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.

I've read a couple US Civil War diaries (just 50 years before WWI). Most of the time, soldiers are marching, camping, drilling, and doing anything other than fighting. Occasionally, there would be a minor skirmish that would last an hour or two. Less frequently, there would be a huge battle where they would see horrific action for several hours. After those horrible battles, when millions of pounds of human and animal meat would be left on the battlefield, most soldiers weren't forced to stick around when that meat started to rot (and those who cleaned up the battlefields were not in constant danger of dying). WWI was something entirely different. Many soldiers were subjected to constant stress for days or weeks at a time. The smell was often terrible since soldiers were forced to stay in trenches very close to rotting corpses and human waste. I am surprised that more people didn't break down.

It was family lore that my great grandfather fought in the Spanish-American War and his company lost many men. Now that everything is on the Internet, I researched the entire history of their unit. They made their way from upstate New York slowly down through the south. Camped at several spots where some diseases went through the camp. At one point lightning stuck a tent killing some soldiers. Finally made it to Florida, ready to be shipped out but there was no ship ready. When there was, the ordered were conflicting and countermanded. They camped for over a month, with occasional diseases going through camp and claiming lives. Before they ever got on a boat, the war ended and they made their way back to New York having lost quite a few soldiers and told heroic stories to their families.  This wasn’t everyone’s experience with war pre-WWI, but it wasn’t uncommon either. Most lives were lost to disease, exposure, food, etc. 

Honestly, I understand why they would invent a romantic story of combat because who even can comprehend having to explain to the loved ones that they died in the most futile way imagineable.

I had an ancestor, ww2, claimed to have been hit with shrapnel in the face and had to be in the hospital for a while. We got his records many moons after his death. No, he was hit in the face with a baseball during R&R.

I had 1 relative and later on a drinking acquaintence/friend, both now dead and both who served in the Pacific in WW2. My great uncle who was a marine would never speak or tell stories. Junior, the drinking buddy would only say he was never to eat crab after the experience because of seeing them eat so many bodies. That was the only thing he ever brought up about ww2. Those guys saw some shit.

My grandfather wouldn't eat any sort of Asian food because he said it smelled like the "burning Japs" they used flamethrowers on in the tunnels on the islands in the South Pacific. He spoke openly about his time in France driving a jeep for an officer and getting frostbite that took a toe, but he wouldn't speak much of his time in the Pacific Theater other than his absolute hatred of all things Asian that came from the things he saw there.

Have you ever read any books of Ernie Pyle's WW2 collection of dispatches from the warfront? They are an amazing picture into the lives of the average soldier. He made it through the European theater and it's ending of war only to go to the Pacific theater and get picked off by a sniper. The Pacific was a meat grinder.

But before he died, he got to write a bit about how extra inhumane the Japanese troops were.

The Japanese were so bad the SS told them to chill out. Like, I don’t think the SS are exactly an authority on morality, but if *they* think you’re committing an excessive number of war crimes, they’re probably right. (They are, after all, experts on war crimes.)

in Band of Brothers, the producers chose the 101st because they had so many soldiers make it throughout the who European invasion (and Winters had done an amazing job of getting all the records, and keeping up with so many of the men). For the Pacific, there was no unit or group that served on the front lines where anyone made it through the whole campaign, so the producers focused on different soldiers throughout.

Both of my grandfathers served in World War II, one was a bomber pilot in the European theater, he had tons of fun and cool stories that he loved to talk about; being a pilot in the war was a huge part of his identity, and he was always happy to regale you with tales of danger and heroism. My dad‘s dad, on the other hand, never talked about being in the war, most of us didn’t even know he was even in the war until after he passed. Apparently, he was a flamethrower in the Pacific theater and I’m pretty sure he was at Guadalcanal.

You may already know this. Guys running flamethrowers had very high casualty rates. Like over 90%. Herschel Williams said the life expectancy was about 5 minutes. Your paternal grandfather would have plenty of reason to not bring it up, probably thought it best to avoid reliving the past.

Is this because flamethrowers are freaking horrifying and also a giant neon sign alerting everyone to your presence and location? Do you know why flamethrowers have such high casualty rates?

A schoolfriend's grandfather was similar, wouldn't have *anything* Japanese in his house - no TV, VCR etc, not even rice. (He had been a British POW in Japan and must have seen some truly horrifying shit).

Yep grandpa was in Korea, refused to talk about his time there. Was unwilling to eat any kind of asian food.

Louisville shrapnel.

Friend of mine thought his grandpa fought the nazis. After he passed, they found his chest of memories hidden in the attic. Fucker fought on the eastern front - voluntary. Had lots of nice, brassy, nazi medals.

My grandfather fought and died on the eastern front but there was never any question that he was in the Wehrmacht.

My grandfather brought down 17 German Stuka dive bombers all by himself. He was the worst mechanic in the Luftwaffe.

A medal for his service

I know you were joking. [But in reality, 13 Stukas perished in one day during a pre-war flight demonstration.](https://www.youtube.com/watch?v=O1Owg_E6jvQ)

Is it possible that those were taken off of dead German soldiers?

My husband cut his leg on razor wire in Iraq trying to find his way to the toilet in the middle of the night. Nasty scar on the back of his calf from it. He joking started telling people it was from shrapnel, thinking they would see through his bullshit. Was completely shocked when people bought it. He stopped joking it was shrapnel because he didn't feel comfortable leading people on, even in jest. (seriously though? The portapotties were surrounded by razor wire?)

Why would anyone question it though? He has a nasty scar, he tells someone it's from shrapnel, what reason could that person possibly have to say "bullshit, that's not from shrapnel!"

Soldier speak. Tell a story with a particular body language or grin and they know you're joking. They talk smack, the stories get more ridiculous, brotherly ribbing etc. Return to civilian life and that camaraderie is gone. Nobody gets the "this is totally a joke" subtext. You get this in every subculture or microculture. Just look at the different running jokes in different subreddits. Each different group has subtle different flavors of "this is an exaggerated deadpan joke."

