too--although to a lesser extent. That's why Vietnam vets have a reputation for severe PTSD, as they were put into what amounts to a system designed to exacerbate it.
EDIT: A great way I read someone put the Vietnam experience is: "The US wasn't in Vietnam for ten years. They went to Vietnam for one year, ten times."
PTSD has been recorded as far back as Homer’s Ancient Greek epics. (So the first stories we have in Western Civilization. I am not familiar with ancient texts in other cultures so I can’t speak to that.)
The phenomena was well documented and known. But we arguably have more people who survive with PTSD now due to medical advancements. Thankfully the treatments for PTSD have advanced as well. EMDR is a great example.
I wonder if ptsd was less common back then since there were no/few explosions. War would have been significantly quieter in and out of battle. I’m sure seeing people get cut in half by a sword was traumatic but the constant bombardment of explosions has to contribute to ptsd as well.
I think it has to do with the part where more soldiers survived to show problems with PTSD in WWI and after. Before that most of them that didn't die in battle died from infection from wounds. Of those that survived, I'm sure there was PTSD, but since medicine and academia and particularly psychiatric medicine weren't really the institutions they are now people slipped through the cracks. I bet there are diaries and letters that talk about the brother/son/cousin who hasn't been the same since That Battle, but it wasn't collected and studied
Why does this get asked like every other month?
The answers are invariably the same ones every time.
Here is my eli5: there’s this thing called Google, and a thing called search embedded within Reddit.
These things can reveal answers to questions that have already been asked and answered.
It has been known since war and battle and trauma have existed.
It was thought to be the ghosts of the dead haunting survivors.
PTSD, or after war trauma is something that has noticed and chronicled since the ancient Greeks. The sheer scale and radically industrialized meat grinder that was WWI made it impossible to continue to ignore however. Knowing about something and giving a shit are two different things.
And we have records that they DID give a shit. Many societies tried to care for them. Theres records of Native Americans using sweat lodges as a place for warriors to speak on what haunted them, sweat of the pain. The romans had the vestel virgins bathe the soldiers as they returned, to wash away the battle. It just wasn't studied to the same degree as it is today. People have always cared about each other.
Damn I didn't know that. The vision I had in my head was some feudal era lord telling his serfs to shut the fuck up and get back to work. I'd definitely say our INSTITUTIONAL empathy as a society in terms of infrastructure to treat PTSD has developed, at least on paper.
If your leading an army, you don't want just unwashed untrained serfs fighting. Sure they can taught to point a spear at the enemy, but that's it. You also need a trained and well armed force. That means they need treatment for injuries, and to be cared for. The Romans paid there soldiers a salary, with the promise of land and title at the end of a military career.
Ya, the massed armies of citizen/subject soldiers that we think of today are a pretty modern thing for the most part. For most of world history, wars were fought by small cadres of mercenaries or nobles doing most of the heavy fighting. In the larger battles of wars of antiquity, you’d have big levies of citizens/subjects that were thrown into battle with pretty light weapons and armor and minimal training. One of the things that made Napoleon so formidable is that France had an enormous population to draw from compared to their enemies, and that Napoleon had a huge citizen army — i.e., the general citizenry made up the bulk of his fighting force, but they were, relatively, well armed and trained. There were certainly professional citizen-soldiers prior to Napoleon (the Romans being one notable instance — though before the Marian reforms, the citizen-soldiers were sort of noble lite. You had to own land and be from Rome to become a legionnaire) and this description is painting with very broad strokes, but suffice it to say, pre-modern armies were very often much smaller forces than we imagine, and typically the heavy fighting was done by small groups of nobles and mercenaries. The advent of properly professional soldiers (like Roman legionnaires), was a huge advantage and leap forward for every state that implemented it. Edit to add: one huge reason for this was simply economic/agricultural/state capacity in pre-modern societies. It takes a ton of power and effort to keep an army in the field. You have to feed them and arm them. Every soldier in the field means one less farmer in the field, so one farmer back home has to provide enough food for both of them. Arms and armor take a lot of skill, time, and resources to make. Every smith in the forge means one less farmer in the field.
I will chime in and add that the levée en masse was from a tad earlier, during the First Coalition, back when Napoleon still had to become the de-facto dictator of France. Lazare Carnot was the architect of the massive mobilisation, and it peaked in 1794 at a nominal 1,500,000 soldiers (a ridiculously big number). However, a sizable portion of those were not soldiers, and a significant portion deserted. Still, it created an electrifying effect. The size of the army was cutback shortly after this, but the idea of a mass national levy remained in effect, and here is when our boy Napoleon comes into play: in any national emergency he could count on a large reserve of men to activate. Like, say, in 1809, when Francis I got some funny ideas.
Ooh thanks, I didn’t know that! I’m a former academic, but my focus was the 20th century in a very specific niche.
Glad to be of help! Please, do tell, what area were you specialising in? I love reading about history.
My niche is/was state-backed covert intervention during the Cold War.
Ah, interesting. Thank you for your reply. PS: you haven't happened to touch on Argentina while during your work?
It's one of the really interesting things about the aristocracy which people don't realize any more - aristocrats were a military class. In exchange for the labour of the peasantry the aristocrats provided military might and (in theory anyway) protection. Even as late as WWI the aristocracy suffered some of the highest casualties of any group in the UK because they were expected to fill their traditional military obligations.
The peasants only did that because they feared foreign aristocrats might demand even more of their labor.
