PTSD in Pre-Modern/Perpetual Conflict Societies

[Queequeg]

Watching Downtown Abbey got me thinking about the phenomenon of Shellshock.  I know that something similar happened in the Napoleonic wars, but I am having trouble finding a reference to some kind of similar totally debilitating anxiety disorder.  There seems to be a lot more comfort with warfare.  I might be wrong, though.  Are there records and studies of anxeity disorders in people who lived in areas as conflict-stricken as Medieval or Early Modern Europe?  Do we have references to post-battle anxiety dating back a long period?

[HVC]

I think, but I could definitely be wrong, but in a society where death was much more common PTSD would be less common. You'd have a few siblings you watched die as kids, more the likely seen live stalk slaughtered, etc. hell if your neighbor got a splinter on day there's a good chance he'd be dead by the next.

[HVC]

Also, most conflict were intense, but short lived. Not months and years if explosions. Even sieges were waiting punctuated with a few attacks.

[jimmy olsen]

Watching Downtown Abbey got me thinking about the phenomenon of Shellshock.  I know that something similar happened in the Napoleonic wars, but I am having trouble finding a reference to some kind of similar totally debilitating anxiety disorder.  There seems to be a lot more comfort with warfare.  I might be wrong, though.  Are there records and studies of anxeity disorders in people who lived in areas as conflict-stricken as Medieval or Early Modern Europe?  Do we have references to post-battle anxiety dating back a long period?

If you're interested in this topic, then read this book.

[Siege]

This is too heavy a read for me today.
I'll read it tomorrow.

[Queequeg]

I think, but I could definitely be wrong, but in a society where death was much more common PTSD would be less common. You'd have a few siblings you watched die as kids, more the likely seen live stalk slaughtered, etc. hell if your neighbor got a splinter on day there's a good chance he'd be dead by the next.

I was wondering the same thing-if the daily exposure to the death of people and comfort with general butchery would somehow deafen the anxiety.  Also worth noting is that before the massed artillery of the Napoleonic Conflict I don't think we are dealing with war as a total assault on the very limits of the human senses in the same way-the constant artillery and maintenance of something as complex, economically useless and unhygenic as the Western Front's trenches would have been impossible. 

Also would be interesting to compare PTSD between WW2 vets and WW1-Vietnam vets.  If somehow the "good" nature of the war changed perceptions on it.

[Razgovory]

Part of the problem is that terms like PTSD get thrown around to much.  I think there is a whole category of combat related mental illnesses that get lumped together as PTSD even if they have different symptoms and different causes.  For instanced the term "Shell Shocked", is sometimes taken to mean "PTSD", but probably covered a wide range of problems such as concussion, depression, extreme anxiety, and simple mental and exhaustion.

[The Brain]

Part of the problem is that terms like PTSD get thrown around to much.  I think there is a whole category of combat related mental illnesses that get lumped together as PTSD even if they have different symptoms and different causes.  For instanced the term "Shell Shocked", is sometimes taken to mean "PTSD", but probably covered a wide range of problems such as concussion, depression, extreme anxiety, and simple mental and exhaustion.

Yeah.

[syk]

Part of the problem is that terms like PTSD get thrown around to much.  I think there is a whole category of combat related mental illnesses that get lumped together as PTSD even if they have different symptoms and different causes.  For instanced the term "Shell Shocked", is sometimes taken to mean "PTSD", but probably covered a wide range of problems such as concussion, depression, extreme anxiety, and simple mental and exhaustion.

That's for non-psychiatric sources I hope. The criteria for that diagnosis are quite clear for the ICD and DSM.
ICD 10 has PTSD as as a subset of an acute stress reaction

F43.1Post-traumatic stress disorder

Arises as a delayed or protracted response to a stressful event or situation (of either brief or long duration) of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone. Predisposing factors, such as personality traits (e.g. compulsive, asthenic) or previous history of neurotic illness, may lower the threshold for the development of the syndrome or aggravate its course, but they are neither necessary nor sufficient to explain its occurrence. Typical features include episodes of repeated reliving of the trauma in intrusive memories ("flashbacks"), dreams or nightmares, occurring against the persisting background of a sense of "numbness" and emotional blunting, detachment from other people, unresponsiveness to surroundings, anhedonia, and avoidance of activities and situations reminiscent of the trauma. There is usually a state of autonomic hyperarousal with hypervigilance, an enhanced startle reaction, and insomnia. Anxiety and depression are commonly associated with the above symptoms and signs, and suicidal ideation is not infrequent. The onset follows the trauma with a latency period that may range from a few weeks to months. The course is fluctuating but recovery can be expected in the majority of cases. In a small proportion of cases the condition may follow a chronic course over many years, with eventual transition to an enduring personality change (F62.0).

The DSM criteria are on wikipedia.

[Siege]

Ok, I just read the last two post,

Don't confuse PTSD with TBI (traumatic brain injury)
PTSD is mental, TBI is actual physical damge to your brain, as in getting blown the fuck out in an IED strike.

