“Shell shock” was a term used to describe acute stress reactions in soldiers during World War I. Negative attitudes led to a lack of treatment options, but modern armies recognize it as a genuine condition and offer counseling and support. Symptoms include autonomic nervous system reactions, and treatment is often offered close to the battlefield. Returning soldiers to war after experiencing a combat stress reaction could predispose them to long-term PTSD.
The term “shell shock” was used during World War I to describe the acute stress reactions exhibited by many soldiers on the battlefield. When left unaddressed, short-term combat stress reactions can lead to more prolonged problems, such as post-traumatic stress disorder (PTSD). The study of combat stress reactions has advanced significantly since World War I, when soldiers with shell shock were commonly treated as simulacra trying to get out of combat.
A number of slang terms have been used to refer to combat stress reactions, including soldier’s heart, war neurosis, and battle fatigue. Many of these terms, such as bullet shock, had pejorative implications in which they were meant to suggest that soldiers suffering from these conditions were cowards, rather than people experiencing real psychological and physical strain. Negative attitudes about the effects of battle stress have led to a lack of treatment options for soldiers suffering from acute stress reactions.
Several things are signs of shell shock. Most commonly, soldiers appear disoriented and unable to concentrate. They can also experience a variety of autonomic nervous system reactions such as tremors, nightmares, spasms, headaches, fatigue, insomnia, dizziness, anxiety, and irritability, among others. The rate of combat stress reactions tends to increase as the rate of injury and death increases. In the trenches of World War I, the 10% casualty rate was devastating, and combat stress reaction rates were extremely high.
Doctors treating soldiers during World War I initially believed that shell shock and its infamous “thousand-yard stare” was the result of physical trauma to the brain caused by close proximity to explosive shells. Doctors tended to prescribe rest away from the front for officers suffering from shell shock, while enlisted men were often accused of being cowards and sent straight back to the battlefield. Some were shot for cowardice or punished in a variety of creative ways that no doubt increased their emotional distress.
Modern armies recognize that so-called “shell shock” in a genuine and complex condition. A variety of techniques are used to reduce the risk of shell shock among soldiers, including morale-building exercises and the provision of plenty of food, shelter, and rest. In combat situations where a stress reaction may be likely, soldiers are offered psychiatric counseling and support in addition to physical measures. Treatment for combat stress reactions is often offered close to the battlefield, allowing soldiers to return when they are declared fit for duty. Some people believe that the policy of returning soldiers to war after experiencing a combat stress reaction could be dangerous, as it could predispose soldiers to long-term PTSD.
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