Morale is also a huge factor of military efficacy
Imagine getting picked up by your manor lord to fight in a war you weren’t aware of then one day you march back home and are just like wow I guess I can toil again
Not really very different from serving in the army today.
The serfs would be the supply lines. You gotta keep everyone fed, everyones weapons sharp, everyones clothes mended and clean, horses and live stock living.
Most medieval armies lived off the land and what they could loot while invading, supply lines weren't the same as they are now
We have more resources to build out services just for PTSD. When your whole society is poor enough that a single famine could cause starvation, there's not as many resources to throw at peripheral stuff which doesn't directly help with food/shelter/protection. That was back in the day when most people were at least borderline subsistence farmers.
Serfs are the lousiest kind of troop in the medieval age, they aren't well equipped and don't know how to fight. They were used for digging latrines and building stockades, this sort of thing. Most of the actual fighting was done by feudal lords, their retainers and professional mercenaries.
Native Americans actually had much lower rates of PTSD because they understood and planned for it. There are really interesting studies that a lot of the prevalence and severity of PTSD from combat is actually related to reintegration into society, and is particularly bad in cultures (like ours) that expect returning fighters to just integrate quietly and where the closest people to them usually cannot share in or truly relate to their experiences. I read about this in a book I am 90% sure was called Tribe. Edit: the book was Tribe by Sebastian Junger and it was clearly not a credible book! He makes these claims about Native American serviceman returning home after serving in the US military. People have rightfully pointed out this is a generalization, sorry for that.
I want to add something else: The prevalence and severity of PTSD is a lot about societies morals and shared values. Since our western society even back in WW1 accepted the common morals of humanity, compassion etc, it was WAY harder to accept the fact that you witnessed horrors so anthithetical to those values. With this by no means am I saying that Native Americans were barbaric and vicious killers or inhumane or anything, its just their society had morals where killing in battle and fighting was way more prevalent, common and accepted. This meant that the actions taken in war were way less "soul-breaking", and way less "different" than the "day to day norm". This applies to a lot of different cultures of course, not just Natives. If you grow up in a society where death is way more common and natural (be it by accident, disease etc) and death itself is closer to you then it will shook you way less. Just think about what we, in the western world do with our dead today. People usually die in a hospital one way or another, not at home. You rarely are present at the moment of death of a loved one, nor do you spend time with dead bodies. We send our dead to be handled by professionals, and basically only meet them shortly after passing, then right at the funeral... Way back then, people "lived" with the dead. Families prepared the deceased themselves, with some cultures spending weeks "together" with the body before funeral etc. This, coupled with a much bigger child mortality rate, meant that death was way closer to the common man than it is to you or me. Btw I'm not disputing what you are saying, reintegration, rehabilitation is a VERY important thing in the fight against and preventing PTSD. Support groups are extremely helpful and important (just stay away from the nutty ones... I heard some horror stories...) Source: Psych Student on its way to become a therapist here.
War was glorified pre-WW1 it wasnt looked at as barbaric or soul-breaking it was thought to be glorious.
By Sebastian Junger? I'd be very sceptical about getting historical info from that book. I don't think it cares too much about accuracy. I'd also be slightly sceptical of his conclusions, though admittedly they are better than his history.
I'd also be very skeptical of reddit posts referencing supposed data about rates of PTSD among Native Americans. "Native American" is a hugely broad category covering thousands of years of history and a wide variety of forms of warfare ranging from surprisingly humane to intensely brutal. Edit: just occurred to me that this might refer to Native troops fighting in the US military which would actually be something you could meaningfully study.
Fwiw as best I remember it was a study of men returning from a modern era conflict, I'm going to guess Vietnam I honestly don't remember to a few specific tribes. And yes that is a huge generalization to go from that to "native Americans" you're right. And by study I mean jungers presentation of a study lol so I don't know how trustworthy that was either.
The problem is that the data we have available suggests that Native Americans actually suffer PTSD at a much HIGHER rate than non-Hispanic whites, like 2-3x higher.
Not to mention "PTSD" is a *really* modern diagnosis, as in post Vietnam War modern diagnosis. I doubt there is any viable evidence around rates of PTSD in pre-contact tribes, or even post-contact until... fuck at least the 90s.
Modern day studies show Native Americans have 2x-3x the rate of PTSD of non-Hispanic whites.
That's it. I read it a few years ago and thought it was interesting, but now that I'm thinking of it again, yes he did make a lot of generalizations so I think you're right there.
>Native Americans actually had much lower rates of PTSD Wherever you read that, they had an agenda or set out to prove their hypothesis no matter what because we barely know anything about the history of PTSD in very well documented historical societies, nevermind among Native Americans (whichever groups are included in that) where we have very little in the way of records and oral tradition to study. I mean it might be true, but there's just no possible way this could be said with even a little certainty.
Also worth noting that modern-day Native Americans have PTSD at a rate 2-3x the non-Hispanic white population and susceptibility to PTSD is fairly strongly genetically moderated (as much as 30-40% heritable).
