Why do some people miss war. Why do some soldiers end up winning the battle but losing their
minds? PTSD or Post Traumatic Stress Disorder has sadly become more and more prominent in
our societies over the last few decades. But have soldiers always come home with shattered
minds? Were the comrades of Achilles or Caesar suffering after putting down their swords?
What is the history of this disorder and what can it tell us about modern warfare and civilian
life? Let’s find out.
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What exactly is PTSD? According to the Diagnostic and Statistical Manual of Mental Disorders
it can be caused by:
- Exposure to actual or threatened death, serious injury
Along with
- Recurrent, involuntary, and intrusive distressing memories of the traumatic events
- Flashbacks
- Psychological distress at exposure to internal or external cues
- Angry outbursts
- Hyper vigilance
- Experiences of feeling detached
Note that PTSD is not exclusive to combat. Combat is not even the leading cause of PTSD.
PTSD can be triggered by car crashes, assaults, and other traumatic experiences. But for this
video we will focus on combat PTSD.
PTSD didn’t enter our vocabulary until the 1980’s after the Vietnam War. But we can
see hints of its existence in writings from Homer to Dickens.
So let’s go back thousands of years to some of the earliest evidence we have for what
would become PTSD.
At Marathon in 490BC Athenian Hoplites fought against the invading Persians. Amidst the
martial clamour and tumultuous cries an Athenian, Epizelus, stood in horror.
He was immediately stricken with blindness. According to Herodotus, even after the Athenians
won, Epizelus who “neither having received a blow in any part of his body nor having
been hit with a missile, and for the rest of his life from this time he continued to
be blind”
Epizelus was suffering from Hysterical Blindness, a rare symptom of PTSD. He seems to be the
first figure in history that we can pinpoint as walking away from a battle with mental
injuries.
The psychiatrist Jonathan Shay in his 1994 book, Achilles in Vietnam, noted that returning
veterans of the Vietnam war shared some parallels with the experiences of Achilles in the Iliad.
According the Shay, the story of Achilles was the story of a soldier undergoing the
effects of PTSD. When Hector kills Achilles' best-friend Patroclus, Achilles is overcome
with an "inability to sleep or eat...preoccupation with revenge",. Achilles changed from a regular
soldier into one filled with grief and rage, symptoms of PTSD.
The Romans too seemed no strangers to trauma. The general Marius “fell into a state of
dreadful despair, and was a prey to nightly terrors and harassing dreams...And since above
all things he dreaded the sleepless nights, he gave himself up to drinking-bouts and drunkenness”.
While possibly part of a smear campaign, these reports do show us that that Romans were aware
of PTSD like symptoms.
Moving on through history we see the condition that would become PTSD take on many names.
Swiss physicians
Oh what a difficult f------ word combination!!!!
Swiss physicians in 1678 were some of the first to identify PTSD and they referred to
it as “Nostalgia”
The Germans and French quickly picked up on the idea and called it heimweh and maladie
du pays or homesickness.
Then the Spanish came along and made it super dark by referring to the condition as estar
roto, to be broken.
It was only with the massive scale of The First World War that the higher-ups and even
the public began to pay attention to the mental states of soldiers.
Hundreds of thousands of men were returning from the front-lines completely traumatised.
Contemporary theories suggested it was the large artillery weapons that were causing
it.
Thus the term "shell shock" came into common use.
Rapidly this understanding changed and even the doctor that coined "shell shock" changed
his mind. The nightmares, the tics, the flashbacks, these were mental injuries.
Unfortunately, this allowed people to just blame weak character and ignore the victims.
As World War II, humanity’s most destructive endeavour, went on the scale of this stress
only increased. According to Stéphane Audoin-Rouzeau and Annette Becker, "One-tenth of mobilized
American men were hospitalized for mental disturbances between 1942 and 1945, and, after
thirty-five days of uninterrupted combat, 98% of them manifested psychiatric disturbances
in varying degrees."
It was a resounding rebuttal to those claiming that only those of weak character were suffering
breakdowns. By the end of the war "combat neurosis" transformed into “combat exhaustion.”
which soon became "battle fatigue".
Finally during the Vietnam War when record numbers of soldiers returned the the United
States with traumatic injuries we see the term Post-traumatic Stress Disorder appear.
From the evidence that we do have, it seems that some degree of PTSD did occur in ancient
times. But modern soldiers seemed to be affected more. Why is that?
First of all, danger was much more localised for the ancients. There were no drones, no
one could shell you from miles away, and IED’s did not threaten the local Roman legion. When
an ancient warrior went to war they usually saw the faces of their enemy, felt some control
over their fates. Along with this, danger was almost entirely constrained to planned
set pieces and short bursts of fighting on the battlefield. Once they were back at their
camp an ancient soldier’s mind could rest.
Modern Soldiers have no such refuge and need to be constantly vigilant. Explosions too
are common and concussions follow along with them.
It has been shown that concussions vastly contribute to the risk that PTSD will develop.
Being blown up and the effects of explosions was not something Caesar would have to take
into account.
Then we have culture.
The ancient world was much more violent than our own. A Roman inhabited a world in which
half of all children wouldn’t survive their first years. The sight of blood and death
was not as shocking to them as it would be to a modern human.
The expectations and social roles of soldiers were also entirely different.
Greek and Roman society, for example, told boys that being a good warrior, slaying their
enemies and bringing home loot was one of the most glorious things a man could do. By
going out and killing others a man was filling a vital and respected societal role.
While a 21st century person, even though they have been raised in a culture that respects
soldiers, upon killing will need to reconcile with an upbringing that taught them that killing
in any form is wrong.
