What we label today as post-traumatic stress disorder was called “nostalgia” during the Civil War because doctors felt the condition was due to homesickness. In WWI, it was called “shell shock”. The disability was first called the “Guadalcanal Disorder” in WWII because in the first campaign of the war, the number of cases was high. Symptoms included ““sensitivity to sharp noises, periods of amnesia, tendency to get panicky, tense muscles, tremors, hands that shook when they tried to do anything. They were frequently close to tears or very short-tempered.” And since it was the Marines that were coming down with it, it became apparent that even the toughest Americans were susceptible to it. During the war, over 500,000 American military personnel were lost to “psychiatric collapse”. It accounted for 40% of discharges. In a survey of soldiers in the European Theater, 65% admitted to at least one incident of inability to perform due to fear. A total of 1,393,000 cases of combat fatigue were recorded during the war.
Originally, it was felt that combat fatigue would occur to soldiers who already had psychological instability. The Army tried to avoid the problem by questioning the enlistee or draftee at their physical. However, it turned out that mental problems were not a good predictor of potential combat fatigue. There was a belief that once fighting started, the GI would forget his fear because he was too busy. That proved to be false. It soon became obvious that “there is no such thing as ‘getting used to combat’”. Ability to withstand the stress of combat drains according to the intensity and duration of combat. Most soldiers had a finite amount “in the tank” and when it was sapped, you might snap. The duration varied. It was found that 98% of American soldiers in Normandy suffered from combat fatigue after 60 days in combat. The British had a better feel for the problem. They routinely gave a frontline soldier four days of rest for every 12-14 days in battle. Americans routinely were at the front for up to 80 days before getting some relief. A soldiers performance peaked at 90 days and then began going downhill until having to get medical care.
It became clear that “psychiatric casualties are as inevitable as gunshot and shrapnel wounds.” Not everyone accepted that finding, Patton being the most famous example of the outdated view that combat fatigue simply referred to cowardice. In 1943, a committee of 39 psychiatrists, psychologists, and social scientists produced a 456-page manual for soldiers called Psychology for the Fighting Man: What You Should Know About Yourself and Others. The book offered advice on every aspect of a soldier’s life, from morale and training to food and sex. But it devoted only nine pages to the topic of fear in combat.
A breakthrough in treatment came from Capt. Frederick Hanson who was a neurologist and neural surgeon. After dealing with cases from the disaster at Kasserine Pass, he acknowledged that it was normal for a soldier to suffer from exhaustion caused by several factors, but the most important was lack of sleep. His treatment was to get the soldier a bed and food close enough to the front to be within earshot of the fighting. (It was found that the further back the hospital was, the worse the problem became for the soldier. Doctors should administer drugs like sodium amytal to knock the victim out for up to 48 hours. These drugs became know collectively as “Blue 88”, a reference to the feared German artillery piece which knocked out tanks. After the soldier woke up, he was given a hot shower, fresh uniform, and a pep talk before being sent back to his unit. Clearly, this type of treatment was out of the question for most combat fatigue victims in the Ardennes. In less environmentally challenged battle areas, you could expect successful rehabilitation in 50-70% of the cases.
https://warfarehistorynetwork.com/combat-fatigue-how-stress-in-battle-was-felt-and-treated-in-wwii/
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