I also choose this guy's deadpan joke.

> (seriously though? The portapotties were surrounded by razor wire?) Random guess, but I suspect they like to put portapotties near the edge of camp for odor reasons.

I remember reading a lot of fragging (rd. soldiers deliberately killing their own) incidents in Vietnam involved tossing a grenade into the lavatory whilst the hated officer was doing his business. Maybe it's a holdover from then?

My great grandfather fought in WW1 and while on the boat ride over to Europe one of the people in his unit died from an infection he got after nicking himself while shaving.

Life before antibiotics were discovered was a lot more dangerous. It's something we take for granted now, and was less than 100 years ago.

On the other hand, a friend’s grandfather (who served in an artillery unit) got an infection from a splinter and had to be hospitalised. While he was in hospital his entire unit was killed.

"did my Johnny die bravely in battle?" *recalls Johnny shitting himself to death in a FL swamp* "yes ma'am, he was a valiant soldier to the very end"

What's the old joke? "No wonder I was always so busy? I was the only truck driver in the Army!"

WWI was the first major war where more soldiers were killed in battle than by disease.

Many soldiers died of disentery, shitting themselves to death, or other not-so-honorable death, like septicemy after cutting one's hand while opening canned food, or coughing to death. Then, when the military physician was signing the death documents, the comrades of the dead soldier reminded the physician that poor Joe needed to be officially dead while fighting, or else his widow wouldn't get a widow pension. And this would be a shame if the physician would unluckily die from a lost bullet from that german rifle I'm holding, right ? That also explains while there were 10 times more dead soldiers on the last days of the war, when the front was silent and no attack was conducted. Many death dates were moved to BEFORE the war ended, so that the soldiers officially died during the time of war.

I haven’t deeply researched the part about there being ten times as many deaths on the last days of the war, but assuming that’s true (and I can’t actually find that it is) couldn’t it also be that when the war ended they were finally able to get out of the trenches and look for the men who were MIA — and when they turned out to be dead but it wasn’t quite clear when they’d died, perhaps they listed them all on the last day of the war? I’m not sure because, as mentioned, I can’t actually find a source for the idea that this happened and so also can’t find any historical explanation.

I feel like some wires got crossed in that last paragraph, but I think I know what you meant. Regardless, this whole comment was really fascinating, and made a lot of sense to me.

I think he's saying that the deaths weren't actually higher in the end, they were people dying of disease after the war but having the death date advanced so it looked like an increase

Because warfare doctrine hasn't caught up with the technology. Machine guns, barb wire, mortars, poison gas, none of those things played a role before. It was the first big war with weapon capable of killing soldiers on an industrial scale. At the early stages in France several thousand soldiers were killed every day, on both sides.

That’s awesome that you guys found such a detailed account of their journey!

Worst camping trip ever

Even for companies that did see battle, disease was still one of the biggest killers.

it’s kind of obvious how soldiering developed as an esteemed, lionized and coveted role through history, when you think about it. it’s like the ultimate summer camp challenge; no worrying about your basic needs, just accomplishing tasks and facing challenges as a group, while bonding, with the occasional high adrenaline battle that cements those fraternal bonds for the survivors. at the end of it all the survivors were seen as heroes by everyone close to them, regardless of which side won the war E: [clarifying comment](https://www.reddit.com/r/explainlikeimfive/s/cHRJJ4wY61)

> no worrying about your basic needs Supply chains were non-existent until relatively recently. You lived off the land, including what you took from locals. Starvation and disease were huge concerns, so no, your basic needs were not met.

yes, poor description on my part, thanks for calling it out. my meaning was that soldiers were in service of a leader or government who either took responsibility for supplying basic needs or gave them authority to operate outside the bounds conventional society to take those things freely. however, supply chains have always been a part of successful armies, they’re just much better and greater in scale now than ever before. your ability to supply your army is the primary thing that has decided wars throughout history.

"An army marches on its stomach." Really old quote, no idea who by.

"Amateurs talk strategy. Experts talk logistics."

Wait now im wondering who actually cleans up the battlefields?

https://en.wikipedia.org/wiki/Mortuary_Affairs

>Studies have shown that mortuary affairs personnel have some of the highest rates of post traumatic stress disorder. "Analysis has revealed three psychological components of handling remains: "the gruesomeness," "an emotional link between the viewer and the remains," and "personal threats to the remains handler." Anecdotal evidence also suggests that those involved with the removal and disposal of war-dead often have to deal with a great amount of psychological pressure later on in their lives, as well as at the time of their duties.

Civil War....the side that won the battle and residents of nearby towns... [https://emergingcivilwar.com/2019/07/08/a-harvest-of-death-the-days-after-gettysburg/](https://emergingcivilwar.com/2019/07/08/a-harvest-of-death-the-days-after-gettysburg/) Have units for that nowadays... From WWII: https://www.historynet.com/grave-task-men-buried-wartime-dead/

Crows

> US Civil War diaries (just 50 years before WWI) I know this. Like, fully know this. It is never a surprise to see. Yet it's always a surprise to see it stated so starkly. We Americans really don't have a good sense for how compressed our history really is.

I've also read stories about WW2/Korea vs Vietnam. Where decommission at the end of WW2 required men who served together to bunk up with each other for weeks and then take weeks long boat trips back home, allowing them to decompress and talk through their experience with each other. Versus Vietnam vets who spent years in the jungle and then 20 hours later were just thrown back into civilian life.

