Post Traumatic Stress Disorder and the American Civil War

War-induced psychological trauma in American soldiers was first observed during World War One. The physicians who diagnosed soldiers with ‘shell shock,’ a form of ‘war neuroses,’ believed it to have been the first time psychiatric ailments could be attributed to military service.[1] They were wrong.

Unidentified shell-shocked British WWI soldier, Wounded at Courcelette, 1916. Canadian War Museum, George Metcalf Archival Collection

Abundant evidence suggests that Civil War soldiers, like their twentieth-century counterparts,  exhibited symptoms that today we would associate with war trauma, notably post-traumatic stress disorder (PTSD), a diagnosis that emerged out of the experiences of the Vietnam War.[2] Yet for years historians failed to consider the possibility that Northern and Southern soldiers and veterans suffered psychologically as a result of their military engagement. For one reason, the American Civil War lacked the weapons of mass destruction, including lethal gases, airplanes, and tanks, which stoked fear and anxiety among WWI soldiers and contributed to mental breakdowns of many. Civil War soldiers faced none of these so, the reasoning went, had fewer reasons to suffer psychological collapse. This explanation, of course, fails to consider that other forms of warfare could be just as terrifying to its participants. Moreover, this claim also neglects other factors unique to the Civil War that could prove just as traumatic for nineteenth-century soldiers as those in twentieth-century wars, notably, companies were formed locally. Company mates were likely to be relatives or men the soldiers had known for years. Thus, witnessing a soldier – maybe a neighbor or brother – horrifically killed had a more personal impact.

A Vietnam War soldier suffering emotional distress.

But the main reason historians have been late to consider the problem of psychological harm among Civil War soldiers is that mid-nineteenth-century America lacked the scientific understanding that a traumatic experience, like warfare, could harm the mind, meaning they had no words to identify PTSD or shell shock, as medical caregivers in later wars did. Nor could they comprehend that a symptom – like startle response to a loud noise, a reflexive action of fright conditioned by the sounds of battle – was triggered by combat. Historians, therefore, have been justifiably cautious about studying Civil War combat disorders. Civil War doctors and soldiers themselves didn’t see a connection between war and mental breakdowns, and left little direct evidence about psychological injuries. How could historians, working over 100 years later, and applying modern terms and diagnoses, confidently conclude that Civil War soldiers suffered the effects of war trauma?

Despite these warranted reservations, recent studies have uncovered ample evidence that psychological injuries among Civil War soldiers and veterans were common. While historians can never with certainty conclude that an individual soldier’s symptoms were definitively linked to his military experience, we can nonetheless harness modern scientific knowledge and medical research and draw informed assumptions that his military experience was a likely cause.

Civil War soldier in solitude. Library of Congress.

Take the case of Confederate veteran William James, who first showed signs of derangement shortly after war’s end. Held captive in a northern POW camp, he had emerged physically ill, his mind “much disordered.” An Alabama farmer, he tried to restart his old life by putting in a crop in the fall of 1865. But within a year James had become uncontrollably violent. He threatened to kill his father and endangered his own life by jumping in a well in a failed attempt to kill himself. Violence, including self-harm, are common indicators of PTSD. Post-war lunatic asylum records are filled with veterans whose uncontrollable rage jeopardized their lives and those of family members. Like Neal Story. Story was just a teen when he enlisted in Georgia’s 46^th Infantry. He exhibited “peculiar” behavior during the war, and when he returned home he was “wanting in his former energy and activity.” Still, he tried to reintegrate into civilian life as a farmer. But by 1872, he had grown exceedingly violent. He threatened to kill family members and to burn down the house. Desperate, his family built a small log cabin expressly to confine him. Finally, they resorted to institutionalizing him in the Georgia lunatic asylum in Milledgeville where caregivers noted he ate and slept erratically, and was listless and disinclined to move or talk.[3]

Georgia State Lunatic Asylum, now Central State Hospital, where many Civil War soldiers and veterans were treated for mental illness.

Suicidal behavior, another indicator of PTSD, plagued Civil War veterans. While we lack the data to quantify suicide among Civil War veterans, we can draw on contemporary research of veterans of modern wars that provides context for nineteenth-century veterans. We know, for example, that 20% of Vietnam vets made suicidal attempts and another 20% were preoccupied at times with suicidal thoughts.[4] Eric T. Dean Jr.’s path breaking study Shook Over Hell found that over half of the residents of an Indiana Civil War veterans’ home either attempted or completed suicide or were suicidal.[5] The downward spiral of Albinus Snelson, a Georgia native who served in the Confederate Cavalry, exemplifies a recovery-and-relapse cycle peppered with multiple suicide attempts. Like Neal Story, Snelson was just a teen when he enlisted. He struggled while a soldier and in fact was discharged early and entered the Georgia asylum, where he attempted to burn himself and throw himself out of windows in efforts to kill himself. He finally succeeded in 1871 when he ingested strychnine.[6]

