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Post-traumatic stress

The wounds of war

Psychiatric casualties are nowadays recognised as an inevitable consequence of modern warfare, yet just 100 years ago, they were rarely acknowledged and even more rarely treated. Mike Cardwell looks at the relationship between the stress of warfare and the development of psychiatric illness, particularly post-traumatic stress disorder.

The term post-traumatic stress disorder originated in studies made of soldiers who served in the Vietnam War
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The origins of post-traumatic stress disorder (PTSD) can be found in studies of combat veterans, although prior to the Vietnam War in the 1960s and early 1970s, it was referred to in other terms (shell shock, combat fatigue and soldier’s heart). The official psychiatric definition of post-traumatic stress disorder came after large numbers of soldiers returning from the horrors of the Vietnam War displayed similar symptoms. Even then, many of those who advocated US involvement in Vietnam labelled this as a made-up illness that was part of the anti-war propaganda on behalf of those who did not support the war.

The US government conducted the National Vietnam Veterans’ Readjustment Study (NVVRS) to understand better the development of PTSD from this war. The findings were alarming. At the time of the study, over a decade after the end of the Vietnam War, approximately 15% of the men and 9% of the women who served in Vietnam were found to have PTSD. When these figures were adjusted to include all those veterans who had experienced PTSD at some point in their life following Vietnam, the figures rose to 30% for men and 27% for women. These findings showed that for many veterans, their PTSD had become a chronic (persistent and long-lasting) condition. The general public has fortunately learned about PTSD through the film industry rather than through actual involvement in warfare. Films about the Vietnam War, such as Apocalypse Now, The Deer Hunter and Born on the Fourth of July, emphasise the difficulties of war veterans dealing with the issues that accompany PTSD.

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The Three Faces of Eve

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Post-traumatic stress

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