Combat Fatigue & PTSD

These days everyone has heard of PTSD (Post Traumatic Stress Disorder). The symptoms have been around since ancient times but had never defined as a diagnosis until 1980 when the DSM-III first introduced the term and diagnosis derived from studies of Vietnam War veterans. Although the first diagnosis of PTSD was based on combat experiences, the disorder can come from any traumatic event. Yet the disorder occurs more often in combat veterans, whether officially diagnosed or not.

During World War I the military used the term “shell shock” to describe men who came off the battle field unable to function normally. These men had spent too much time in the trenches with artillery shells bursting around them and machine gun fire rattling their brains. The only treatment was rest and hope that the men would eventually return to normal. Many never did.

By the time World War II started, the medical field had advanced in all areas, including in treatment of mental health problems. The term for PTSD used in WWII was “Combat Fatigue” or “Battle Fatigue.” If a soldier, sailor, airman or marine showed symptoms, his commanding officer sent him off the battlefield to a medical facility close to the front lines, such as the battalion aid station or clearing station, like any other casualty. Treatment consisted of medication to knock the soldier out for a couple of days. Once the patient woke up from his medically induced sleep, he usually felt better, maybe not good enough to return to duty, but better. The thinking in the medical community was to keep the man in the field, close enough to the fighting that he could hear the artillery fire, rather than sending him far back to a Rest and Recreation Center. With time to rest in a safe place, most of the men could return to duty. Often they didn’t return to their combat unit but to some other type duty.

Servicemen whose Combat Fatigue was so bad that they didn’t bounce back were sent to a General Hospital in the Theater of Operations and assigned to a neuropsychiatric ward. There the men received psychiatric care and, eventually, returned to the states. Depending on the severity of the symptoms and the response to treatment, the servicemen might be kept in the hospital for a while and then discharged. Severe cases remained hospitalized for longer periods of time. Forty percent (40%) of all medial discharges during World War II were due to Combat Fatigue.

Many other servicemen who returned from the war showed symptoms of PTSD but were never diagnosed. Families noticed the changes in them but the military offered no help. Some untreated sufferers, unable to return to some form of normal life, turned to alcohol, drugs or violence. Many of these ended up in jail or, worse, committed suicide.

If you want more information about PTSD/Combat Fatigue during WWII, I have included some links to interesting articles below:

The Perilous Fight – A PBS article about the mental toll of combat.

Warfare History Network article about combat fatigue

Article from Patton’s Best Medics about Combat Exhaustion

The following links are to training films made during WWII.

Combat Fatigue Irritability Film 1945 – Starring Gene Kelly, the famous actor, dancer, producer and director.

Introduction to Combat Fatigue 1944 – A film intended for patients to explain their illness.

Combat Exhaustion 1943 A training film for military physicians.

Let There Be Light, a documentary film by John Huston about soldiers suffering from psychiatric wounds and their treatment. It was intended to help the public understand the men returning from war. This film was suppressed by the military until the 1980’s because it was deemed controversial and demoralizing.

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