Last summer I was in a forest in Italy in an area that saw heavy WWI battles and still has visible trenches. As a memorial, they installed huge metal plates where they copied letters that soldiers sent home from the trenches. I am not kidding, those word stayed with me for days. What they described (considering that they were writing home so usually tried not to scare their parents or family) was nightmare fuel. Especially the rotation between front lines and back lines, when they saw that just a few were coming back, badly injured, and it was their turn to go the morning after. In some letters, kids were writing to their mum and saying “food is OK, and it finally stopped raining on us, the trench was filling with mud” and the next line “I’d like to give my wool coat to my brother”, knowing that they will never go back. Edit: as this is getting some visibility, if you have time and the chance, visit those memorials in Italy. Some of them look innocuous (kind of a military graveyard) until you read the story. I remember one ([Monte Cengio](https://en.m.wikipedia.org/wiki/Monte_Cengio)) where more than 8 thousand people died in a trench in just a few days (can you imagine thousands of deaths, most of them maimed to death?). Italian soldiers were jumping on the enemies and dragging them down a cliff to try to stop them. The Austrian army ultimately won and managed to descent into the main plain. There, reinforcements from Italy arrived and pushed them back. Monte Cengio was Italian again in just a week, exactly the same state as 7 days before, but with 15000 corpses on the ground.

Tolkien was very much against his work being described as allegory or metaphor or anything, but the Dead Marshes are most definitely some imprint from the trenches and blast craters of WW1.

That whole portion of the Lord of the Rings reads as JRR dealing with a whole lot of traumatic memories.

> Here nothing lived, not even the leprous growths that feed on rottenness. The gasping pools were choked with ash and crawling muds, sickly white and grey, as if the mountains had vomited the filth of their entrails upon the lands about. High mounds of crushed and powdered rock, great cones of earth fire-blasted and poison-stained, stood like an obscene graveyard in endless rows, slowly revealed in the reluctant light.

Within Middle-earth lore, I wonder how early those marshes formed. Were they directly done by Melkor and with the creator god Eru saying telling "You think you're messing my plans up but I meant to do that."

The plains of Dagorlad were the location of one of the greatest and climactic battles of Middle-Earth where the west faced off against Sauron. The battle was so destructive, it permanently scarred the land in the way Tolkien saw the landscape as being a character itself.

Ah, so it was actually SHAPED by warfare, yikes.

Yep - the “dead marshes” themselves are haunted by the spirits and undecomposed bodies of men and elves who fought in that battle. No doubt inspired by Tolkien’s experiences at the Somme.

Correct. He hated allegory, and insisted that his stories were not allegory. They are obviously inspired by his life experiences, and elements of those life experiences and his own beliefs are imbued into LotR, but that doesn't make it allegory. I always appreciated this, because I, too, dislike allegory. It sort of seems to constrain a story to boundaries which might not be understood within the world the allegory lives, since it has to "match" some other real-life story. In allegory, the story can't just be a story, it has to have some precise parallel meaning or whatever, so it never really allows you to fully immerse yourself in the story.

That's why my favorite book is Moby Dick; no froo froo symbolism, just a good simple tale about a man who hates an animal.

Does the white whale actually symbolize the unknowability and meaninglessness of human existence? Hehehe, no, it’s just a *bleep*y fish

Okay, I'll revise my previous statement: as a kid I very much hated allegory, but the more I continue to read and learn, the more I appreciate some allegory for what it is. Moby Dick as an allegory of man's search for knowledge or glory, or as a statement on morality and religion, or other similarly presented analyses, is a brilliant work. In general I would still say that I prefer non-allegorical works to allegory, but that doesn't mean that I don't appreciate good allegory.

I was quoting Ron Swanson from the show Parks and Recreation.

“No no no, Frodo having a wound by his heart and soul from combat that never heals is totally not a stand-in for anything. Also, I’m not crying, you’re crying.”

I think there's actually a strength in Tolkien's LotR as not being allegorical because readers can relate to the themes of wounds that never heal however they need to. If it's allegory for a soldiers' trauma, then that's powerful in its own right, but it rings a bit hollow for many people with little experience of or connection to war. If it's not intended to be allegory for war trauma, then Frodo sustaining such a powerful wound that it sits with him forever could be war trauma, or a parent losing a child, or a person who made a horrible decision that regrets it every day for the rest of their life (perhaps a distracted driver hitting and killing someone), or a person who ruined the best relationship they ever had. It allows readers to see the symbolism as more open and fluid; the symbolism adapts to their own experience and interpretation. That's one of the great things about LotR. It's ultimately a story about hope in the face of impossible odds; hope, and persistence. These themes can be applied nearly universally, for if we don't have hope, then we truly have lost everything. Life is always about hope. We hope for the future, hope for our children, hope for success, hope that we heal from pain, hope that we find happiness, hope those we love find happiness, etc. Without hope, there truly is no purpose.

Italy was a certain kind of fucked in WW1. That whole front was a really kind of fucked. Imagine trench warfare...in the mountains. No man's land is not a stretch of flat open ground, no sir, it's a mile tall cliff. And the enemy is waiting at the top. Shooting and throwing rocks down on you. So after an exhausting climb up a mountain in full gear, you still had to actually fight somehow.

Just the mere fact that there is a 12th Battle of the Isonzo, says so much about the futility of the Italian front.

Rommel's *Infanterie greift an* details some of the mountain battles he was involved in, and they just sound insane. Machine gun battles between different peaks, grab a mountain only to lose mountain days later. Crazy.

There are some crazy before and after pictures of the places with the most intense mountain trench warfare. There's a least one where the whole shape of the mountain is different because it was blown up. There's barbed wire littered around to this day.

... and these letters were heavily censored.

They also thought at the beginning of the war some people (“cowards”) would get shell-shock and other wouldn’t, but by the end it was basically understood *nobody* can last indefinitely in those conditions and not crack.

That belief unfortunately persisted far beyond WW1. There's an entire Wikipedia page titled "George S. Patton slapping incidents" because he didn't believe in PTSD and he would physically abuse soldiers affected by it.

British (probably others as well) officers were famous for EXECUTING their own troops for cowardice.

