People with PTSD continue to produce high amounts of these hormones outside of dangerous situations and their amygdala—the part of the brain that handles fear and emotion—is more active than people without PTSD. Over time, PTSD changes the brain, including by causing the part of the brain that handles memory the hippocampus to shrink. Long before the dawn of modern psychiatry, people and situations depicting PTSD may have been recorded in early works of literature.
For example, in the Epic of Gilgamesh , the earliest surviving major work of literature dating back to B. Later, in a B. This blindness, brought on by fright and not a physical wound, persisted over many years. Other ancient works, such as those by Hippocrates , describe soldiers who experienced frightening battle dreams. In the Indian epic poem Ramayana , likely composed around 2, years ago, the demon Marrich experiences PTSD-like symptoms, including hyper-arousal, reliving trauma, and avoidance behavior, after nearly being killed by an arrow.
Marrich also gave up his natural duty of harassing monks and became a meditating recluse. In the last several hundred years, medical doctors have described a few PTSD-like illnesses, particularly in soldiers who experienced combat.
In the late s, Swiss physician Dr. Around the same time, German, French and Spanish doctors described similar illnesses in their military patients.
In , Austrian physician Josef Leopold Auenbrugger wrote about nostalgia in trauma-stricken soldiers in his book Inventum Novum. The soldiers, he reported, became listless and solitary, among other things, and efforts could do little to help them out of their torpor. Civil War — In fact, nostalgia became a common medical diagnosis that spread throughout camps. While nostalgia described changes in veterans from a psychological perspective, other models took a physiological approach. After the Civil War, U.
During the Industrial Revolution , rail travel became more common—as did railway accidents. The term itself first appeared in the medical journal The Lancet in Feb. Charles Myers of the Royal Army Medical Corps documented soldiers who experienced a range of severe symptoms—including anxiety, nightmares, tremor, and impaired sight and hearing—after being exposed to exploding shells on the battlefield. It appeared that the symptoms resulted from a kind of severe concussion to the nervous system hence the name.
By the following year, however, medical and military authorities documented shell shock symptoms in soldiers who had been nowhere near exploding shells. The extent to which blast force was responsible for shell shock is of more than historic interest. According to a Rand Corporation study, 19 percent of U. In , the U. The study revealed that limited traumatic brain injury TBI may manifest no overt evidence of trauma—the patient may not even be aware an injury has been sustained.
Diagnosis of TBI is additionally vexed by the clinical features—difficulty concentrating, sleep disturbances, altered moods—that it shares with post-traumatic stress disorder PTSD , a psychiatric syndrome caused by exposure to traumatic events.
So they were ahead of their time. They were betrayed by the stammering and trembling they could not control, the distressing lack of focus, their unmanly depression and lassitude. No list of clinical symptoms, such as the written records preserve, can do justice to the affliction of the shellshocked patient. This is more effectively evoked in the dreadful medical training films of the war, which capture the discordant twitching, uncontrollable shaking and haunting vacant stares.
But we were all brought up to show good manners, not to upset. Possibly, it was social training, not medical, that enabled Lady Clementine to assist and solace the damaged men who made their way to Lennel. If she was unsettled by the sights and sounds that filled her home, she does not seem to have let on.
That she and her instinctive treatment were beneficial is evident from what is perhaps the most remarkable feature of the Lennel archive—the letters the officers wrote to their hostess upon leaving. A number of the letters are written from hotels while awaiting the results of medical boards. Most hoped for light duty—the dignity of continued service but without the dreaded liabilities.
One catches glimpses of them, however, through a variety of oblique lenses. They crop up in a range of fiction of the era, hallucinating in the streets of London, or selling stockings door to door in provincial towns, their casual evocation indicating their familiarity to the contemporary reader. Officially they are best viewed in the files of the Ministry of Pensions, which had been left with the care of 63, neurological cases; ominously, this number would rise, not fall, as the years passed, and by —more than a decade after the conclusion of the war—there were 74, such cases, and the ministry was still paying for such rehabilitative pursuits as basket making and boot repairing.
An estimated 10 percent of the 1,, military wounded of the war would be attributed to shell shock; and yet study of this signature condition—emotional, or commotional, or both—was not followed through in the postwar years. She died in , by which time the letters and papers of her war service were stored in the Lennel House basement; there may be other country houses throughout Britain with similar repositories.
Lennel House itself, which the family sold in the s, is now a nursing home. Oh it is too cruel after waiting three long weary years for him to come home. A photograph that had been in the possession of Capt. William McDonald before he was killed in action in France, in , and which is now archived in the Australian War Memorial, shows him gathered with other officers on the Lennel House steps, with Lady Clementine. It rained a heavy storm last night. War neurosis was four times higher among officers than among the regular soldiers.
The war poet Siegfried Sassoon, himself a victim, describes the psychological pain of shell shock in his poem Survivors. He writes of soldiers with "dreams that drip with murder" and their "stammering, disconnected talk". At the end of the war over 80, cases of shell shock had passed through British Army medical facilities.
The huge number of shell shock cases was completely unexpected. By there was a shortage of hospital beds for sufferers. Many county lunatic asylums, private mental institutions and disused spas were taken over and designated as hospitals for mental diseases and war neurosis.
By there were over 20 such hospitals in the U. Many shell shock victims served at the Battle of the Somme - official figures put the figure at 16, but military experts say that the true figure could be much higher.
Many soldiers suffering from the condition were charged with desertion, cowardice, or insubordination. Some shell shocked soldiers were shot dead by their own side after being charged with cowardice. They were not given posthumous pardons. Shell shock victims found themselves at the mercy of the armed forces' medical officers. The "lucky" ones were treated with a variety of "cures" including hypnosis, massage, rest and dietary treatments.
Today the hospital is part of Plymouth University, but in its early days it was at the centre of a national crisis. More than 80 years ago men arrived at the hospital nervous wrecks, seemingly destroyed by the terrors of the First World War.
They were suffering from shell shock, and the hospital's treatment was revolutionary for its time. Arthur Hurst, an army major, swept aside opposition to establish himself at Seale Hayne. Soon Hurst was being acclaimed as a miracle worker, but how did he weave his magic on the sick soldiers? Hurst made the only film in existence about how shell shock victims were treated in Britain.
These rare recordings give an insight into Hurst's dramatic techniques. One of the films follows Private Percy Meek who was driven almost mad during a massive bombardment of the Western Front.
When he first came under Hurst's care, he'd regressed into a babylike state and was sitting in a wheelchair.
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