Combat stress reaction
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| - | '''Neurasthenia''' was a term first coined by [[George Miller Beard]] in [[1869]]. Beard's definition of "neurasthenia" described a condition with symptoms of [[Fatigue (physical)|fatigue]], [[anxiety]], [[headache]], [[impotence]], [[neuralgia]] and [[depression (mood)|depression]]. | ||
| - | ==Symptoms== | + | '''Combat stress reaction''' ('''CSR'''), in the past commonly known as '''shell shock''' or '''battle fatigue''', is a military term used to categorize a range of behaviours resulting from the stress of battle which decrease the combatant's fighting efficiency. The most common symptoms are fatigue, slower reaction times, indecision, disconnection from one's surroundings, and inability to prioritize. Combat stress reaction is generally short-term and should not be confused with [[acute stress disorder]], [[post-traumatic stress disorder]], or other long-term disorders attributable to combat stress, although any of these may commence as a combat stress reaction. |
| - | Americans were supposed to be particularly prone to neurasthenia, which resulted in the nickname "[[Americanitis]]" (popularized by [[William James]]). It was explained as being a result of exhaustion of the [[central nervous system]]'s energy reserves, which Beard attributed to civilization. Physicians in the Beard school of thought associated neurasthenia with the stresses of [[urbanization]] and the pressures placed on the intellectual class by the increasingly competitive business environment. Typically, it was associated with [[upper class]] individuals in sedentary employment. | + | |
| - | ==Treatment== | + | The ratio of stress casualties to battle casualties varies with the intensity of the fighting, but with intense fighting it can be as high as 1:1. In low-level conflicts it can drop to 1:10 (or less). |
| - | Beard, with his partner [[A.D. Rockwell]], advocated first [[electrotherapy]] and then increasingly experimental treatments for people with neurasthenia, a position that was controversial. An 1868 review posited that Beard's and Rockwell's grasp of the [[scientific method]] was suspect and did not believe their claims to be warranted. | + | |
| - | William James suffered from neurasthenia, and was quoted as saying, "I take it that no man is educated who has never dallied with the thought of suicide." (Townsend, 1996). | + | In [[World War I]], shell shock was considered a [[mental illness|psychiatric illness]] resulting from injury to the nerves during combat. The horrors of [[trench warfare]] meant that about 10% of the fighting soldiers were killed (compared to 4.5% during World War II) and the total proportion of troops who became casualties (killed or wounded) was 56%. Whether a shell-shock sufferer was considered "wounded" or "sick" depended on the circumstances. The large proportion of World War I [[veteran]]s in the European population meant that the symptoms were common to the culture. |
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| - | ==Diagnosis== | + | |
| - | In the [[late 19th century]], neurasthenia became a "popular" diagnosis, expanding to include such symptoms as [[weakness (medical)|weakness]], [[dizziness]] and [[fainting]], and a common treatment was the [[rest cure]], especially for women, who were the gender primarily diagnosed with this condition at that time. [[Virginia Woolf]] was known to have been forced to undergo rest cures, which she describes in her book ''[[On Being Ill]]''. In literature, [[Charlotte Perkins Gilman]]'s protagonist in ''[[The Yellow Wallpaper]]'' also rebels against her rest cure. [[Marcel Proust]] was said to suffer from neurasthenia. To capitalize on this epidemic, the Rexall drug company introduced a medication called 'Americanitis Elixir' which claimed to be a soother for any bouts related to Neurasthenia. | + | |
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| - | ==Skepticism== | + | |
| - | In 1895, [[Sigmund Freud]] reviewed electrotherapy and declared it a "pretense treatment." He highlighted the example of Elizabeth von R's note that "the stronger these were the more they seemed to push her own pains into the background,". See also [[placebo effect]]. | + | |
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| - | Nevertheless, neurasthenia was a common diagnosis in [[World War I]] - for example, every one of the c.1700 officers processed through the [[Craiglockhart War Hospital]] was diagnosed with neurasthenia - but its use declined a decade later. | + | |
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| - | ==Today== | + | |
| - | The modern view holds that the main problem with the neurasthenia diagnosis was that it attempted to group together a wide variety of cases. In recent years, Richard M. Fogoros has posited that perhaps "neurasthenia" was a word that could include some psychiatric conditions, but more importantly, many physiological conditions marginally more understood by the medical community, such as [[fibromyalgia]], [[chronic fatigue syndrome]], and various forms of [[dysautonomia]]. He emphasizes that the majority of patients who would have once been diagnosed with neurasthenia have conditions that are "real, honest-to-goodness physiologic (as opposed to psychologic) disorders... and while they can make anybody crazy, they are not caused by craziness." (see reference, below) | + | |
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| - | ==See also== | + | |
| - | * [[Combat stress reaction]] | + | |
| + | == See also == | ||
| + | * [[Post-traumatic stress disorder]] | ||
| + | * [[Acute stress disorder]] | ||
| + | * [[Psychological trauma]] | ||
| + | * [[Eye Movement Desensitization and Reprocessing|Eye Movement Desensitization and Reprocessing (modern treatment)]] | ||
| + | * [[Combat Stress| Combat Stress (Ex Services Mental Health Welfare Service)]] | ||
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Combat stress reaction (CSR), in the past commonly known as shell shock or battle fatigue, is a military term used to categorize a range of behaviours resulting from the stress of battle which decrease the combatant's fighting efficiency. The most common symptoms are fatigue, slower reaction times, indecision, disconnection from one's surroundings, and inability to prioritize. Combat stress reaction is generally short-term and should not be confused with acute stress disorder, post-traumatic stress disorder, or other long-term disorders attributable to combat stress, although any of these may commence as a combat stress reaction.
The ratio of stress casualties to battle casualties varies with the intensity of the fighting, but with intense fighting it can be as high as 1:1. In low-level conflicts it can drop to 1:10 (or less).
In World War I, shell shock was considered a psychiatric illness resulting from injury to the nerves during combat. The horrors of trench warfare meant that about 10% of the fighting soldiers were killed (compared to 4.5% during World War II) and the total proportion of troops who became casualties (killed or wounded) was 56%. Whether a shell-shock sufferer was considered "wounded" or "sick" depended on the circumstances. The large proportion of World War I veterans in the European population meant that the symptoms were common to the culture.
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See also
- Post-traumatic stress disorder
- Acute stress disorder
- Psychological trauma
- Eye Movement Desensitization and Reprocessing (modern treatment)
- Combat Stress (Ex Services Mental Health Welfare Service)
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