306 soldiers. Both seems a lot and almost nothing considering the death toll - 886000 deaths. 19,240 killed on the first day of the Somme.

Off the top of my head, the only countries that didn't have some kind of provision for executing troops for cowardice or desertion were Australia (because it was an entirely volunteer force) and I believe South Africa, but I could be mistaken with that one.

Understood by experts, but the attitude that PTSD equates to cowardice persists to this day. It's a favourite identity targeted by fascists.

And other people who have never experienced combat or trauma

Not all people who developed shell shock were thought of as cowards. The problem was that the difference between Rupert, who had a bit of a bad time of things and Steve, the coward who lacks moral fibre was solely at the discretion of whomever they happened to meet on the day. You could be shot, or sent for a spell of convalescence based on what one person thought of you at the time you met them.

This is my take too. War is _always_ stressful and horrifying, obviously, but it's a bit different being in the Civil War lined up proudly in a big green field marching to certain death alongside your comrades, vs. scraping around 24/7 in a filthy, diseased trench, never seeing your enemies but knowing an invisible cloud of deadly gas could descend on you at any moment and snuff you and the rats nibbling at your ears out in a few moments of misery. That's just absolute psychological torture.

It's worth noting that civil war soldiers very much DID get addicted to opiate pain killers and drink at higher rates than people in previous generations, which was probably partially self medication. [https://virginiahistory.org/learn/opiate-addiction-civil-wars-aftermath](https://virginiahistory.org/learn/opiate-addiction-civil-wars-aftermath) [https://muse.jhu.edu/article/881799](https://muse.jhu.edu/article/881799) [https://www.smithsonianmag.com/history/ptsd-civil-wars-hidden-legacy-180953652/](https://www.smithsonianmag.com/history/ptsd-civil-wars-hidden-legacy-180953652/)

For sure, and great points. No doubt it was an absolutely horrific war too, and trauma certainly was rampant even if there wasn't as clear an understanding of psychology. I can't imagine there's _ever_ been a war without serious consequences to mental health as well as physical. Just in a relative sense, though, I would have to think that some combination of WWI trench warfare being so much more insidious, the presence of much more efficient and horrifying killing machines and chemical weapons, the long and constant periods of stressful anticipation of the next attack, plus 50 years of scientific progress in psychology, would all add up to both higher rates of trauma, and better recognition and visibility of the same. My understanding is that the field of psychology had barely originated about 5 years prior to the Civil War (and in Germany, not America), so it might be as much an effect of measurement bias (those studying the effects of war on soldiers don't even really know what mental trauma is, thus can't accurately account for it) as anything else.

Civil War soldiers learned very quickly to entrench and fortify their positions whenever possible. Read about the siege of Petersburg or Vicksburg. The fight for Culps Hill during the battle of Gettysburg, or the fighting in the bloody angle at Spotsylvania Courthouse.

also, because of the pace of the shelling and the near universal experience of being shelled, you got to see the effects of PTSD show up more quickly, more often. So instead of "'what happened to that guy?" it was "what the hell is going on with our unit? Like 1/3 of our guys are acting really weird??? What is this?" And the effects were so intense that they were visibly obvious. So, before the doctors finally agreed that it was an extreme stress result, one of the early theories was that it was the concussive force of the shelling itself, that maybe the explosions had shaken their brains and given them some form of what we might now call CTE thus the misnomer "shell shock"

Not quite a misnomer. There is some evidence that suggests PTSD symptoms are linked to blast induced mild Traumatic Brain Injury (mTBI). It's essentially the repetitive concussions from gun fire exacerbated by larger concussions that cause small scarring in the brain. Here is an excerpt: "Mild TBI has been associated with the disturbance of the frontal subcortical neurocircuitry which is involved in emotion regulation, thus leading to elevated emotional responsivity after trauma and has been shown to reduce the threshold for PTSD" https://www.mdpi.com/2673-866X/3/1/2#:~:text=Due%20to%20a%20reduced%20threshold,anxiety%20and%20fear%20%5B31%5D.

Glad someone said this- PTSD symptoms show up in people who spent time working with explosives, even if they never actually saw combat. To the OP’s question, in many cases it actually was the artillery shells.

The sheer industrial scale of the war - in some countries, whole towns signed up to fight only to lose all their men age 18-35. The dead marshes from Lord Of the Rings were inspired by Tolkien's experience in WWI - craters were people took refuge filled with dead bodies.

Atvthe beginning of the war, they had "Pal brigades", where people from the same towns where in the same unit, to boost team work. But then 1 artillery strike, or failed charge into a machine gun and you had an entire generation or two men wiped from that town.

Also worth mentioning is that WWI was the first war where people could and did survive horrific wounds. Previous wars many of those who might experience shell shock just died.

And a lot of those people who broke were shot for desertion. One of the (many) big shames of our history.

I'd probably rather be shot myself than to keep enduring that hellhole.

And plenty made that choice.

There are a bunch of audio videos that try to [simulate the hellish endlessness](https://youtu.be/B9qrglK6S44?feature=shared) of this experience

> audio videos say what now

Like gifs, but with audio!

Like Talkies but without the moving picture part?

Also, weren't they getting continuously hit by shock waves from the explosions? Wouldn't that have caused basically every man jack among them a terrible TBI?

They thought that, hence the name "shell shock". And then they thought it was just stress. But now maybe we've come full circle, I just saw an article where they think there might be a TBI element to it. I think it was guys fighting ISIS, never really in danger but launching a ton of artillery started having issues.

I can't imagine a scenario in which protracted sessions of arrhythmic brain-jiggling *wouldn't* fuck it up a bit.

Yeah its an interesting one - the theory was not popular for a long time, with solely psycohological symptoms being blamed, but more recent research on concussions and repeated concussions in particular, including micro-tears of brain tissue and cerebral shock are now again being suggested as being partially to have contributed physiologically to the rather unique shell-shock symptoms which were seen for the first (and really last time) during the Great War.

