I mean war always has been a part of our life since the first civilizations was established. I’m sure “shellshock” wasn’t only caused by artilery shots.
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Shell shock wasn’t discovered during WW1. It’s the first time it was called that, but the idea of a big battle causing trauma in the survivors is about as old as big battles.
That said, WW1 was the first time a war of that size and deadliness occurred. You can’t really compare two people’s trauma, but suffice it to say that the survivors had plenty of stress to be post-traumatic about.
Shell Shock is a somewhat specific condition, and not exactly the same as PTSD. PTSD is a psychological condition brought on by trauma. Shell shock is a neurological condition brought on by experiencing artillery fire, both the noise and the concussive impact. A person with shell shock had a physically damaged nervous system and damaged brain, which is why they would have uncontrollable body movement. However, when removed from the shelling and with treatment, they would show some improvement in motor skill.
WWI was a bit unique in the regard because in no other war were soldiers exposed to that much heavy artillery fire over a long period of time. Even in WWI, the cases of shell-shock were more pronounced during the mid-war period, where stationary trench warfare was the norm. There were fewer cases at the end of the war when the army became more mobile.
Prior to WWI, it was often dismissed as a flaw of character, rather than a mental health problem that can be treated and healed.
People have written about soldiers carrying trauma from war since classical times, but WWI was fundamentally different.
For most of history, war meant long periods of walking, lots of time spent in a camp, and then relatively brief battles. An army might spend weeks or more marching to a battle that was over in a day, and they’d be mostly safe on the march and in camp. That last part is crucial.
In WWI, soldiers are spending weeks, months on the front line with danger that never goes away Artillery *constantly* pounding, preventing you from even sleeping. You aren’t safe in your own bed. You aren’t safe eating breakfast. It’s a state of prolonged danger, with no chance to let your guard down and recover mentally. War wasn’t a few isolated battles – the battle was at all times, without end, for 5 years.
Being rotated off the front helped, but only once they realized people would mentally and physically break if they didn’t. And people still broke.
It was the first war with that *phrase.*
But one can find it in the hellscape of the American Civil War.
>[[R]ecent studies have uncovered ample evidence that psychological injuries among Civil War soldiers and veterans were common.](https://www.civilwarmed.org/ptsd/)
Consider the difference between 18c warfare and mid 19c warfare.
Muskets were inaccurate and slow loading. Injuries were more likely to be fatal thanks to a lack of medical care.
Contrast with rifles and machine guns. Rapid fire. Much louder. Much bloodier. And with combat medicine, much higher survival rate with permanent, life altering injuries.
War got mechanized and it got so much worse.
PTSD is largely caused by people feeling helpless to avoid death for an extended period of time. While there were some limited cases of PTSD pre-WWI, WWI represented a rather dramatic change in the day to day experience for a soldier at war.
Pre-WWI it was rare for soldiers to be in combat for an extended period of time. Armies were relatively small and an entire army would march as a distinct group of men. You can look at civil war campaign maps to get an idea for how Napoleonic era wars were fought, but it wasn’t like a modern war where there was a front line or even a border.
There were just big blobs of troops marching around and occasionally they would meet up at a strategic chokepoint, like a mountain pass, crossroad, or railhead. When the army blobs did come into contact, it was rare for combat to be the result. The limited range of the weapons at the time meant that the two sides just kind of stared each other down before the weaker side withdrew. If combat did occur, the battle was over within a few days, at which point things returned to how they were.
The end result of this was that most soldiers either never saw combat or only saw very brief combat where they, personally, were only in danger for a brief period of time. The soldiers also didn’t develop a sense of helplessness because the enemy was in sight and the soldier could shoot back. Those conditions just aren’t extreme enough to give rise to PTSD.
WWI represented a big change to that because front lines developed in which there were static defensive systems hundreds of miles long. Soldiers just sat in those defensive lines, enduring occasional shelling and gunfire for months on end. On top of that, much of the incoming fire came from artillery that was miles away – far beyond what people could see or respond to.
In effect, WWI soldiers spent months living in a situation where they could die at any time from a shell they never saw coming, which was fired from a gun they couldn’t shoot back at. Those are the conditions that result in PTSD and WWI was the first time in human history that those conditions were present.
Because WW1 was freaking terrifying.
While battles had happened before, they had taken hours or at most days. While sieges had happened before, they had been smaller scale and less intensive. So while PTSD had previously been explained away, as cowardice and other things that people viewed as moral failures, it was impossible to ignore the magnitude of PTSD during WW1 (in terms of how widespread it was and how severe the symptoms were). In WW1 soldiers were exposed to the full horror of industrialized warfare, and not just for days but for weeks and months of intense artillery barrages* and awful living conditions.
It wasn’t though until after Vietnam that PTSD emerged as a unified diagnosis for the psychological symptoms of having experienced trauma.
*Unless you’ve experienced an artillery barrage there is no way that you can understand how terrifying it is. The sudden and thumping shockwaves that you can feel in your lungs and gut. The primal terror of knowing that someone is trying to kill you. The helplessness in that there is nothing you can do about it except curl up in a ball (trying to maximize the protection of your helmet and body armor) and just hope that there isn’t a direct hit on whatever hole or cover you’re hiding in/behind. Also knowing that as soon as there is a lull you need to get up and either retreat or attack, or it’s going to repeat.
It wasn’t. There are accounts of people who clearly have some form of ptsd in the Odyssey, Iliad, and Aeneid. But WW1 was the worst war to date and by far the biggest.
A lot of people are pointing out the extended nature of the combat and the physical damage from shelling.
There is another key aspect which is how visible the danger is. In all previous wars you would see the person who was trying to kill you. The guns weren’t really capable of supporting snipers and artillery didn’t really exist except for attacking buildings. So you would see your enemy, know they were going to try and kill you, and then feel the stress. When there was no event in sight then you were safe.
In WWI, with artillery and more long range guns, you could be just minding your business eating lunch and then be blown to bits. When going over the top you wouldn’t know where the dangers were until a hidden machine gun opened fire or you stepped in a mine.
A part of how PTSD works is that your brain is trying to figure out how to keep you safe. If there are clear signs that danger is about to happen, such as someone pulls a gun on you, then your defensive instincts kick in and we consider this healthy. If the harm you experienced didn’t have any clear indicators then your mind will try to find some and will come up with multiple false positives. This is what is meant by triggers. The more unexpected and frequent the negative outcome was, the more things your brain will fixate on as potential dangers and the more of your life you will spend in terror mode watching out for the super bad thing you’re mind wants to avoid at all costs.
Sustained battles.
Previously most active battles lasted hours. Maybe a couple days at most. In WW1 you could be under bombardment for days on end. You could be part of a battle that lasted for MONTHS without a break.
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