Shell shock a century later

This is Mental Illness Awareness Week in the United States, so it seems an appropriate time to consider shell shock. Trenches, biplanes and shell shock are probably the things most Americans associate with World War I.

The BBC offers a fine description of shell shock historically understood to be the result of psychological trauma,

And here’s a contemporary description of what it’s like to live with the after-effects of combat, which we know as PTSD, from a website for American veterans.

PTSD doesn’t just affect troops, of course. It can be seen in anyone who suffers or even witnesses traumatic events. Some people who saw the Twin Towers fall on 9/11 developed PTSD, even if they only watched the events on TV.

What causes some people to suffer from shell shock or PTSD — how could any soldier walk off the battlefields of the Western Front and NOT be out of his senses?  No one knows.

Perhaps there’s a clue in a report published in the Nov. 2007 issue of the American Journal of Psychiatry by researchers who compared shell shock with the increasingly common mild traumatic brain injury affecting troops who were deployed to Iraq and Afghanistan, where explosions were an everyday occurrence.

The researchers write:

“The high casualties of the Somme battle brought the issue of shell shock to the fore when, as traumatic brain injury has done today, it caught the popular imagination and the attention of the media. … (However) in states of uncertainty, it may be that contemporary service personnel prefer to be labeled as suffering from mild traumatic brain injury than any psychological disorder, just as shell shock in its initial quasi-neurological formulation was very popular.”

Whether shell shock — or whatever name we give it — is caused by psychological or physiological trauma, successful resolution is complicated and, so far, elusive.

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