Friday, October 7, 2011

Post-Traumatic Stress Disorder


Shell Shock is not just a First World War condition, but is seen in modern day soldiers. Shell Shock, also called Combat Stress Reaction, Battle Fatigue, Post-traumatic Stress Disorder or Traumatic Neurosis is an anxiety-based disorder most commonly caused by combat stress.

Shell Shock was first identified by an over activation of the startle reaction. There are three components to the set of symptoms: reactions, trouble sleeping and emotional disturbance.

In the first segment of symptoms, loud noises, quick motion and sudden bright lights may evoke an overreaction, jump or startled jerk. In the second segment, sleep disturbances may include an inability to fall asleep, nightmares or battle dreaming. In the third segment, irritability and snap anger can lead to unintended reactionary violence.

The term Shell Shock was first used by doctors to describe the intense symptoms of returning solders after the First World War in those that would otherwise be considered mentally stable.

Depending on the country and the particular war, the psychiatric community has referred to post-war emotional reactions in a variety of ways. The symptoms include all those described as Shell Shock but may include more symptomology and rate the degree of particular symptoms.

Russian doctors called the symptoms Traumatic Neurosis. They were among the first recognize the mental trauma resulting in autonomic responses to either traumatic combat or prolonged combat stressors.

The diagnosis of Combat Stress Reaction was popularized for military compensation claims after World War II included symptoms depression or melancholy as well as the jerking reflex. Many soldiers appeared to be deep in thought until startled from their mournful contemplation.

Another term for Shell Shock was Battle Fatigue added lethargy to the list of indicators. Returning soldiers with slowness of thought and reaction time (except when startled) as well as difficulty with prioritizing or creating a daily routine were diagnosed with this variant after World War II and other subsequent combat venues.

Since the Vietnam War ended, Post-traumatic Stress Disorder became the popular diagnoses for soldiers returning from combat. This diagnosis has undergone a redefinition to include anyone who has undergone a traumatic stress and exhibits enough of the symptoms to fit the category. For the purposes of military compensation claims Post-traumatic Stress Disorder has recently been given a particular time frame which limits the most intense symptoms for 90 – 120 day duration. After which the medical community has deemed the most appropriate term: Shell Shock.

It is not uncommon for returning soldiers to exhibit some symptoms of Shell Shock to a greater or lesser degree for the remainder of their lives. For this reasons military compensation claims should cover the cost treatment and provide the income to reduce daily stress so the soldiers have the time required to recover from their honorable, yet traumatic service.

Shell Shock by any other name includes an intense jump or jerk reaction to what would otherwise be common movements, sounds or lights within daily living. The added stress and anxiety creates a physical, involuntary reaction activating the fight or flight response which in all likelihood saved their lives in battle but creates social difficulties in civilian life.

If someone you know suffers from Shell Shock, there is an increased chance their diagnosis will be termed PTSD or Depression. With corrective therapy it is possible to overcome many of the symptoms and return to a functioning member of society.


** Thanks to the National Archive for the Photo of WWI soldiers crossing a bridge (c) 1918. http://www.archives.gov/

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