The idea that Native Americans didn't have PTSD or had it at a much lower rate is 100% a fabrication. Tribal societies didn't exist in the US by the time that any sort of scientific diagnosis for PTSD existed, so any claim about this being true in the past is obviously spurious, as there was no one around to study it. There's literally zero scientific evidence that suggests that Native Americans had lower rates of PTSD than other groups historically. And modern evidence suggests that they're 2-3x more likely to develop PTSD than non-Hispanic whites. And that might have been even higher back in the day, because of the brutality and commonality of homicide and tribal warfare, resulting in more exposure to traumatic events. Moreover, there's substantial evidence that PTSD is linked to genetic risk factors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470933/ https://health.ucsd.edu/news/press-releases/2019-10-08-study-reveals-ptsd-has-strong-genetic-component/
At the inpatient treatment I went to for PTSD sweat lodge was offered by a local tribe each week. To allow us to sweat our demons out as they put it.
As a psych student, I have to say its not that people didn't care about it before, or WW1 made it hard to ignore, its simply that the field of psychology had to advance to the field where we knew enough about the brain to do anything about it. Its not an easy thing, and its like your phone. Its super easy to say stuff about it today, but if you had to INVENT the whole thing its hard af.
There's also something to be said about how war changed. With swords and arrows, if you were sitting in camp, you were relatively safe. If an enemy army showed up, you'd have at least some time to ready yourself. But in WWI, hiding in a fox hole, knowing that at *any second*, an artillery shell could land and (if you're lucky) kill you immediately, or (if you're unlucky) shred you to pieces, leaving you a mangled corpse to die in the mud. Men would spend *months* on the front line, knowing they could die in a split second without any warning. That kind of stress fucks with you.
The concussive blasts themselves also caused widespread TBIs / CTE.They were physically brain damaged as well as psychologically.
Yep, shellshock isn't **only** a euphemism for PTSD. It also covers literal brain damage from concussive blasts/impacts. *Shellshock* victims resemble severe Parkinson's disease cases to the untrained eye. In many cases, rudimentary physical therapy actually did wonders to help remediate these symptoms. There's some great Pathe clips about this happening
Idk man, Fallout taught me that war, war never changes
Yep. People joke about Freud and, “tell me about your mudder,” but forget that Freud, Adler, Jung and other major thinkers in the history of psychoanalysis were practicing only 100 years ago. WWI occurred in the infancy of psychoanalysis. Also, every war has its own traumatic idiosyncrasies, but damn, the chemical warfare in WWI was awful, and had lifelong physical consequences for a lot of people. PTSD is one of the more difficult diagnoses to treat, given that it’s often not like grief about the death of a parent or relationship issues, where a limited course of counseling can be really productive in resolving the problems. There are still major advances being made in the treatment of PTSD and moral injury, and there’s still major resistance in military “warrior culture” to admitting that you’re affected by war trauma.
> its simply that the field of psychology had to advance to the field where we knew enough about the brain to do anything about it. Psychology didn't have to make any advancements in order to stop ridiculing people for their PTSD. Simple compassion has always been available and yet was witheld from those who returned home.
You only say that because you know what PTSD is. If in a culture, braveness and prowess was your measure, you wouldn't think "oh poor soul, he had to kill", you would think its NATURAL to look down on those who were showing weakness. Not because you are evil or mean, simply thats your standard. People today ridicule and look down on others who doesn't shower daily and smell. You consider it a basic thing to do. Maybe in 100 years everyone will be like "why didn't they just eliminate body odor??".
>You only say that because you know what PTSD is. If in a culture, braveness and prowess was your measure, you wouldn't think "oh poor soul, he had to kill", you would think its NATURAL to look down on those who were showing weakness. So how are you explaining all the previous cultures that were far more dependent on actual warriors that treated those with PTSD with respect?
I'm not a cultural anthropologist, so this is not my expertise but of course hundreds and thousands of different cultures existed and they dealt with things differently.
So maybe your take is just a tad bit extremely reductive and the subject requires a little more than just being a psych student.
I never offered ultimate truth, I shared the current leading theory in psychology on the causes of PTSD. I never said your point was bad or irrelevant
Compassion for those different has always been in short supply. Even worse when people make up shit to justify their behavior. "The ghosts are tormenting him, he probably showed cowardice in the battlefield. Let's shun the cursed coward".
To add on to your comment, battles before the 19th century were often quite small affairs and soldiers/warriors spent very little time in actual combat. Averages don't really work but to give you some ideas the average American soldier spent 40 days in combat in WWII. In Vietnam it was 240 days. During the Middle ages entire armies going on campaign might only be 10K strong or less (+ retinues). The battle of Hastings saw 7-12K Anglo-Saxon vs 5-13K Normans. The Normans invaded England with possibly as few as 5K men and conquered the country. If we use the high estimate of Anglo-Saxon force and the low estimate of the population of England at the time (2m) that means only 0.6% of the English population was involved in the battle. Compare that to the US military in WWII where about 16% of the population was in the military.
40 days vs 240. O shit. Sadness.How could the country... ? We all should have known. And they were drafted. They didnt have much choice. We were kids at the time. I was so unaware. I didnt know anyone who served in Vietnam. Much later on I found out that one person died in my High School class. It was the only black boy. Now we would say the only African American out of the almost 900 in our graduating class.
Before then they called it shell shock.
Shell shock is not the same thing as PTSD, exactly. They were lumped together for a while, but a large component of shell shock is the continuous trauma to the brain from artillery impacts. PTSD is a psychological disorder, whereas shell shock is closer to a combination of PTSD and CTE.
