Va Like A Soldier
Exposure to traumatic experiences has always been a part of the human condition. Attacks by saber tooth tigers or twenty-first century terrorists have likely led to similar psychological responses in survivors of such violence. Literary accounts offer the first descriptions of what we now call posttraumatic stress disorder (PTSD). For example, authors including Homer (The Iliad), William Shakespeare (Henry IV), and Charles Dickens (A Tale of Two Cities) wrote about traumatic experiences and the symptoms that followed such events.
Va Like A Soldier
Prior to U.S. military efforts, Austrian physician Josef Leopold (1761) wrote about "nostalgia" among soldiers. Among those who were exposed to military trauma, some reported missing home, feeling sad, sleep problems, and anxiety. This description of PTSD-like symptoms was a model of psychological injury that existed into the Civil War.
A second model of this condition suggested a physical injury as the cause of symptoms. "Soldier's heart" or "irritable heart" was marked by a rapid pulse, anxiety, and trouble breathing. U.S. doctor Jacob Mendez Da Costa studied Civil War soldiers with these "cardiac" symptoms and described it as overstimulation of the heart's nervous system, or "Da Costa's Syndrome." Soldiers were often returned to battle after receiving drugs to control symptoms.
The thought that physical injury led to PTSD-like symptoms was supported by European reports of "railway spine." As rail travel became more common, so did railway accidents. Injured passengers who died had autopsies that suggested injury to the central nervous system. Of note, Charles Dickens was involved in a rail accident in 1865 and wrote about symptoms of sleeplessness and anxiety as a result of the trauma.
In 1919, President Wilson proclaimed November 11th as the first observance of Armistice Day, the day World War I ended. At that time, some symptoms of present-day PTSD were known as "shell shock" because they were seen as a reaction to the explosion of artillery shells. Symptoms included panic and sleep problems, among others. Shell shock was first thought to be the result of hidden damage to the brain caused by the impact of the big guns. Thinking changed when more soldiers who had not been near explosions had similar symptoms. "War neuroses" was also a name given to the condition during this time.
In World War II, the shell shock diagnosis was replaced by Combat Stress Reaction (CSR), also known as "battle fatigue." With long surges common in World War II, soldiers became battle weary and exhausted. Some American military leaders, such as Lieutenant Gen. George S. Patton, did not believe "battle fatigue" was real. A good account of CSR can be found in Stephen Crane's Red Badge of Courage, which describes the acute reaction of a new Union Army recruit when faced with the first barrage of Confederate artillery.
Despite growing evidence that trauma exposure was associated with psychiatric problems, this diagnosis was eliminated in the second edition of DSM (1968). DSM-II included "adjustment reaction to adult life" which was clearly insufficient to capture a PTSD-like condition. This diagnosis was limited to three examples of trauma: unwanted pregnancy with suicidal thoughts, fear linked to military combat, and Ganser syndrome (marked by incorrect answers to questions) in prisoners who face a death sentence.
Research shows that deployment increases risk of PTSD. In some studies, PTSD is 3 times more likely among Veterans who deployed compared to those who did not (of the same service era). Some factors in a combat situation may contribute to PTSD and other mental health problems, including military occupation or specialty, the politics around the war, where the war is fought, and the type of enemy faced.
Veterans are more likely to develop PTSD than civilians. Among Veterans, those who deploy are more likely to have PTSD than Veterans who do not. Also, Veterans who use VA for health care are more likely to be diagnosed with PTSD than those who use community health services. This may be due, in part, because VA screens for MST and PTSD for all Veteran patients.
Hatfield noted the strenuous times for all health care providers and the added commitment for military members whey they leave their families during call-ups like her recent one. And with the unpredictable nature of this pandemic, that call could come again any day, she said.