[Siege]

PTSD is more what you live through, as in the boys you lose, the firefights you survive unscathed, while others don't.
TBI is actual brain damage from explosions or bullet/frag impacts.
When you get blown the fuck out, even if you don't bleed, you might have TBI from explosion.
TBI is the unseen injury.

[Martinus]

There is also one aspect you are ignoring that may be relevant - Napoleonic wars, as far as I am aware, were one of the first ones to use mass conscription.

The wars of antiquity, middle ages and pre-Napoleonic era used either some sort of a warrior caste or mercenaries, especially in protracted, foreign campaigns - unless you were defending your own strip of land, noone expected, say, burghers or peasants to participate in extended foreign military expeditions.

The invention of a rifle democratized the battlefield - you could get a soldier by getting a common man, giving him a gun and spending a couple of weeks teaching him how to use it - that would have been impossible with a morgenstern or a longbow. But that also meant you didn't have enough time to build the long term exposure and resistance to violence.

[CountDeMoney]

There seems to be a lot more comfort with warfare. 

Really?

[Razgovory]

Part of the problem is that terms like PTSD get thrown around to much.  I think there is a whole category of combat related mental illnesses that get lumped together as PTSD even if they have different symptoms and different causes.  For instanced the term "Shell Shocked", is sometimes taken to mean "PTSD", but probably covered a wide range of problems such as concussion, depression, extreme anxiety, and simple mental and exhaustion.

That's for non-psychiatric sources I hope. The criteria for that diagnosis are quite clear for the ICD and DSM.
ICD 10 has PTSD as as a subset of an acute stress reaction

F43.1Post-traumatic stress disorder

Arises as a delayed or protracted response to a stressful event or situation (of either brief or long duration) of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone. Predisposing factors, such as personality traits (e.g. compulsive, asthenic) or previous history of neurotic illness, may lower the threshold for the development of the syndrome or aggravate its course, but they are neither necessary nor sufficient to explain its occurrence. Typical features include episodes of repeated reliving of the trauma in intrusive memories ("flashbacks"), dreams or nightmares, occurring against the persisting background of a sense of "numbness" and emotional blunting, detachment from other people, unresponsiveness to surroundings, anhedonia, and avoidance of activities and situations reminiscent of the trauma. There is usually a state of autonomic hyperarousal with hypervigilance, an enhanced startle reaction, and insomnia. Anxiety and depression are commonly associated with the above symptoms and signs, and suicidal ideation is not infrequent. The onset follows the trauma with a latency period that may range from a few weeks to months. The course is fluctuating but recovery can be expected in the majority of cases. In a small proportion of cases the condition may follow a chronic course over many years, with eventual transition to an enduring personality change (F62.0).

The DSM criteria are on wikipedia.

Sort of.  Shell Shocked is a WWI term and treatment and knowledge of mental illness is better known now.  Still PTSD is used to often in the media for other combat related illnesses such as TBI.

[garbon]

Part of the problem is that terms like PTSD get thrown around to much.  I think there is a whole category of combat related mental illnesses that get lumped together as PTSD even if they have different symptoms and different causes.  For instanced the term "Shell Shocked", is sometimes taken to mean "PTSD", but probably covered a wide range of problems such as concussion, depression, extreme anxiety, and simple mental and exhaustion.

That's for non-psychiatric sources I hope. The criteria for that diagnosis are quite clear for the ICD and DSM.
ICD 10 has PTSD as as a subset of an acute stress reaction

F43.1Post-traumatic stress disorder

Arises as a delayed or protracted response to a stressful event or situation (of either brief or long duration) of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone. Predisposing factors, such as personality traits (e.g. compulsive, asthenic) or previous history of neurotic illness, may lower the threshold for the development of the syndrome or aggravate its course, but they are neither necessary nor sufficient to explain its occurrence. Typical features include episodes of repeated reliving of the trauma in intrusive memories ("flashbacks"), dreams or nightmares, occurring against the persisting background of a sense of "numbness" and emotional blunting, detachment from other people, unresponsiveness to surroundings, anhedonia, and avoidance of activities and situations reminiscent of the trauma. There is usually a state of autonomic hyperarousal with hypervigilance, an enhanced startle reaction, and insomnia. Anxiety and depression are commonly associated with the above symptoms and signs, and suicidal ideation is not infrequent. The onset follows the trauma with a latency period that may range from a few weeks to months. The course is fluctuating but recovery can be expected in the majority of cases. In a small proportion of cases the condition may follow a chronic course over many years, with eventual transition to an enduring personality change (F62.0).

The DSM criteria are on wikipedia.

Sort of.  Shell Shocked is a WWI term and treatment and knowledge of mental illness is better known now.  Still PTSD is used to often in the media for other combat related illnesses such as TBI.

Of course it isn't the case that a psychiatrist has ever given a misdiagnosis.