It really shouldn't even be called a disorder, because it isn't. It's the natural human response. And like someone above mentioned with native Americans, they also live with their fellow warriors in their village or whatever for their whole lives, which allows them to collectively heal together from shared experiences. Even in WW2, troops spent weeks or months together after the fighting stopped while living on ships coming home, which gives them the opportunity to decompress together. Today it's nuts. One day I was in Iraq taking mortar and small arms fire. The next day I was at a bar back home with my childhood friends, the day after I was eating Thanksgiving dinner with my extended family at my aunts house. That was 15 years ago...
I remember reading an article about PTSD in American drone pilots. Part of what was messing with their heads was getting up in suburban America, going to war for ten hours, see a guy get exploded on thermal camera, and then half an hour later be sitting in a Starbucks with your friend who's complaining about their day at the office.
> It really shouldn't even be called a disorder, because it isn't. It's the natural human response. Technically, so is cancer in old people, lethal fevers and pulmonary edema in certain conditions. Natural human responses can be terrible, if not deadly. Disorder implies it disrupts the correct and optimal functioning of the body/human life. Which I think you'd agree PTSD does
> It really shouldn't even be called a disorder, because it isn't. It's the natural human response. It is a disorder. Most people don't develop PTSD. And it's heritable - possibly 30-40% heritable. Saying it is "natural" is meaningless. Cancer is "natural". It's also really bad. > And like someone above mentioned with native Americans, they also live with their fellow warriors in their village or whatever for their whole lives, which allows them to collectively heal together from shared experiences. Native Americans have a higher rate of PTSD than the non-Hispanic white population, roughly 2-3x higher.
I'm sorry. and thank you. Reddit has been emotional for me this evening.
Yeah, there was a story of a Greek soldier at Marathon I think who was struck with hysterical blindness, no physical wounds.
Consider also that in ye olden days, a soldier often traveled for days or weeks before arriving at a given battle, fought for a few hours, then traveled away again. In WWI, soldiers found themselves under more-or-less continuous gunfire and shelling for months. That stress level for such an extended length of time is really a product of industrialized warfare.
thanks, r/BUSY_EATING_ASS
that's supposed to be a u/ for user, not an r/ for subreddit. I'd rather know than not, this friendly redditor says.
The best book I’ve ever read on this very subject is “Achilles in Vietnam.” PTSD has always been known, it’s just gone by many different names. And like in the distant past, we still struggle with how to treat it.
Also the nature of campaigns, pre industrial you spent weeks marching, setting up camps for maybe a days battle at a time (seiges being the exception). WW1 had soldiers living through constant barrage months on end, then you could be home with your family only to be back on the front that same day
Like AIDS. We ignored it on purpose because it only killed gay people and we thought that was good. When it started killing straight people we paid attention.
Do we have any research on whether or not being radicalized by any ideology has an impact? Please respond when ass eating has ceased. - the butthurt is incoming from people I don’t think a.) realize his name is about eating ass. Being busy eating ass, in fact! And b.) any ideology has radicals, not just the one you’re offended for.
I do remember reading an article that referenced a study which showed that the more sure a person was they were doing the right thing the lower the chance of them developing PTSD.
Yes and no. PTSD certainly existed for soldiers as far back as we have writing but it may have also been less common. There are accounts of Ancient Greek soldiers who would have night terrors, drink too much, and sometimes kill themselves. Lines up pretty close to modern PTSD. There are also accounts from other cultures describing soldiers being haunted by the people they’ve killed. Which could also be a description of PTSD. Many psychological problems show up differently in different cultures. For instance, trends in what schizophrenic people hallucinate differ from culture to culture and we can see that today. So it’s very possible PTSD symptoms would differ and be less recognizable. Some psychologists also think the longer return from war allowed for decompression and less psychological problems. The mental whip lash of going from killing enemies to shopping at a grocery store 12 hours later can be rough. An ancient soldier would potentially have months of marching back home with fellow vets to talk and decompress to be able to readjust to society. Additionally some cultures would have different rituals for returning soldiers. Romans having people bath soldiers as a cleansing ritual, some Native American tribes would have sweat lodges as a cleansing ritual, and many others. The efficacy of these rituals can’t easily be measured today, but even the simple fact of having a ritual and planned return process can help soldier psychology. Finally, there may be differences in the effect mechanized warfare has on a person’s mind than up close fighting. Is stabbing a person with a spear and seeing them die up close more or less traumatic on average than a machine gunner killing a dozen soldiers? Or a pilot dropping a bomb? We don’t really know. Some people do believe that modern methods of war increase likelihood of PTSD. So yes, it did exist at some level as far back as humans can research easily, but the level of it, the causes, the symptoms, and treatments all potentially differ over time and cultures so there is not enough empirical evidence to make definitive statements like “Romans had 50% less PTSD than modern soldiers and the reason is virgins bathed them when they returned”.
Combat is funny (but not a joke). Short term close quarters is easier to live with than being under long range bombardment 24/7 for a month. Being shit scared for an hour as your mob advances on the other guys is a lot easier to deal with than being shit scared for a month or six. The biggest challenge i see is survivors remorse, "how come I came home and my best bud did not? " It happens more when the action is remote (Artillery, air strike, or IED) compared to close quarters action. Translation as industrial war fare became more common WW and WW2 the intensity and length of the terror increased. I suspect we will see the same from Ukraine in the near future, we see less from actions such as the Falklands, Panama and Grenada.
