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Battle Fatigue, Shell Shock, PTSD: The Three Scary Faces of War

Seeing the consequences of war on social media, there is no question that the public is aware of the terrifying situation in countries that became center of the conflict. Unfortunately, consciousness about warfare ends there — for most people, at least.

What many people don’t see on social media — or anywhere else for that matter— is the three scary faces of war from the perspective of those in the frontlines. Soldiers, medical personnel, even members of the documentation staff face these three crippling effects of warfare: battle fatigue, shell shock, and PTSD.

Battle Fatigue, Shell Shock, and PTSD: What is the Difference?

Out of the three terms, PTSD is probably the most common in this modern society. It stands for post-traumatic stress disorder and, as you may already know, is a mental condition that occurs after a frightful situation occurred in the patient’s life.

Although the term was officially added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, the condition itself has always been present since the time when humans were hunting or were being hunted by saber-tooth tigers. It just wasn’t called PTSD back then.

After President Wilson declared November 11 as Armistice Day, soldiers and other people who were on the front lines of the World War I showed signs of PTSD.

At the time, the condition was called “shell shock” because experts initially believed it to be a reaction from the explosion of artillery shells. Shell shock was considered a condition describing potential damage to the human brain caused by explosives and big guns.

However, after other military personnel who weren’t on the frontlines showed similar shell shock symptoms, the term evolved into “w[G2] ar neuroses.” Patients were given varying treatments, including hydrotherapy, electrotherapy, and hypnosis. Others were merely allowed to rest for a few days, only to be brought back to war zones. Those with chronic or severe symptoms were forced.

Then, in battle fatigue, also known as Combat Stress Reaction (CSR), was born. During World War II, soldiers reported being exhausted about the seemingly unending conflict. Although military leaders for the United States like Lieutenant Gen. George S. Patton didn’t believe the condition was real, experts eventually treated CSR using the principles of PIE, or Proximity, Immediacy, Expectancy.

However, it wasn’t after about four decades later before PTSD was officially recognized by the American Psychological Association (APA).

General and Specific Symptoms of PTSD, Battle Fatigue, or Shell Shock

Given that the three faces of war are actually one massive aftereffect of governments, societies, and people clashing with each other, there are several universal symptoms for PTSD, battle fatigue, and shell shock, including:

  • exhaustion;
  • decreased in responsiveness;
  • indecision and uncertainty;
  • feeling disconnected; and
  • inability to focus.

But while these are signs common among all PTSD patients, there are certain individuals show various symptoms that aren’t typical in every patient.

At one point, soldiers who had a first-hand experience with explosives and gunfire often show signs of [G4] sudden deafness or muteness, tremors, inability to walk or even stand, convulsions, and unexpected and medically unexplainable loss of consciousness. It is important to note, however, that while shell shock is a previous name given to what we now know as PTSD, it is — in this case — a unique face of warfare.

There are also experts who classified battle fatigue or CSR as a condition different from PTSD in a sense that it is more short-term than the latter although symptoms are quite alike. Patients with CSR find themselves affected in three ways: emotionally, mentally, and physically.

Emotional symptoms include frustration, anxiety, and mood swings. Patients may also feel sad or hopeless and may experience nightmares related to their traumatic experience in the battlefield.

Physically, they may experience inexplicable body pains, increased heart rate, sweating, and difficulty breathing. Female patients may also experience irregularity or sudden change in their menstrual cycle. There are also some who sleep too much or too little while others eat more or less than they usually do.

Mentally, war veterans and others caught in the crossfire may also experience obsessive thoughts about the event that caused their trauma. Some may also become paranoid while others often think of death or dying more often than a person normally would. Patients also show signs of decreased focus and concentration as well as impulsiveness in making decisions.

Although these three are what doctors consider in their diagnoses, relatives and loved ones may also notice behavioral changes such as alcohol abuse, compulsiveness, paranoia, self-imposed isolation, decreased sexual activity, and impatience to the point of aggressiveness.

PTSD: An Evolving Condition that Requires Progressive Treatment

Since it wasn’t initially known to man, PTSD wasn’t as it is now. As you may have noticed in the discussion about its main difference with shell shock and battle fatigue, PTSD is still evolving.

As the years passed, treatment has also grown to be more progressive and effective. Techniques like psychotherapy — where PTSD patients are brought into fear-triggering scenarios in a safe environment, so they can replace the traumatic memory with new ones — have been developed. This treatment is designed to help patients of post-traumatic stress develop skills to cope, including relaxation, mindfulness, and regulation of emotion.

But even with this, there remains a big gap between treatment and the disorder as older memories are more difficult to get over and patients require stability for the therapy to work.

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