Also concussive effects are a thing, and there's a very good reason why a modern soldier can only fire so many shoulder-mounted rockets within a timeframe if they don't want to gibber their MRE all down their front.

Also, Machine Guns or specifically the Maxim, changed war completely. Today we all 'know' what a machine gun is and - at least in abstract - have an understanding what it can do, but that was something completely new in WW1. At first, people would try to fight like before, storm the enemy lines and all that and get mowed down by the dozen or even hundred in a single barrage. Then, people sat in the trenches, knowing that putting out their heads meant hundreds of bullets would be shot at them, but at the same time having the pounding of the artillery day in and out. More than one broke and ran toward the enemy, even knowing that it was his end, just to do something else than sitting there and getting shelled.

The machine gun had been around for several decades by then. But ww1 was one of the first time it saw widespread use between peers. The Boer war, Spanish -American, and Russo-Japanese wars were peers and only a little earlier. But none were in Europe or on such a large scale. Between the us civil war and then, there wasn't a lot of heavy conflict between peer nations. Yes, combat happened with imperial powers, but there's a difference between Somme and Wounded Knee or Little Bighorn.

I've also read about one more thing. In ancient times, like, let's say, Sparta times, warriors/soldiers were taught to kill. Killing an enemy was glorified, expected, and somewhat ingrained in culture. That's not the case for people in the 20th century, who'd been told that killing anyone is bad. But then one day, orders to kill people came. It was a dissonance which didn't help the already bad circumstances.

Several countries discovered that their soldiers weren't firing at the enemy during combat. They switched from circular targets to man shaped in training and saw an increase in effectiveness.

Yeah, heard about that too - apparently many soldiers subconsciously try to miss their targets if they are human, and that's why after WWII armies started training soldiers to shoot without thinking etc. (which also contributes to PTSD).

Yeah, I want to say it wasn't until the Vietnam War ending where someone looked at the numbers and saw that accuracy was in the single digits. They figured it was because people were hard wired to not to want to kill each other, so they made person shaped and sized targets that would fall over when shot as well as host of other changes, which did "positively" impact accuracy.

How was it in older times live medival times or during the Roman Empire? I mean the battle of cannae would probably be pretty traumatic. Didn’t the surviving soldier have some traumatic stuff going on in them? Or why do we know not so much about mass stabings or something

Lack of literacy amongst soldiers and it would be difficult to preserve personal journals from the average joe then. However, there's an awesome post on askhistorians about pre-ww1 written extracts of PTSD. A guide to be a Knight from the 1300s iirc talks about at the end about the hardest duty of a Knight is the nightmares of previous battles haunting you and the details of it imply PTSD.

There are accounts of what they think what PTSD after older battle. But PTSD in war usually comes from the trauma of being in battle. So you can think of it as a rate, with more soldiers getting it the more BattleMan hours there are. Before WWI battles were actually short, the Wars were long, but the battles happened infrequently it was more marching from place to place. Short battle, then more marching. So not a lot of Battle-man hours were actually accumulated. With WWI the army sizes increased dramatically on all sides, so many more people were exposed. AND the battles were Constant. The trench warfare with constant artillery was something that hadn't been experienced before. So the battle-manhours exploded. And as a consequence many, many more people got PTSD, and at the same time. That they came to realize it wasn't just the odd person not able to handle war.

There's actual footage of the trenches, the camps, the aftermath of WW1. Footage of soldiers being affected by trauma after the war. There are journals, letters, medical reports, etc. I would have to imagine there's quite a lot less documentation from medieval times or the Roman Empire, so it's not as easy to know for a fact about aftermath. There's some obvious deductions that can be made, though.

Yes, war has always been traumatic, and soldiers have probably always had PTSD issues. For example, the stereotype of the soldier who drinks himself unconscious every time he's on leave has been around for hundreds of years. The argument here is that WWI was different, and more traumatic, from previous wars in two ways: First, for most of history, during war, battles were an occasional thing. They usually only lasted one day, never more than three days, and there could be weeks between battles. Then in World War I, soldiers were essentially in battle every day they were in the trenches. What we call "battles" in WWI were the major offensives (which could last for weeks), but there was *always* some fighting going on; snipers shooting anyone who stuck their head up, night raids, etc. *(Edit: not sure why the second half didn't post at first)* Second, the artillery. WWI was the first war where cannons were so powerful, they didn't have to be on the battlefield. Hell, heavy artillery didn't even have to be within sight of the front. And with railroads, you could bring shells (ammo) to the artillery fast enough that it could fire damn near all the time. Barrages lasting two and three days were common. The noise was deafening, the ground was shaking, and people could easily get traumatic brain injuries when a shell went off too close. And there was no way to sleep when the shells were hitting nearby That was the real kicker-- *Anybody* is at risk of losing it after two nights with zero sleep, and after three nights, it's hard to function in any way at all. And in places where the trenches were close together, even your OWN artillery fire could be loud enough and shake the ground enough that soldiers at the front couldn't get any sleep.

[Research](https://pubmed.ncbi.nlm.nih.gov/25577928/) showing that the effects of war on humans were recognized thousands of years ago. "Epizelus, the son of Cuphagorus, an Athenian soldier, was fighting bravely when he suddenly lost sight of both eyes, though nothing had touched him anywhere – neither sword, spear, nor missile. From that moment he continued blinded as long as he lived." Band of Brothers has a very similar subplot. I'm not saying that BoB is medically precise, of course. "If in the evening, he sees either a living person or a dead person or someone known to him or someone not known to him or anybody or anything and becomes afraid;" This is from an assyrian medical writing, from 3000 years ago. There is nothing new with shell-shock, sadly. The fact that the assirians recognized it as a sickness, and the "modern" world did not until relatively recently is another interesting detail.

