When someone is in danger, it is natural and normal to feel afraid. This fear triggers the fight-or-flight response, causing split-second changes in the body to help it prepare against danger or to avoid it. This stress response is a healthy reaction that is meant to protect a person from harm. However, with post-traumatic stress disorder (PTSD), the body’s reaction is supercharged or damaged, making the person feel stressed or frightened even when there is no danger present (National Institute of Mental Health [NIMH], 2016).
In any year, approximately 5.2 to 7.7 million Americans struggle with PTSD. It can occur at any age, and women are more than two-and-a-half times more likely than men to develop PTSD (New York State Office of Mental Health, 2016; NIMH, 2016). An estimated 8% of Americans will experience PTSD at some point in their lives (Nebraska Department of Veterans’ Affairs, 2007). There is some evidence that susceptibility may run in families (NIMH, 2016). Globally, an estimated 3.5% of the world’s population has suffered from PTSD in the previous year (World Health Organization, 2013).
An Ancient Malady
PTSD is a new name for a disorder that is thousands of years old. Bentley (2005) provides an exhaustive review of the history of PTSD in his feature article in The VVA Veteran (a publication for Vietnam Veterans). Key events described in the article include the following:
- Three thousand years ago, Hori, an Egyptian combat veteran, wrote about the fear he was experiencing before going into battle.
- Romans, Greeks, and Egyptians broke and ran because of their fear of dying when faced with combat circumstances.
- The Greek historian Herodotus wrote about the battle of Marathon in 490 B.C.E. He described an event in which an Athenian warrior became permanently blind when the soldier standing next to him was killed, even though the blind soldier had no physical wounds.
- During the battle between the English and the Danes in 1003 C.E., the English commander Alfred reportedly became so violently ill that he was not able to lead his men.
- Swiss military physicians in 1678 were among the first to identify and name a group of behaviors that make up what was known as nostalgia (and are similar to current-day PTSD symptoms).
- German physicians diagnosed a similar problem in their troops at the same time as the Swiss and called it heimweh (homesickness), believing the symptoms resulted because the soldiers longed to return to their homes.
- French doctors called the same symptoms maladie du pays (“homesickness”) and the Spanish called these reactions in their soldiers estar roto (“to be broken”).
- The Russian army of 1905 was the first army in history to recognize that “mental collapse” was a direct result of the stress of war. They regarded it as a legitimate medical condition.
- During the last stages of World War I, U.S. physicians realized that psychiatric casualties were not “shell shock” but emotions that caused soldiers to collapse with a wide range of symptoms. Many physicians believed that these men were “weak in character.”
- During World War II, almost 38% of the soldiers who saw direct combat had serious psychiatric issues, and it became clear that it was not just the “weak” in character who were having psychiatric breaks. The term combat fatigue gave way to combat exhaustion.
- The Korean War resulted in over 24% of the soldiers experiencing “psychiatric casualties” as a result of the trauma of combat.
Between 1959 and 1973, over 58,000 U.S. soldiers died in the jungles of Vietnam, Laos, and Cambodia. Ongoing psychological distress was common, but veterans had difficulty obtaining disability benefits because there was no accepted psychiatric diagnosis for their emotional and behavioral anguish (Jones, 2005).