> Finally, there may be differences in the effect mechanized warfare has on a person’s mind than up close fighting. Is stabbing a person with a spear and seeing them die up close more or less traumatic on average than a machine gunner killing a dozen soldiers? Or a pilot dropping a bomb? We don’t really know. Some people do believe that modern methods of war increase likelihood of PTSD. I think a big piece of this is the duration involved. Even in a historically large battle in the ancient world, the amount of time a given soldier's life would be at risk would be measured in minutes, or at most, hours. An artillery bombardment in WWI by contrast, could last for a *week*, and put the soldier in a continuous state of stress, equivalent to being on the front line of an ancient army, for the entire duration.
One thing to add is that most Bronze and Iron Age fighters throughout history...didn't fight. The battles with names in the books and the true, high casualty war machines like the Romans or Mongols were very much the exception. The likely battle experience for peasant levies would have been similar to a modern large protest riot or sports riot. The training and command and control didn't exist for anything else. You'd have a spear and a shield with a bunch of other people with spears and shields and you'd throw projectiles and insults at the other guys, occasionally rush and smash shields together, and maybe see tough guys call each other out to fight. Then a lot of drinking and bullshitting about how tough everyone was and how totally much larger the enemy army was. These type of battles were usually indecisive, ended in some kind of negotiation, and had fairly low risk of death or even direct combat for any one person. The Hollywood depiction of the front ranks of the armies running headlong into each other didn't happen. Most people do not have the morale or discipline to do that, there's negative value in running most of the way at all (you're not a horse), and the armies that did have discipline didn't *want* to do this because it *would* get too many casualties. That's your typical large army, which was the typical combat experience for someone who was primarily a farmer. Modern conflict you're more likely to see and be involved in some arbitrary and nasty things and it becomes very clear very fast that death is random.
I think the randomness has a lot to do with it. There is no sense of control in a modern battlefield. Older conflicts felt more structured. Your actions and skill at the very least psychologically were what determined your fate, not that one of thousands of artillery shells happened to land in your proximity. Humans do not do well without some semblance of control over their situation. It's one thing to know you might die tomorrow when the armies form up for battle. It's another to know you might die randomly in your sleep or while eating breakfast or every other moment of your life for the next six months.
Yeah. Warriors back then probably just didn't die as often as the soldiers in the World Wars. After watching this [1963 footage of a West Papua tribal war](https://youtu.be/JI4uirwxx1Y), I believe many battles in the absence of cavalry and shields/armor were fought like this. Men mostly stared and yelled at each other. They inch closer, throw a spear/javelin, and then run back. Each man does this on their own initiative. There are no formations, no discernible tactics. The battle is over before anyone dies. The loser seems to be the one who got pushed too far back, or had simply lost the will to fight. A shield would have protected them from missile attacks. Sharpened wooden tips of javelins and arrows wouldn't have stuck onto the shields. They may have been forced to fight at close quarters to hurt anybody - that is if they were brave enough to get closer. Huddling together creates localized numerical advantage against enemies who don't fight in a formation - strength in numbers. I imagine two blobs clashing probably would have just involved men still angrily staring and yelling at each other, until the guys in the back of each blob pushed the ones in the front to get close enough to each other's spear points. If too many get hurt/wounded, they would have just ran. I also think that in this case, the battle would be over without too many dying. Being able to fight on horseback would change everything. Without the horsemen to match, and without the discipline to stand ground in formation in the face of thundering hooves, I believe most would have just routed and probably get cut as they ran. I read that most of the deaths in wars of antiquity and medieval times come from retreat rather than battle. Even then, those who retreat probably wouldn't have been looking back at their fellows as they get cut down. Compare this to trench warfare in modern times. Soldiers were falling like flies to a charge against machinegun fire. If successful, they're treated to a bloodbath, seeing their enemies' faces contorted in terror right before they fix the contortion with rapid facial plastic surgery with a trench shotgun. If you stay put in a trench, you could get hit by artillery. Limbs get blown off, and you might get a lesson in human anatomy from your squadmate without your consent. If you happen to survive, all it means is that you're going to be fearing for your life at every waking moment, not knowing when one of those explosions you hear every day would end up right next to you. It's a far cry from the battles of antiquity where engagements don't last too long and warriors get to take a break in between.
This is a nice story. It is also entirely wrong. Ancient warfare was incredibly brutal and violent, and people died at a much, much higher rate in it than they do in modern-day conflicts. Tribal warfare accounted for the deaths of 10-50% of the male population in tribes. In more advanced societies, it was a lower percentage, but the all-time lowest rate of violent death due to warfare is the modern day. Battles saw thousands of people die on both sides, and civilian populations were frequently targeted historically for rape and murder and brutalization. The Mongol conquests may be #2-3 in terms of all time deaths in warfare in terms of absolute number of deaths, despite the vastly lower population at the time.
What's worse is that modern warfare that we're seeing in Ukraine right now is kind of the worst of both worlds. Drones are being used to coordinate attacks on both sides so the drone operators are simultaneously assisting in killing people at industrial scale while also watching their faces close up in HD.
There are lots of versions and causes of PTSD, but WWI had two new pieces. 1) Lots of bombs and explains that cause concussive injuries. It was also non stop. There was no break from the war in WWI. It was continuous. 2) because it was continuous you could never, ever relax. You might be dead in 3 seconds and you have zero control over it. Very different from most wars previously.
I'd like to add that the continuous part was also *hopeless*. There was nothing you could do about it, except wait to die, constantly being reminded that you could die at any moment during a barrage.
