Remembering Combat Stress

100 years ago, World War 1 started. And with it started a modern phenomenon - post-traumatic stress disorder or PTSD. With much of the focus on the dead and physically wounded, the mentally ill were often overlooked. Some were shot for cowardice - as though british stiff upper lip were enough to 'snap out' of a severe psychaitric condition where trauma has re-propgrammed the brain. Stigma against mental illness has been around for a long time...

The technical term in WW1 was 'shell shock', but the doctors who treated it were clear its origins were psychiatric. Among these was Colonel Rivers, who was among the first to treat PTSD at the Craiglockhart Hospital - near where I work today. Among his famous patients were the war poets Sigfried Sasoon [picture here] and Wilfred Owen. Read more about the history.

Watch this 3 minute BBC video about Shell Shock and PTSD, starting with actual footage from Craiglockhart.

PTSD Today

The stigma of mental illness combines with the stigma of being a wounded veteran of an increasingly distant combat, which is not a nice combination. The physical damage cause and the psychological shock are accompanied by other huge questions like "Why?" or "Did I do something wrong?". Depression is a common co-morbid condition. Medication helps to some degree [anti-depressants, anti-psychotics, alpha-blockers], Cognitive Therapy can help process the memories back where they belong. But for many it is an ongoing battle - one that can affect behaviour such that the army discharge can be just as dishonourable as 100 years ago. I can think of many patients whose war experiences left them unable to function, turning to drink and fighting, and then being cashiered in the most ignoble way - all because they saw someone die...

The 100th anniversary of WW1 is a time when we can remember those who were first diagnosed with PTSD - and how many in the millenia before? As churches remeber those who have died - and churches have a special place in our ceremonies as the news of today has made clear - perhaps they can also remember those who still suffer today. Not suffering in their bodies or their souls - for they were physically unharmed and have come to terms with their acts of war - but those who suffer in their minds. They are trapped in the 'blast from the past', thinking it may happen again in their immediate present. The soldiers of WW1 may no longer be alive, but those who grew up in houses racked by PTSD still live today - still fearful for 'dad's temper', still never sure how he would react when you jumped playfully on his back.

Partners in Hope

For almost 90 years, one charity called Combat Stress has been pushing for greater recognition of the mental welfare of ex-servicemen and making sure the support is available for them for the long term through homes, respite care and outreach. Many do not get ongoing support from the Ministry of Defence after being discharged from the services. You can read more about their work at www.combatstress.org.uk and make a donation online.

Rob Waller, 04/08/2014