PTSD causes the brain to stay in survival mode, producing stress hormones like adrenaline and norepinephrine. These hormones lead to a number of symptoms, including avoidance; increased arousal, such as difficulty sleeping, hypersensitivity to stimuli, or anger outbursts; and negative cognitions and mood. Although the formal recognition of when was PTSD discovered came when it was added to the Diagnostic and Statistical Manual of Mental Disorders in 1980, the condition’s symptoms have been observed for a long time, with its discovery and understanding evolving over time.
Symptoms of PTSD were first described in history under a variety of names, such as “railway spine” and “shell-shock.” Research led to the diagnosis of PTSD in 1980. Since then, new treatments for PTSD have emerged, such as eye movement desensitization and reprocessing (EMDR).
World War I
The term PTSD was first used in 1980 to describe a disorder defined by the American Psychiatric Association (DSM-III). This diagnosis moved away from the idea that trauma was caused by something within the victim and towards recognizing that outside stressors can also trigger the condition. The 1980 diagnosis is widely credited for helping to shift public perception of the effects of war and other traumatic events.
Civil War:
Although the symptoms of PTSD have been known for centuries, it wasn’t until the Civil War that physicians began to document them and create treatment options. This was the first war where soldiers were exposed to new and terrifying technology including poison gas and aerial combat. As a result, thousands of soldiers were left with what would later be described as PTSD. Despite this, military leadership struggled to align beliefs in heroism and masculinity with the reality of men who suffered invisible wounds.
World War I:
The outbreak of World War I brought with it an entirely new set of psychological problems. Some of these were immediately apparent, such as the heightened anxiety experienced by troops who witnessed a friend or family member killed in action. Others, such as sleep issues and recurring nightmares were less easily diagnosed. The introduction of aerial warfare and other terrifying new tactics introduced to the front lines by WWI created a whole new set of stresses that exacerbated existing mental health issues like depression and anxiety.
By the end of the war, many of these new traumas were being recognized and treated, but at the time PTSD was still viewed as something that affected only weak individuals. This attitude was perhaps fueled by the fact that many of the same symptoms were also found in civilians who had been exposed to wartime trauma such as fire bombings and gas attacks. In addition, the use of alcohol and drugs to treat immediate symptoms was common as depicted by Captain Stanhope’s attempt to drink away his fear in the novel Journey’s End. These self-medicating behaviors often exacerbated untreated cognitive symptoms and led to an ineffective overall treatment.
Modern PTSD Treatments
Psychiatrists today are able to treat many different aspects of PTSD, such as nightmares and flashbacks, through psychotherapy and medication. In particular, techniques such as Eye Movement Desensitization and Reprocessing have been shown to help patients who have PTSD by using the same kind of brain patterns that occur during REM sleep to process memories of the traumatic event and reduce their distress.
Another important change since the 1960s and 1970s has been that veterans themselves have become advocates for their own mental health care and helped to redefine PTSD from a sign of weakness to a normal response to a traumatic experience. This, along with greater awareness of PTSD from victims of domestic abuse, child abuse and rape, has made it easier to recognize and diagnose PTSD. The current DSM-lll (2013) continues to refine our understanding of PTSD and its causes. In the future it is hoped that advances in our understanding of the biological and psychological causes of trauma will allow us to prevent and treat PTSD more effectively.