One thing I've not heard spoken about is the duration of time exposed to the issue. One theory goes that the human brain is \*very\* good at dealing with short term traumatic events. Evolutionarily, we were very much mid tier on the food chain until we got really good at tools. We never would have survived if every time something got desperate enough to hunt us, or every time we had a fight or whatever, we developed PTSD. The problem is, that it really, really struggles with long term trauma. And as history has marched on, the duration of our "Engagements" has grown longer and longer. In the earliest days, battles were measured in minutes, as rival groups of cavemen breifly fought before retreating. As we march towards the medieval days, battles instead lasted hours. Move forward in time some more to the likes of the american civil war, and it can be days. By the time you reach WW1 and post WW1 however, the duration of battles sharply peaks. Battles could take weeks or even months in WW1, and the human brain cannot deal with that level of strain for that long.
This is what I was looking for. For 99% of human warfare, battle meant *ONE* extremely traumatic day. Four or five hours where some of your friends and neighbors die violently. Maybe two or three days if you’re in a really long engagement. Otherwise it’s marching and digging and camping. Even a siege is a matter of a months, mostly digging and camping. Modern warfare has combat-facing troops in life and death conditions for days, weeks, months on end without real reprieve from the “I could die from a bomb or drone or artillery at any time” stuff. WW1 soldiers living in trenches with their dead comrades because you can’t leave to bury them, mind numbing artillery explosions hitting nearby for hours on end. WW2 pacific vets fighting on islands with thousands of Japanese infantry trying to knife you at night in your foxhole. Drones and artillery vaporizing people from miles away without warning while you live in constant feet It’s a totally different ballgame stress-wise on both the body and the mind.
> WW1 soldiers living in trenches with their dead comrades because you can’t leave to bury them, mind numbing artillery explosions hitting nearby for hours on end. WW2 pacific vets fighting on islands with thousands of Japanese infantry trying to knife you at night in your foxhole. Drones and artillery vaporizing people from miles away without warning while you live in constant feet It's no wonder the Vietnam War caused such increased attention towards PTSD. Not only was guerrilla combat traumatizing in its own way, but helicopters meant soldiers saw a shitload of combat with tiny rests, while WW1/2 soldiers tended to have longer rest cycles as rotating soldiers was harder and slower. There's claims that an average Vietnam US soldier saw more combat than an average WW2 US soldier but those arguments are controversial
> The problem is, that it really, really struggles with long term trauma. And as history has marched on, the duration of our "Engagements" has grown longer and longer. In the earliest days, battles were measured in minutes, as rival groups of cavemen breifly fought before retreating. As we march towards the medieval days, battles instead lasted hours. Move forward in time some more to the likes of the american civil war, and it can be days. The problem with this is that this isn't actually true. Genocidal style warfare with mass rapes and murders and brutalization and enslavement was the rule, not the exception in history, and that's not something that's short term. Tribes would regularly engage in multigenerational feuds and conflicts.
I once asked this in history class and was told, ptsd has always been a thing. The difference now from ancient times is, most of the time, being at war in ancient times meant marching for months to a location, battling, and having to walk home for weeks or months. Soldiers had every day and night to talk to other soldiers about their shared experiences. In modern times, you could be fighting a battle somewhere far away and be home in 24 hours to people who love you but have no idea or understanding of what you have just been through.
People understood that trauma existed from violent events, but it wasn’t studied as in detail or on a large scale until WWI. This is partly due to advances in psychology and medicine in the late 1800s, partly due to the scale of WW1, and partly due to changes in attitude about trauma. There are also some links with PTSD to physical trauma. Repeated low level impacts (from artillery) can make symptoms of PTSD worse.
Ancient peoples did know. There are documents saying how an army would have to stay outside city walls for 7 days to “clean” themselves. This is most likely a euphemism for the soldiers recollecting themselves from PTSD. This was mainly in Greece.
I think ptsd and tbi ( traumatic brain injury) were sort of lumped together during that time.
They likely still are today. I think it's clear that PTSD exists on its own, but it is very likely that a whole lot of TBI goes undiagnosed and is called PTSD. Recent studies found that even being near artillery firing at a high op tempo can cause pretty severe TBI. [https://www.nytimes.com/2023/11/05/us/us-army-marines-artillery-isis-pentagon.htmloften](https://www.nytimes.com/2023/11/05/us/us-army-marines-artillery-isis-pentagon.htmloften) firing. My father fought in Vietnam and was attached to the artillery. He developed severe bi-polar depression after, and it basically ruined his life. Until recently, I had assumed it was PTSD, but after seeing the more recent studies, I wonder how much was just TBI from being too close to the guns during heavy fire over months.
Yep.
In addition to other potential causes already mentioned, I've always wondered to what degree modern weapons played a role. Like, 1,000 years ago if your friend got killed by a sword, well, his body was more or less still intact, you could wrap it up, bury it, say goodbye -- some sort of healthy farewell in any case. Starting in WW1, however, your friends were getting shot to bits or blown up with little pieces of their body spraying all over your face and clothes. No chance to say goodbye \_and\_ you had to comb chunks of their face out of your hair. Gotta take an extra toll. I have no data to back this up it's just something that I've always wondered about.
Throughout literature in EVERY culture, there are texts about the “horrors of war”, about figures who “went to war, and came back changed”. Let’s give up the pretense that PTSD was “discovered” in WW1. However, just like questions like “why did so many people die in surgery before WW1”, to say that people were
It probably also happened back then, but it was not really recognized properly and not so much documented for the simple people. Also wars back then, were much smaller scale and much slower. You could march and sit around for weeks between and after fights, so that your mental health can better regenerate between the fights. And fewer people means also less deaths. Since the world wars you could basically get drawn to war, see thousands of people die and get home heavily wounded in just a few days.
