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mamatha shastri

PTSD after the American Civil War

“In the summer of 1862, John Hildt lost a limb. Then, he lost his mind.”

BACKGROUND

What is PTSD ?

Post traumatic Stress Disorder (PTSD) is a psychiatric disorder to which people that have witnessed, or experienced traumatic events fall victim too. The first signs of PTSD are intense, harshly disturbing thoughts and feelings. Patients experience continual vivid and extremely graphic flashbacks of their trauma period and even gruesome nightmares, re-living their worst days on a loop. Estrangement from close friends and family is also a side effect that the patient may face. Sufferers of this condition are often negatively aroused to events one would usually render normal, such as an accidental touch, loud noises or even bright lights. According to the DSM-5, behavioural symptoms that occur propose four distinct diagnostic clusters, namely re-experiencing, avoidance, negative cognitions and mood, and arousal. PTSD could also cause long-lasting damage to the nervous system and neurological wiring of the brain. A diagnosis of PTSD, unfortunately, could snowball into the patient experiences a spectrum of mental disorders such as Acute Stress Disorder, Depression and memory loss to name a few in addition to underlying bearings such as trust issues and anger.




War-related PTSD

Although soldiers are considered stoic human beings, the trauma they suffer during combat can be insufferable. War-related PTSD or non-medically referred to as “shell-shock” or “combat stress” is fairly common. Out of troops that have been exposed to war-related traumatic experiences, close to 31.6% of the soldiers develop PTSD. Some of the common inflictors of PTSD in war veterans can be- witnessing combat bloodshed and fatalities, losing a close companion during a crossfire, a bomb explosion within a camp, sexual assault and gaping injuries. These incidents, out of an innumerable number of others, can cause serious cases of PTSD. Young soldiers in combat are 7 times more likely to fall victim to the disorder compared to their older peers. 23 out of 100 women (or 23%) and 38 out of 100 men (or 38%) have experienced sexual harassment when in the military. In similarity with most mental illnesses, PTSD does not and cannot have a definite cure. It can only be treated. Medication and psychiatric therapy can reduce the effects of it, however.


The American Civil War

The Civil War started because of uncompromising differences between the free and slave states over the power of the national government to prohibit slavery. Abraham Lincoln won the general elections in 1860 as the first Republican president on a platform pledging to keep slavery out of the territories, seven slave states in the deep South seceded and formed a new nation, the Confederate States of America. Increased civil tensions simmered between the Confederate States of America and the United States of America before they broke out into a civil war that took place between 1961-1964. Around 2.75 million soldiers have been known to have fought in this war for freedom.

TRAUMA

Army Recruits

Geographically, the Civil War servicemen were far less distant from home than soldiers in foreign wars. Most of the recruits were farm boys in their teens or early 20s, who had rarely if ever travelled far from family, friends and familiar surrounds. Enlistments usually lasted three years. We must cogitate that during these times, communication wasn’t as fast or reliable as it is today, leaving these masses of young boys detached from loved ones, onwards alone to fight a fatal war. These conditions contributed to what Civil War doctors termed “nostalgia,” a centuries-old term for despair and homesickness. Despair and homesickness so severe that soldiers became listless, emaciated and sometimes died. Military and medical officials recognized nostalgia as a serious “camp disease,” but generally blamed it on behavioural faults such as “feeble will,” “moral turpitude” and inactivity in camp. Few sufferers were discharged or granted furloughs from camp. The recommended treatment was in-fact the shaming of “nostalgic” soldiers—or, better yet, “the excitement of an active campaign,” meaning non-friendly combat. This was one of the primitive forms of trauma that taxed many young soldiers.



Disease

Bullets, shells and bombs did not threaten soldiers as much as diseases and infection did. Amongst the distinctly unsanitary camps and unhygienic overcrowding, diarrhoea claimed its position as their primary enemy. Rheumatism, malaria and continued chronic diarrhoea lingered amongst the servicemen, killing off twice as many men as combat did. This emanated deeper trauma to the psyches of several more heroic soldiers.

Combat and Imprisonment

Barely trained soldiers were hastily mustered in 1862 as the ‘Men of the 16th’ and they were ordered into battle at Antietam, the bloodiest day of combat in U.S. history. The raw recruits rushed straight into a gruesome Confederate crossfire and then broke and ran, 25% of them suffering agonizing casualties within minutes. In a battle that took place subsequently, all but a few out of the Men of the 16th were captured and sent to the notorious Confederate prison at Andersonville. Here, 1/3rd of the newly turned prisoners died from more disease, exposure, sexual and physical abuse and starvation, all tallying into a long list of PTSD inflicting causes.

RETURNING HOME

Amalgamating into Society

American society welcomed their brave soldiers back home with brimming laughter, huge smiles and open arms, grateful for their service and thankful for the freedom they so gallantly were awarded. However, soldiers affected by PTSD were quickly recognized as “changed” or “eerie” by their close ones. But, the medical understanding that we have today did not exist back then. PTSD, or even a trauma inflicted mental illness, was a concept undiscovered. Men who exhibited what today would be termed war-related PTSD were thought to have character flaws or underlying physical problems. A disturbing example of this would be the fact that constricted breath and palpitations, both of which are symptoms of war-related PTSD, were credited to knapsack straps drawn too tightly across the soldiers’ chests or that mental breakdown were blamed on a "weak heart" and sometimes, asylum records even penned down masturbation as a cause for manic behaviour. Families of young soldiers had no know-how about traumatic disorders and were thus, quick to blame the sufferer's behaviour on Insanity.



Insane asylums

Admissions into Insane asylums spread across the United States of America like wildfire, majority of the solitary confinement asylums overbooked. In these asylums, "hydrotherapy" (water) or "electrotherapy" (shock) were used along with hypnosis in vain attempts to re-establish traumatized soldiers into having productive post-war lives. Historians speculate, through evidence collected through letters sent and diaries kept at the asylums, that the veterans' experiences at the insane asylums were far more traumatic and painful than the primary causes of their conditions at war. Genealogists have even rediscovered forgotten veterans in their graves in asylum cemeteries.

Divorce, Drugs and Suicides

Divorce rates skyrocketed during these years, considering that a majority of the soldier population had left their spouses and children at home while they left for war. Helpless wives, unable to handle traumatic episodes and dramatic flashbacks and constant anger, left their husbands in search of more peaceful and “normal” lives.

Throughout the 1800s, opiates were widely available and generously dispensed for pain and other ills, causing a large population of veterans to rely on them for relief of some kind. Drug addictions followed, driving families farther away from veterans and veterans farther away from society.

All of the above snowballed into a jump in veteran suicide rates. PTSD riddled, suffering ex-army men ending their pain in the only way they could find solace- suicide.

CONCLUSION

In 1980, nearly a century post the American Civil War, the American Psychiatric Association officially recognized the term “Posttraumatic Stress Disorder” in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Although the exact number of PTSD victims from the war is hard to pin down and impossible to reduce into statistics, those heroic soldiers’ accounts, their stories and experiences helped make massive breakthroughs in the field of psychiatry and the diagnosis and treatment of PTSD.


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