Post-battle carnage of Civil War. Library of Congress

Civil War soldiers also suffered from delusional paranoia, the kind associated with extreme cases of PTSD. Veteran John Williams was admitted to the Georgia asylum with what we would recognize as post-combat hypervigilance – he was “constantly frightened.” He constantly complained that people were trying to kill him. In a state of extreme agitation, he cut his own throat. Forty-year-old Joseph Pearman, a harness maker from Petersburg, Virginia likewise took his own life in 1875 after protesting that “someone was coming out from the city to kill him.”[7]

While the circumstances of the Civil War might have been very different from twentieth-century wars, those citizens who took up arms suffered the same fate as many veterans of later wars.

The historical record leaves no doubt that Civil War veterans contended with emotional and psychological fallout from their military experiences, whether or not they realized it.

Learn more in this interview with Dr. Diane Sommerville, the post’s author:

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About the Author

Diane Miller Sommerville is associate professor of history at Binghamton University, SUNY, where she teaches Civil War, women’s, and southern history. She is the author of Aberration of Mind: Suicide and Suffering in the Civil War-Era South (University of North Carolina Press, 2018), a Lincoln Prize finalist for 2018.

Bibliography and Endnotes

Andersen, Judith. “‘Haunted Minds’: The Impact of Combat Exposure on the Mental and Physical Health of Civil War Veterans.” in Years of Change and Suffering: Modern Perspectives on Civil War Medicine. Eds. James M. Schmidt and Guy R. Hasegawa. Roseville, MN: Edinborough Press, 2009. Pages 143-158.

Anderson, Rebecca. “Shell Shock: An Old Injury with New Weapons.” Molecular Interventions 8:5 (October 2008): 201-218.

Dean, Eric T., Jr. Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War. Cambridge: Harvard University Press, 1997.

Finley, Erin P. Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan. Ithaca: Cornell University Press, 2011.

Fussell, Paul. Wartime: Understanding and Behavior in the Second World War. New York: Oxford University Press, 1989.

Gabriel, Richard A. Ed. Military Psychiatry: A Comparative Perspective. New York: Greenwood Press, 1986.

Gabriel, Richard A. No More Heroes: Madness and Psychiatry in War. New York: Hill & Wang, 1987.

Hendin, Herbert and Ann Pollinger Haas. Wounds of War: The Psychological Aftermath of Combat in Vietnam. New York: Basic Books, 1984.

Historical Records Shed Light on Soldiers’ Lifelong War Scars,” February 7, 2006, http://www.sciencedaily.com/releases/2006/02/060206233356.htm

Leed, Eric. “Fateful Memories: Industrialized War and Traumatic Neuroses.” Journal of Contemporary History 35:1 (2000):85-100.

Sommerville, Diane Miller. “‘A Burden Too Heavy to Bear’: War Trauma, Suicide and Confederate Soldiers.” Civil War History 59:4 (Dec. 2013): 453-491.

Sommerville, Diane Miller. Aberration of Mind: Suicide and Suffering in the Civil War-Era South. Chapel Hill: University of North Carolina Press, 2018.

Sommerville, Diane Miller. “‘Will They Ever Be Able to Forget?’ Confederate Soldiers and Mental Illness in the Defeated South.” In Weirding the War: Actually Fresh Perspectives on the American Civil War, ed. Stephen Berry. Athens: University of Georgia Press, 2011. Pages 321-339.

Strecker, Edward A. “Military Psychiatry: World War I, 1917-1918.” In One Hundred Years of American Psychiatry. American Psychiatric Association. New York, Columbia University Press, 1944. Pages 385-416.

Yahuda, Rachel. “Current Concepts: Post-traumatic Stress Disorder.” New England Journal of Medicine 346 (January 10, 2002): 109-114.

Endnotes

[1] Edward A. Strecker. “Military Psychiatry: World War I, 1917-1918,” in One Hundred Years of American Psychiatry (New York: Columbia University Press, 1944), 385-441.

[2] For an excellent definition of PTSD consult Rachel Yahuda, “Current Concepts: Post-traumatic Stress Disorder.” New England Journal of Medicine 346 (January 10, 2002): 108.

[3] Diane Miller Sommerville. Aberration of Mind: Suicide and Suffering in the Civil War-Era South. Chapel Hill: University of North Carolina Press, 2018, 154-155.

[4] Herbert Hendin and Ann Pollinger Haas. Wounds of War: The Psychological Aftermath of Combat in Vietnam. New York: Basic Books, 1984. 160-161; Erin P. Finley. Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan. Ithaca: Cornell University Press, 2011, 69-70.

[5] Eric T. Dean, Jr. Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War. Cambridge: Harvard University Press, 1997, 151.

[6] Sommerville, Aberration of Mind, 156.

[7] Sommerville, Aberration of Mind, 155.