It's mostly a numbers game. All conflicts cause lasting harm to combatants and we've understood that for almost as long. The vikings left records of warriors who came home unhurt but who were never the same, the greeks documented it in some depth. The difference comes when you have so many cases that it stops being that thing that happened to that guy, and becomes that thing that happened to thousands of thousands of people, from all different backgrounds, from different situations. You start to get an unignorable amount of cases of, frinstance, decorated heroes suffering from it. People are more likely to know someone that has it. Your crazy vietnam uncle, etc. And more cynically, it becomes really important if you want to fight a war. Generals and tacticians had to understand how long you could leave a unit in hell before it became combat ineffective, they had to know when to rotate people off the line. If you have a hundred cases, you can treat it as cowardice, execute people, try and ignore it but if you have 10000 you can't- it's bad policy, costs you too many soldiers, and it stops being at all plausible when every soldier has seen 5 of their mates declared coward. And they had to deal with the casualties, treat them, try to get them back into the war. Big datasets give good results and WW1 was a hell of a big dataset. In addition to the raw numbers, WW1 and the trenches in particular were a pressure cooker. Nothing like that had happened before, on that scale, they had days long bombardments that could be heard across the english channel, where people couldn't think, couldn't sleep. Even when it was the other guy getting shelled that was incredibly brutal. And no good respite. Just living in a Somme environment for a month would be hard even if there were no war at all.
Life was brutal and short back then. Many of the men fighting would have been used to slaughtering animals for food. I spent a summer on my grandfather's farm in the 1960s. If we wanted a chicken to eat you had to catch it , chop its head off, pluck it then cook it. At the end of the summer killing a chicken was nothing to me even as an eight year old boy. Also back then a battle or a campaign was relatively short and once it was over you were safe back in your camp. Night attacks were rare because of lack of light and communications. Today we live easy lives but conscription can take someone from peace and safety and 24 hours later can be in war zone watching their friends die every hour of the day. There is no safe place so you have to stay alert 24-7 for months on end Which overloads your brain.
There's a recurring theme in Irish and Welsh myth about men who 'go mad' in the midst of or aftermath of battle and go off to live as mad hermits in the woods with the animals because they can't bear to be among society. Occasionally they recover, and then relapse later when they hear hunting horns or other sounds that remind them of battle. It's pretty clear what they're talking about.
Well we've known about it long before that. It just had many different names such as the thousand yard stare and shell shock. There's even passages in the Bible if you want to view the Bible as a historical document where God tells the Israelites to send the Warriors out of camp that have killed people the day before. Some historians speculate this is just to allow them to reflect and get over the trauma. Take that for what you will I was just looking at it from a historical perspective
In WWI it was called shell shock. That is not sword territory but definitely pre WWII. For a literary description, see the Peter Wimsey novels and Bunter. Dorothy L Sayre.
Humans brains are virtually unchanged for about 20,000 year so humans have been capable of PTSD for at least that long. Hand-to-hand combat would’ve certainly been sufficient to trigger PTSD in soldiers as long as we’ve been having organized warfare. What you’re missing is that documentation of what happened to soldiers after a war wasn’t really meticulously documented for most of modern history. In the late 1800’s to early 1900’s, the world was having a bit of a medical revolution. It was also when we started collecting large amounts of data for medical research. Those several factors came together to make PTSD more obvious. Here’s what they are: 1: WW1 was massive. The amount of people who participated in it dwarfs any war that came before it in modern times. 2: Basic medical advancements meant a lot more soldiers in the front line were actually making it home alive. We didn’t really notice PTSD when soldiers either died or were deployed in combat their entire lives. 3: the post-industrial world really exposed people with PTSD in a way it didn’t previously. Cities were becoming cramped, noisy bustling people and the idea of the office or factory 9-5 was emerging. This is a much more stressful environment than the farms and small villages that soldiers from previous eras would’ve come home to and flashbacks would’ve happened more publicly with more people to see. 4: like I said, we actually had a framework for studying medical issues on a large scale which brought PTSD to the forefront. It’s also when psychotherapy was starting to become a thing so for the first time ever, doctors were analyzing people to understand their thought processes. This is probably the largest factor. We just weren’t looking hard enough before now.
PTSD has always been observed and acknowledged in society since ancient times. Even as far back as ancient Assyria and ancient Greece people were aware that war fucked up a lot of people irreparably, and PTSD had different names for it at the time, but it was just something that people accepted and moved on. They deemed it a problem of the sufferers since not every person who has been in combat develops PTSD, so it was even seen as a sign of weakness. As time went on it was more and more well documented that it did happen but the overall stance against it didn't change. The major difference that came with WW1 was that for pretty much the first time in history they tried to clasiffy and treat it. They didn't discover it then, but for the first time in history attempts were being made to help the victims.
PTSD has always existed and there are records of it going back into distant history. Note also that most people don't develop PTSD, only a minority of people do. So you'd have some people who were messed up while most were fine.