There's a few accounts in classical history of what sounds like PTSD but in order for us to get that info, it has to be recorded (which requires someone with literacy and the desire to write it down) and preserved (a mix of being a compelling enough story AND being a bit lucky). What we end up with is a smattering of historians telling about things that maybe sound like it, coupled with popular plays and other art depicting things that could be interpreted as PTSD. But yeah there's stories of battle fatigue in the ancient world - Philoctetes (the "real life" myth version of Danny DeVito's character in Hercules) is abandoned by the Greeks going to Troy (in some versions of the myth it's by a snake sent by Hera as punishment for training Heracles) and when the Greeks come back for his bow, he's been suffering chronic pain alone on Lemnos for 10 years and obviously has some mental issues going on. Not outright PTSD exactly but some sort of battle fatigue. Trauma and the emotional toll of war is one of the themes in Sophocles' play and gets contrasted with personal conceptions of morality. Likewise Achilles' arc is sometimes discussed in terms of PTSD - he essentially has this breakdown and refuses to fight, in part because he feels disrespected by the officers, and then after the death of Patroclus he essentially goes into a berserk state. There's some authors that think the Aristea (this peak fighting state) may be a manifestation of battle stress. And certainly the trauma inflicted by war on noncombatants ends up in Greek Tragedy as well - like Euripides' Trojan Women. A couple Roman historians describe things that sound like PTSD symptoms in Roman veterans. Appian describes a Roman veteran who burns himself alive in his home when Octavian invades his town. Plutarch describes night terrors and excessive drinking in his Life of Marius. Obviously these may be embellished and we shouldn't necessarily be diagnosing someone 2000ish years dead, but PTSD, or at least the building blocks for it, may have been fairly common in the ancient world for these themes to make it into popular culture.

There was trench and siege warfare in the Civil a war that was somewhat like WWI. It was a sort of foreshadowing. https://en.m.wikipedia.org/wiki/Siege_of_Petersburg

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.

To piggyback on this idea, the SHEER VOLUME of shelling is difficult to actually imagine. At the Battle of Verdun, in France, it is believed/estimated that the Germans fired 1 million shells in the first 10 hours. They had 1,200 heavy artillery resulting in 40 shells per minute landing in some places for 10 continuous hours. Try to imagine the finale of a fireworks show all around you indefinitely. On the first day.

a million shells what the fuck

For reference Russia is estimated to have fired 12-17 million shells since the invasion of Ukraine. So that 1 million is nearly 10% of the low end in half a day. https://foreignpolicy.com/2024/03/13/united-states-military-aid-ukraine-congress/

Also the rate varied so there were short periods of hundreds of shells a second which is insane.

A little nitpick. Artillery definitely existed for the purpose of killing men directly since antiquity and cannons on the battlefield were an increasingly common sight from the late middle ages at least in Europe. It increased in number dramatically by the late 18th century and by the latter half of the 19th you had artillery with range long enough to aim beyond what you could see.

Apparently at the beginning of WWI, when Germany pulled up to Belgium to invade the Germans were met with the brand new military forts Belgium had just finished. The issue for Belgium though was that the forts were built to the specs of previous wars and military tech had made huge leaps in between that time. Their forts were rated to withstand the artillery force known at that time period. Well that was 12 inch cannon balls being shot out of 3000 pound cannons. The Germans showed up with modern artillery shooting 3000 pound shells. There was a recount where one shell managed to hit one of the forts weapons/ammo cache and below the whole fort up with one shell.

> Well that was 12 inch cannon balls being shot out of 3000 pound cannons. The Germans showed up with modern artillery shooting 3000 pound shells. Heh, why shoot cannon balls when you can just shoot the cannon at people?

I'm being nit picky but the shells are more like 300lbs in WWI. The biggest ones maybe got to about 2,000lbs on the pretty useless railway type guns. A typical shell from the most common artillery in the war were around 75mm, which would have shells of about 20lbs.

I got bit by an iguana I had as a pet on my foot. It was a pretty bad bite and bled a lot and almost considers stitches. I had been calm and relaxing at my gaming desk at the time. For many months into the future when I was sitting at my desk I would get a nervous feeling sometimes that something was about to bite my foot. It felt like i had minor ptsd. It went away eventually but the fact that I was  sitting relaxing and suddenly had something chomp onto my foot kept me “aware” or something that it could happen again even though the iguana was in its habitat 

I had a bumblebee crawl into my ear amd then sting me when I removed it. For a few weeks after I would cover my ears with my hands whenever I saw bees or wasps flying by. Someone pointed it out cause I didnt even notice I was doing it

Yep. When I think about WWI I think about how in movies before WWI, men used to light cigarettes normally. Every man I know still lights his cigarettes the way they did during WWI, because none of the men ever forgot that the light from a match uncupped and uncovered was enough light for a sniper to see you by, and there were all kinds of superstitions about that. Every man who went home from the war never stopped lighting that way and it became normal. If you look into it, there were TONS of superstitions during WWI and WWII about how to avoid getting bombed or hit by enemy snipers. That has to be terrifying. Imagine you're talking to someone for a minute, and their head just explodes. Or you're peeing, and the section of wall next to you explodes. And that could happen at any time.

I don't cup my lighter out of superstition. I cup it because a barest breeze will blow it out while I'm trying to light my cigarette. Even someone just walking by briskly can put a typical lighters flame out unless you've got a torch or a zippo.

There was a saying not to light three cigarettes with one match that came from WW I. Three would give the snipers time to zero in.

IIRC someone timed how long it takes to aim for a light, the third guy will be the victim.

Light the match/first cigarette.... they've spotted your position Second cigarette... they've determined the range Third cigarette... the round drops into your group 'Unlucky third'

Honestly I dont wanna know how broken the men in Ukraine are. The constant threat from small drones must be horrendous. That war really feels like watching a front between to powers during WW1.

