PTSD - Post-Traumatic Stress Disorder

During the early 1800's military doctors began diagnosing soldiers with "exhaustion" following the stress of battle. This "exhaustion" was characterized by mental shutdown due to individual or group trauma. The only treatment for this "exhaustion" was to bring the afflicted soldiers to the rear for a while then send them back into battle. Through extreme and often repeated stress, the soldiers became fatigued as a part of their body's natural shock reaction.

During that time, in England, there was a syndrome know as "railway spine" or "railway hysteria" that bore a remarkable resemblance to what we call PTSD today, exhibited by people who had been in the catastrophic railway accidents of the period. In 1876 DR. Mendez DaCosta published a paper diagnosing Civil War combat veterans with "Soldiers Heart": The symptoms included startle responses, hyper-vigilance, and heart arrhythmia's.

During WWI overwhelming mental fatigue was diagnosed as "soldier's heart" and "the effort syndrome". An article published on a now restricted Internet web site maintained by Med. Access entitled "Chronic Fatigue Syndrome" states that "...some 60,000 of the British forces were diagnosed with the problem and 44,000 of these were retired from the military because they could no longer function in combat". (www.medaccess.com/cfs/cfs_02.htm (this page is no longer accessible without a password))

The term "shell shock" emerged during WWI followed in WWII by the term "combat fatigue." These terms were used to describe those veterans who exhibited stress and anxiety as the result of combat trauma. The official designation of "Post Traumatic Stress Disorder" did not come about until 1980 when the Third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published.

The Diagnostic and Statistical Manual of Mental Disorders (DSM). This "bible", published by the American Psychiatric Association (APA) provides the "official" definition of all mental illnesses. When first published in 1952 what we now know as PTSD was called "stress response syndrome" and was caused by "gross stress reaction".

In the DSM-II (1968), trauma-related disorders were lumped together in an area called "situational disorders".