Combat Stress / Battle Fatigue / Psychiatric Wounds
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- Combat Stress has gone under many names from the Shell Shock of WWI to Battle Fatigue to Post-Traumatic Stress Disorder (PTSD) to Psychiatric Wounds.
Guadalcanal produced extraordinary levels of psychiatric casualties in the First Marine division and the Army units sent in to reinforce it. Rosner (1944) reported that 40 percent of the casualties evacuated from Guadalcanal "suffered from disabling neuro-mental disease" (compared with only 5 percent following the attack on Pearl Harbor). He describes the psychiatric casualties as reduced to a pitiable state of military ineffectiveness after prolonged exposure under severest tropical conditions to exhaustion, fear, malaria, and sudden violent death at the hands of an insidious and ruthless enemy (Rosner, 1944, p. 770).
Reviewing the issue of psychiatric casualties from Guadalcanal in a 1946 article, Theodore Lidz, an Army psychiatrist who had treated evacuees in the Pacific, noted that "even the non-psychiatric casualties showed emotional reactions of a severity that would have been considered incapacitating in later campaigns." In addition to anxiety and depression, symptoms included "headaches, anorexia, . . . tremors, insomnia, nightmares and palpitation [which] were individual symptoms or could all be present in one man." Trying to understand what had contributed to the tremendous psychiatric casualty levels of this prolonged battle, Lidz (1946, p. 194) concluded that:
"...there were many factors preying on the emotional stability of the men. The tension of suspense in one form or another was among the most serious; waiting to be killed, for death had begun to seem inevitable to many, and some walked out to meet it rather than continue to endure the unbearable waiting; waiting for the next air raid and the minutes of trembling after the final warning; waiting for the relief ships; waiting without acting through the jungle nights, listening for the sounds of Japs crawling, or for the sudden noise that might herald an attack; waiting even in sleep for the many warning sounds. The fears were numerous: of death, of permanent crippling, of capture and torture, of ultimate defeat in a war that was starting so badly . . . [as well as] fear of cowardice . . . and of madness...".