Please Note: These primary sources retain the wording, spelling, punctuation, and lack of punctuation as written by the eyewitnesses of the Battle of Antietam and those who experienced its aftermath.Teachers: This handout contains excerpts of eyewitness accounts, diary entries, and letters for you to read to your students or to assign to your students as an independent reading activity. Afterwards, have the students imagine that they are Civil War soldiers or civilians. Have them compose their own journal entries or letters to loved ones.____________________________________________________________Sunday Sept. 21, 1862 Dear Folks,On the 8th we struck up the refrain of "Maryland, My Maryland!" and camped in an apple orchard. We went hungry, for six days not a morsel of bread or meat had gone in our stomachs - and our menu consisted of apple; and corn. We toasted, we burned, we stewed, we boiled, we roasted these two together, and singly, until there was not a man whose form had not caved in, and who had not a bad attack of diarrhea. Our under-clothes were foul and hanging in strips, our socks worn out, and half of the men were bare-footed, many were lame and were sent to the rear; others, of sterner stuff, hobbled along and managed to keep up, while gangs from every company went off in the surrounding country looking for food. . . Many became ill from exposure and starvation, and were left on the road. The ambulances were full, and the whole route was marked with a sick, lame, limping lot, that straggled to the farm- houses that lined the way, and who, in all cases, succored and cared for them. . .In an hour after the passage of the Potomac the command continued the march through the rich fields of Maryland. The country people lined the roads, gazing in open-eyed wonder upon the long lines of infantry . . .and as far as the eye could reach, was the glitter of the swaying points of the bayonets. It was the first ragged Rebels they had ever seen, and though they did not act either as friends or foes, still they gave liberally, and every haversack was full that day at least. No houses were entered - no damage was done, and the farmers in the vicinity must have drawn a long breath as they saw how safe their property was in the very midst of the army.Pvt. Alexander Hunter, Company A, 17th Virginia Infantry____________________________________________________________It was no longer alone the boom of the batteries, but a rattle of musketry--at first like pattering drops upon a roof; then a roll, crash, roar, and rush, like a mighty ocean billow upon the shore, chafing the pebbles, wave on wave, with deep and heavy explosions of the batteries, like the crashing of the thunderbolts.Charles Carleton Coffin, Army Correspondent____________________________________________________________Sometimes a shell would burst just over our heads, scattering the fragments among us.Lt. Thomas H. Evans, 12th U.S. Infantry____________________________________________________________
One moment of time before the mail leaves. I am well and in good spirits. We have just had a big battle day before yesterday. The baggage wagons are in sight and we will all not fit. We have not sent any mail for about a fortnight and I would have written more had I known we could have sent it. Will write more the first opportunity I have.We are on the move and are going into Virginia probably now. We have served in the last two battles. Give my respects to all friends and othersYours truly, Henry14th Connecticut Volunteers____________________________________________________________October 14, 1862 Harper's FerryDear Brothers and SistersI wish that I was home today; I have got a very mean job. You know that we lost our good Captain and now they think they must put me on guard, and I sit right down on the ground and write just as fast as I can to let you know how I am getting along. Not much you had better believe. My hearing is not as good as it was when I left Madison, and my health has not been good since I was on this hill not far from Harper's Ferry, but I keep about and train all the time is wanted of me. It seems rather hard to be a soldier, but I have got to be one after all, I think. But I can tell you one thing: If I ever live to get home, I won't be another I can tell you, but I suppose that you are making some cider. If you get a chance to send me anything, send me some cider put up in bottles, and some apples and a little bottle of pain killer, and don't try to send me any cake or anything that will get smashed, but I want anything that will keep a week. I have not any news to send you today because I wrote to you the other day and suppose that you will get that first. Give my love to all the neighbors and tell Mister Hill that I received his letter and was glad to hear from him and will try and answer him as soon as possible.Tell little Charley that I think a great deal of his letter. I used to say that he could read better than I could read better than I could and he beats me at writing and spelling both, and I could read it very fast, his letter. I am glad to hear that your crops are as good and I hope that all the folks are good because we don't have nothing to eat here, and so I hopes you have got something to eat there. I will try and answer as fast as I can, but won't you answer me as fast you can because that it makes me feel pleased to hear from home. Give my love to all the folks and tell them I want to see them all.From a brother,John Redfield, 13th New Jersey____________________________________________________________The force of a mini ball or piece of shell striking any solid portion to a person is astonishing; it comes like a blow from a sledge hammer, and the recipient finds himself sprawling on the ground before he is conscious of being hit; then he feels about for the wound, the benumbing blow deadening sensation for a few moments. Unless struck in the head or about the heart, men mortally wounded live some time, often in great pain, and toss about upon the ground."