Combat Stress

Combat stress is a very close relation to Post Traumatic Stress Disorder (PTSD) with some slight differences and some major differences.

Both refer to a mental / physiological disorder; through stress / anxiety, related to a Traumatic experience. Although there are some similarities, Combat Stress differs from normal PTSD, (if there is such a thing as Normal PTSD), in so much that only those that have been in a combat situation or, have had extensive dealings with people that have experienced combat can understand the suffering from Combat Stress.

Perhaps there should be another category added, Post Combat Traumatic Stress Disorder or, Post Traumatic Combat Stress Disorder.

It is not modern phenomena dreamt up by modern science nor, a new money making disease / disorder /scam dreamt up by pharmaceutical companies to enhance their profits. It is, Reality.

The disorder; was first describe in 5th Century BC by the Greek historian Herodotus when writing about the Battle of Marathon in 490BC, he described an Athenian soldier that had suffered no physical injuries from the battlefield but who; after witnessing the death of a fellow soldier had gone completely and permanently blind. (However it should be noted that Herodotus circa 484 – 425BC, would have been approximately 6 years of age at the time of the Battle of Marathon)?

There have probably been many instances of Combat Stress through out the ages which have never been recognized although it was noted, that some soldiers fighting in the Napoleonic wars with Wellington (1803 -1815), were suffering from Battle Fatigue and if they were lucky they were given a short rest from the battle.

It was also noted that during the American 1861-1865 that a number of soldiers were suffering from, “Soldiers Heart,” which today would be recognised as Combat Stress Reaction. (It could not have been fun marching in formation to wards a battery of enemy cannon fire only to survive that and then be met with volley after volley of musketry fire).

Sometime between (1894 -1904) the Russians were the first to specifically recognize / diagnose a mental disorder due to the effects of war stress and tried to treat it.

It was not until WWI (1914-1918) and the mass slaughter of soldiers through Frontal attacks against massed machine guns and the constant bombardment whilst in the comparative safety of their own trenches that the high level of mental disorders associated with Combat Stress / shell shock / traumatic war neurosis, came as a surprise to commanders and doctors.

In 1915 a directive issued by The British Army indicates there was still little understanding of the problem and effect of constant fear and tension on the minds of their soldiers:
"Shell-shock and shell concussion cases should have the letter 'W' prefixed to the report of the casualty, if it were due to the enemy; in that case the patient would be entitled to rank as 'wounded' and to wear on his arm a 'wound stripe'. If, however, the man’s breakdown did not follow a shell explosion, it was not thought to be ‘due to the enemy’, and he was to be labeled 'Shell-shock' or 'S' (for sickness) and was not entitled to a wound stripe or a pension."

1915: Charles Samuel Myers was given a commission in the Royal Army Medical Corps and in 1916 was appointed Consultant Psychologist to the British Army in France and it was during this time he is credited with coining the term, Shell Shock.
He is also credited with working hard to get the idea of treatment for, “Shell Shocked,” injured soldiers accepted by the Army and its commanders, by creating treatment centres close to the front line with prompt treatment, suitable environment and Psychotherapeutic treatment available. He also tried Hypnotherapy with limited success.

In December 1916 Gordon Morgan Holmes who had a less than compassionate approach and had a far tougher attitude which was more in line with the Army mindset at the time; so his views prevailed and he was put in charge of the Northern part of the front line.

By 1917 all British “Shell Shock,” cases were evacuated to local neurological centres for treatment. But due to the Adjutant Generals mistrust of the doctors, no treatment could be given until a form, (AF3436), was completed by the commanding officer of the soldiers unit. This created significant and damaging delays to the soldiers’ treatment.

During WWI, 306 British soldiers were executed for cowardice, many of them victims of Shell Shock.

(Personal note: I once heard a quote that; “a hero dies only once, but a coward dies many times,” I often wonder how many of those so called cowards were grateful for the final death and how many soldiers marched forward into the wall of bullets from massed machine guns, not out of heroics, duty or being urged forward, but just wanted to put and end to their own suffering)?