Psychiatric Disorders, Combat Related

As soldiers experience the strain of combat, psychiatric disorders sometimes develop. In earlier wars, notably the Civil [Page 670]War, military medical personnel, as well as the larger military establishment and the general public, failed to recognize the severity of psychiatric trauma related to battle. During World War I, however, when “shellshocked” doughboys reacted psychologically to the dire circumstances of combat in Europe, modern psychiatry began to seriously consider and treat the psychological effects of combat on the soldiers, and the term psychoneurosis came into use, replaced by the term combat fatigue during World War II. The stress of guerrilla warfare that soldiers in the Vietnam War faced, however, increased a particular kind of psychological trauma, one that struck often after soldiers returned to their civilian lives. This phenomenon has been identified as posttraumatic stress disorder (PTSD), a term that has entered the general nonmilitary medical lexicon and is now used as a diagnosis for a range of reactions to severe stress.

Combat fatigue and PTSD are separate but closely related medical conditions brought about by the stresses inherent in war and combat. PTSD is an emotional reaction that occurs in soldiers or veterans after they have left the combat zone, sometimes long after, whereas combat fatigue, which has also gone by other names as discussed below, refers to the emotional and psychological impairment of soldiers still in the combat environment. The severity of disablement can vary considerably, but combat fatigue generally prevents a soldier from continuing to function in combat, at least temporarily, while PTSD impairs a soldier or veteran's ability to function in society after returning from combat. PTSD, broadly applied, includes stress related illnesses that anyone might suffer following a traumatic event, such as a serious accident or natural disaster, but the term was first applied to Vietnam War veterans suffering from various emotional problems related to their war experience.