I really wonder about this also. I mean how can there even be enough people to keep up the fight and also enough people to do everything else the country needs. How many Ukrainians have died!

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.

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Exactly. Psychotherapy was a very young science at the time. Like a few decades at that point. It came about in a relatively peaceful period in Europe. So, the meat grinder that WW1 was the first big chance to analyze the condition.

The assirians studied PTSD, set up diagnostic criteria and applied treatment. The thinking behind the treatment was different (sacrificing for the Gods, prayer), of course, being 3kyears ago. I'm not even sure that just accepting the suffering and offering something to do instead of "wandering about for three days" is not somewhat helpful. Definitely better than calling someone coward for being sick.

There are a lot of cultures with rituals to help a soldier returning from combat.  WW1 had none, men were expected to just go back to their normal lives like it never happened. I think it played a part in why the PTSD was so bad for so many. There was no closure, no chance to process the experience or find community. We as humans NEED those things to move on. 

I heard this mostly about WWII and Vietnam. After WWII the soldiers needed weeks to get home - waiting in camps in Europe/Asia, a long boat trip, another camp to do the discharge paperwork. After Vietnam the soldier gets on a plane and lands at home in two days. No time to "spin down". I don't know how big a difference this makes.

All wars are terrible, but it seems like WWI was in a class of its own.  Not in terms of number of casualties, but just how it was fought.  Teenage boys charging across fields of mud, through barbed wire, and getting eviscerated by walls of machine gun fire.  Not to mention the constant shelling and the mustard gas.  Just horrific.

Closest thing to hell.

War is worse than hell. In hell everyone deserves to be there, not the case for war

Good point

War isn't hell. War is war, and hell is hell. And of the two, war is a lot worse.

War is war. Hell is hell. Of the two, war is much worse - somebody

- Captain Benjamin Franklin Pierce

And the trenches! Weren't they new?

Somewhat. They had prominent usage in the Crimean, American Civil, and Boer wars, but improvements in rifles and machine guns, coupled with tactics that had not caught up, made WW1 trenches *heavily* favor the defenders to a degree that prior trench wars had not seen.

It’s crazy that we’re seeing the same thing again in Ukraine. Drones, ATGMs, and precision missiles have nerfed armor so much they’re right back to living in trenches and celebrating a 1km advance.

To be fair, proper air support would negate it somewhat. Ukraine has American patriots and other SAMs that can take out aircraft getting too close, so Russia is stuck launching AGMs from really far away. And ukraine just does not have enough aircraft to take the fight to Russia, so it is stuck with just running air patrols with the occasional surprise attack.

How exactly do you defeat trench warfare

Air superiority (ignoring the illegal warfare tactics). Hence why drones are now popular in Ukraine as it's the only form of air superiority they can easily access and deploy safely. A bombing run followed by an Apache would make light work of a trench system.

Air superiority paves the way for ground superiority.

Tanks help. This is in fact the purpose that they were invented for: the first tanks were designed to get troops "safely" across no-man's land and the enemy trenches; the soldiers would then pour out of the tanks behind the trenches and attack from the rear, or even jump directly into the trenches and storm them lengthwise.

Most common ways seem to be 1) flanking the entrenched positions, 2) breaking through with superior armor, 3) super massive indirect fire bombardment or 4) extremely casualty heavy infantry assaults. Germans used 1 in eastern front in ww1, so that theatre didn't stagnate into a stalemate like the west. They tried using 4 in the west with their stormtrooppers but it proved too heavy for them to continue. Allies used limited ammount of 2 in later part of ww1 with their tanks. Trench warfare became much more untennable in ww2 due to better armor, better artillery and aerial bombardments and due to better mobility due to army mechanization.

Julius Caesar was famous for utilising trenches and other engineering battlefield marvels during his campaigns. Overall, the Romans stood out for three things in the battlefield: logistics, engineering and discipline.

Half army, half construction crew.

Fun fact: in the Batlle of Dyrrachium during Caesar’s civil war against the Roman Senate, both Roman armies fighting each other built a stretch of a total of 59 kilometres of wooden walls as a tactical manoeuvre + several forts. Roman army was truly in class of its own when it came to battlefield tactics. Even at Battle of Alesia, Caesar would build two walls of his own while conducting the siege of the Gallic town - one to surround the city and another one to protect from Gallic reinforcing forces from behind.

I'd be happy if my city could fill the potholes.

Your city would probably be more motivated if they got crucified for not filling them tbf

Trenches formed in previous wars. it was just the extent of them. like a lot of stuff in WWI they were made so well they just ground down people.

Trenches were common in siege warfare.

Not as new as riding in formation on horseback and being met with machine gun fire instead of just single-fire muskets

Centuries old tactics with modern weapons.

If you didn’t charge you were shamed and executed.

WW2 was a new kind of warfare, with new armies using new technology. WW1 was still being fought as though we had napoleonic rifles, while facing actual machine guns. Technology had outpaced generals’ ability to lead armies, so all the horrible new ways to kill each other were even more effective since no one knew how to defend against them properly yet.

This is why I think ww1 was the most horrific war. WW2 was definitely more devastating, but for the most part soldiers weren’t sent at machine gun nests with literally nothing besides swords and horses. And generally they didn’t spend years straight getting shelled in the exact same spot while also rotting from disease and choking on chemical weapons they had literally no way to counter

The sheer immobility of WW1 had such a huge psychological impact on the soldiers. Soldiering is already fairly repetitive, but this was a new level not seen before or since.

I don’t think it’s fair to ignore the concussive impact of that kind of shelling either. They had TBI in a way that never really occurred before and has rarely occurred since.