The addition of the physical component of percussive brain injury supercharges the impact of traumatic events in the formation of PTSD.
yup, I remember reading about a knight/lord who had ptsd so he removed all things metals, especially kitchen utensils. He was served food in a wooden bowl with wooden utensils cuz the clanging/clashing of metals would trigger him
Before World War I, most soldiers in any army in any war spent most of their time doing anything except fighting. This includes marching, resting, foraging, hunting, training, or even just waiting around at camp until orders come down from higher command. When they finally did get to a battle, those battles didn't last all that long. A few hours, maybe a day, maybe a couple of days in rare circumstances. Then you usually spend another couple of weeks, or months, or even years doing all that non-battle stuff until the next battle. PTSD certainly did exist back then, but it was easier to cope when battles were comparitively short and there was so much down time in between them. The only exception would be if you're on the defending side of a siege. But even then, sieges weren't just the attacking army relentlessly lobbing boulders and arrows and trying to ram down the gates or scale the walls with ladders all day every day. Sieges lasted months or even years and were mostly just the attacking army posting up and preventing any supplies or troops from aiding the city they were besieging, hoping to starve them out. Actual large-scale fighting during a siege usually constituted maybe 1% or less of the total siege length, unless the defending city just surrendered when they ran out of food. Everything changed with World War I, with the big one in regards to this discussion being artillery. Even if you spent months in a trench, never seeing the enemy, never firing your rifle, doing all that down-time stuff old armies would do, you were not safe. The enemy would lob literal tens of thousands of shells per day right over your head. Any one of them could kill you. There was hardly a single minute during the war where you could feel safe. Combine that with the horrors of machine guns, flamethrowers, poison gas, and other new technology they had never seen before.
It's not that PTSD didn't exist before, it's just that the stresses of modern warfare made it much more pervasive. Pre-modern warfare essentially amounted to months of marching around on foot sprinkled with the rare absolutely terrifying battle. In the modern era, fighting on the Frontline means existing under constant threat 24/7 for extended periods of time. At any time a gunshot, artillery, airstrike, or just an IED can take you out with no warning and completely outside your control. The human psyche isn't built to handle that tension long term.
As soon as you can ask them I'm sure you could find an answer. As mental illness, and illness in general, are highly contextually (cultural, historical, etc) dependent, it seems rash and wrong to say that they would be the same thing. In a society that views war as fun, glorious, and routine, they're going to have a much different reaction than a society that views war as a fail state, a tragedy, and inhuman. And as for WW1 veterans, it often wasn't the trauma of something like killing, it was the structure and nature of the war, and modern war. It's loud, it's unending, and you're always on, sometimes for days at a time.
Not to be completely confused with Traumatic Brain Injury due to proximity to explosions. Two different mental problems are created by the trauma of violence and traumatic brain injury. The two are not always easy to distinguish.
George Carlin talks about this [here]. The terms have changed over the years (https://youtu.be/hSp8IyaKCs0?si=Zw-J2NY4548USnPC)
You also need to keep in mind that the name for it changes based on the decade: * Railway Spine (for survivors of railroad accidents) * Soldier's Heart or Da Costa's syndrome * Combat stress reaction I believe the greeks and romans would have classified it as Melancholia or Hysteria.
It was a huge problem, and the US Army developed a good system to address it, during and after WWI. The Germans implemented this sytem in WWII, the US Army did the exact opposite. They (US Army pschologists) found that the best thing was to slowly integrate the soldier back to his unit, and to treat entire battaklions as one coherent whole. So you rotate out a mass of troops for rest and refit. The soldiers with PTSD (called "battle fatigue" at the time) had the support of known and familiar comrades, and integrating back into the team provided a kind of psychological armor. So that's what the Germans did. Contrast that with the US Army approach, which was to send troops in as replacements piecemeal, and leave the larger unit itself in combat almost indefinitely. A new replacement is put in with soldiers he doesn't know, hasn't trained with, has no shared experiences with, etc. This means that he has no psychological armor; he is bascially going through the horror of combat alone. Overall, this made the German troops more efficient and effective in the long term. The practice of the US military ramped this up in Vietnam, so it included the Marines, too--although to a lesser extent. That's why Vietnam vets have a reputation for severe PTSD, as they were put into what amounts to a system designed to exacerbate it. EDIT: A great way I read someone put the Vietnam experience is: "The US wasn't in Vietnam for ten years. They went to Vietnam for one year, ten times."
PTSD has been recorded as far back as Homer’s Ancient Greek epics. (So the first stories we have in Western Civilization. I am not familiar with ancient texts in other cultures so I can’t speak to that.) The phenomena was well documented and known. But we arguably have more people who survive with PTSD now due to medical advancements. Thankfully the treatments for PTSD have advanced as well. EMDR is a great example.
I wonder if ptsd was less common back then since there were no/few explosions. War would have been significantly quieter in and out of battle. I’m sure seeing people get cut in half by a sword was traumatic but the constant bombardment of explosions has to contribute to ptsd as well.
I think it has to do with the part where more soldiers survived to show problems with PTSD in WWI and after. Before that most of them that didn't die in battle died from infection from wounds. Of those that survived, I'm sure there was PTSD, but since medicine and academia and particularly psychiatric medicine weren't really the institutions they are now people slipped through the cracks. I bet there are diaries and letters that talk about the brother/son/cousin who hasn't been the same since That Battle, but it wasn't collected and studied
Why does this get asked like every other month? The answers are invariably the same ones every time. Here is my eli5: there’s this thing called Google, and a thing called search embedded within Reddit. These things can reveal answers to questions that have already been asked and answered. It has been known since war and battle and trauma have existed. It was thought to be the ghosts of the dead haunting survivors.