Now while we are noting all this, it is important to take into account that we aren’t diagnosing
these ancient people with PTSD. While this ancient evidence does hint of reactions to
traumatic stress we should not simply slap a modern label on it.
It could be that there are many different forms of PTSD that can arise in different
cultures and civilsations at different times for different reasons.
What we can be certain of it that ancient soldiers did suffer something.
Especially because from and evolutionary viewpoint, short-term PTSD is a really good idea. After
being in danger you want to be hypervigilant, you want to wake easily, you want to be constantly
reminded of the thing that scared you.
Long-term PTSD though, is a problem. Rather than being prepared, people cease to function
in normal society.
Modern soldiers, especially Americans, are undergoing a massive spike in combat trauma.
Why is this?
Any upset in life will always have longer-lasting consequences if it isn't communalised. Experiences
need to be shared to be properly dealt with.
One of the reasons for the spike in PTSD cases after Vietnam was the suppression of grief
afterwards. According to Johnathan Shay this contrasts the grief recorded in the Iliad,
in which warriors on both sides engage in ceremonies of grieving each night.
"Open grief at the death of a comrade was fully accepted by the Homeric warriors. To
weep was to lose one’s dignity among American soldiers in Vietnam."
It is this communalisation of trauma and grief that could be why victims of massive disasters
tend not to suffer PTSD at rates such as those of combat veterans.
In 1915 an earthquake killed 30,000 people in Avezzano, Italy, in less than a minute.
The worst-hit areas had a mortality rate of 96 percent. The rich and poor died all the
same. Everyone that remained was tossed into a state of survival. Food, water, and shelter
became the only priorities.
“An earthquake achieves what the law promises but does not in practice maintain,” one
of the survivors wrote. “The equality of all men.”
During WW2 for nearly 60 consecutive days, German planes bombarded London, killing hundreds
with each run. This would be known as the Blitz. Eight million people endured an aerial
bombardment that would crack the minds of regular soldiers and yet mass hysteria didn’t
break out. Barely a case of individual hysteria broke out. Psychiatric wards across the country
saw admissions go down.
One doctor ventured to suggest that some people actually did better during wartime.
During the riots in Belfast between 1969 and 1970 the suicide rate dropped by 50%. Homicides
and other violent crimes also went down. Depression rates took a sharp decline all while chaos
took the streets.
“When people are actively engaged in a cause their lives have more purpose … with a resulting
improvement in mental health,” Irish psychologist H. A. Lyons wrote in the Journal of Psychosomatic
Research in 1979. “people will feel better psychologically if they have more involvement
with their community.”
Sometimes it takes sectarian violence, German bombers, and angry plate tectonics to make
modern humans speak to each other.
Humans are strongly wired to help one another and our brains enjoy doing so. After the September
11th terrorist attacks in New York there wasn’t a mass shooting for 2 years, the murder rate
dropped by 50% and even Veterans with PTSD noticed their symptoms improved in the months
following the attacks. The people around them no longer felt like complete strangers as
everyone was now connected by this traumatic event, for a while.
Tragedies, for a short time at least, transform us back into a tribe. It’s that bond that
traumatized people tend to miss.
Well then, what is it about modern society that triggers long-term trauma?
Lack of social support has been found to be twice as reliable at predicting PTSD as the
severity of the trauma itself.
As theorised by Sebastian Junger in Tribe, “Modern society has almost completely eliminated
trauma and violence from everyday life, anyone who does suffer those things is deemed to
be extraordinarily unfortunate. This creates an identity of victimhood that can delay recovery.
”
“A modern soldier returning from combat goes from the kind of close-knit group that
humans evolved for, back into a society where most people work outside the home, children
are educated by strangers, and personal gain almost completely eclipses collective good.
Whatever the technological advances of modern society, the individualized lifestyles that
those technologies spawn seem to be deeply brutalizing to the human spirit. "
When soldiers return from faraway wars they are returning to a society that is alienating
and self-serving.
If we look at Israel, which is probably the only modern nation currently at war that retains
a strong sense of community related directly to combat. The Israeli Defence Forces have
by some measures a PTSD rate as low as 1%, despite decades of non-stop violence. Why
is this.
Well the conflict is right at their doorstep and most people have done some sort of national
military service. According to Dr. Arieh Shalev “Those who come back from combat are reintegrated
into a society where those experiences are very well understood.”
Like we saw previously with the Blitz, according to Dr Shalev, the closer people are to the
war the more the community is able to understand and share the trauma.
As stated by Junger
“All the praise in the world doesn’t mean anything if you’re not recognized by society
as someone who can contribute valuable labor.”
Modern society just happens to be the worst possible one for a victim of trauma to be
integrated into. For the first time in human history a person living in a city or suburb
can spend an entire day surrounded by complete strangers.
Despite all our wealth and advancements our society is afflicted with some of the highest
rates of depression, schizophrenia, poor health, anxiety, and chronic loneliness in human history.
Rates of depression seem to follow urbanisation and wealth.
In war, soldiers tend to experience a tribal way of thinking, they have their unit and
that bond. When they return home they find out that the country they fought for doesn’t
feel like their tribe.
"It’s hard to know how to live for a country that regularly tears itself apart along every
possible ethnic and demographic boundary. In combat, soldiers all but ignore differences
of race, religion, and politics within their platoon. It’s no wonder many of them get
so depressed when they come home."
What modern soldiers and other trauma victims need in order to fight off the effects of
long term trauma is a functioning community that is ready to listen to and reintegrate
them as valuable members of the tribe.
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