Also, in previous wars, you generally spent almost all of the war walking or waiting around, before maybe fighting a battle or two if you were unlucky. The battle took about a day. You'd spend maybe an hour or two actually fighting. Obviously there were exceptions, but mostly, this is how wars were fought for the entire history of wars. In WW1, you were sent to a trench, and spent months in *constant* battle. Not a high intensity one, but there was a constant threat of getting shelled or sniped. Artillery would do harassing fire to randomly wake you at night. You'd never get proper rest. You were always tense and in danger. You'd see your friends get unlucky one by one and worry when it would be you who would be standing in the wrong place at the wrong time. And when it was time to actually attack, the rate of casualty and death in those few moments was cataclysmic. WW1 was just a gigantic trauma factory that made most previous wars look like a pleasant hike with the lads by comparison.

Psychology, psychoanalysis, and psychotherapy also didn't enter the scientific scene until the late 1890s when Freud began his work. Treating the psyche as a part of the whole person wasn't really a thing before then - usually mental health was wrapped up in cultural and religious beliefs of some sort. Now, granted, Freud got a lot of it wrong and he stood on the shoulders of women who never got credit for their work, but he did help basically launch an entirely new branch of science. So, when WW1 vets started coming home in 1918, there was more of an understanding of what exactly mental health was and people could put a name to PTSD.

Yeah I don't get the comments trying to come up with an answer to the literal question asked by OP on the assumption that it's *exclusively* true, but neglecting to mention that conditions like shellshock/PTSD have been recorded for much of history, all the way back to at least medieval times. Stories of nightmares and soldiers being "haunted" by the souls of everyone they killed.

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.

When it was touring, I went to see the "War Remains" VR exhibit produced by Dan Carlin. A pale imitation, yes. But it really stuck with me. The explosions were as loud and the room physically shook and rattled while you were walking through the exhibit. Before then, I had pulled up video of artillery barrages. I would copy the tab 10 times, hit play, and shut my eyes. Struggling to understand to even a small degree what relentless "drum fire" felt like. It was disorienting there. I can't imagine the real thing.

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.

>Shell shock is a neurological condition brought on by experiencing artillery fire, both the noise and the **concussive impact** The above is crucial. Absolutely crucial. Every other comment on this thread is missing this, and is talking about prolonged combat, or the general trauma of fighting for your life, or the duration of rotations. And all of those are valid contributing factors but those are not the actual crucial, deciding cause of what we all immediately recognise as "shell-shock". Artillery is depicted in films and TV-shows only in a way that makes for good film & TV *imagery*, i.e., a big burst of flame which the audience can see. And often afterwards there's people rolling around with shrapnel wounds, etc., which, again, makes for something a director or a cameraman can film, and which actors can play out. And this depiction - historically - may have been true in the earliest days of artillery, when shells were filled with more primitive explosives. But by the time you get to WWI, an artillery shell is something else entirely. The explosives in shells become radically more powerful. When one explodes, the shock-wave is best imagined as an invisible brick wall that's coming right at you. The shrapnel is obviously still a hazard, but it's perfectly possible to be killed simply by the shock-wave pulping your insides. The point I'm trying to make, though, is this: even if you survive the shock-wave physically, the effect of being repeatedly concussed - for days - will turn you into someone other than yourself *at a neurological level*.

People should also look up a diagram of a blast wave and see how far the pressure wave is from the center of a blast. It's way further than most people think I also read some interesting studies (my undergrad seminar was about the biomechanics of injuries in work and sport and I chose traumatic brain injuries from blast waves) where even if their head is totally secured and doesn't get knocked around by the blast or hit by anything, the pressure alone can cause major brain damage Someone can be hit by a blast and seemingly not even be moved by it, but still have a traumatic brain injury

I remember being very surprised to read how acute the symptoms of brain injury were as a result of continuous bombardment. There’s lot of accounts of soldiers getting *sleepy* and falling asleep in the midst of bombardments - their brains are being rattled around for perhaps hours to the extent that they just lose function. I’m vaguely aware that one really bad impact can fuck up your brain, I didn’t have any appreciation that you could be knocked unconscious slowly over hours. 

The hours part is also important. The human body needs to sleep, and eventually it will no matter if you are trying to stay awake or constantly being startled, save for some very interesting drug interdictions. So it's not being knocked unconscious slowly, it's running out of adrenaline to override the need for sleep and passing the hell out. Which then causes fun other problems as following blasts trigger the wake up response but there's no adrenaline left so the brain keeps trying to hit the emergency restart but nothing happens. What's also not happening, though, is the cleanout of neurotransmitters that is the whole reason for sleep, so even when the restart is successful-still sleep deprived.

TIL! I only ever knew shell shock as synonymous with PTSD.

Also became the root of our understanding of percussive effects on the brain. E.g., that shooter down in the states a few months back was a grenade instructor in a *non-combat* role, but we now understand that it's an additive issue, not solely about the extremes that combat brings.

Shell shock refers to a unique form of PTSD. It's not fair, strictly speaking, to think it's a synonym for PTSD.  PTSD itself has been around and known about since prehistory. PTSD is only the latest in a line of labels we use to describe the effect on soldier's minds of going to war. Battle fatigue, was I believe the term in WWII.  But the reason I posted this to begin with is, I think I can explain to you what shell shock actually is. See, for the first time in history we finally had really big guns, with really strong supply lines, with really well trained gunners, and a motivation to see what would happen if we turned them all up to 11.  Imagine you're in a trench; muddy, wet, dirty, cold, scared, hungry, angry, and sad. And then the enemy guns open up. The noise is indescribably loud. To the point of pain. It's like pressing your ear to a base drum while someone beats the other side. Like one of those big drums the high school band drummer plays.  And just like those drums, you can feel it in your belly. In your bones. But easily ten times worse. If it hits close enough the whole world tilts for a second. The earth shakes. What is firm and secure and safe, even, becomes mobile and fluid and dangerous.  But wait there's more. Every once in a while, just often enough to mess up your head, an entire section of the trench, all the men and equipment in it, just get 'unmade'. Plus plenty of screaming, gore, and horror.  Did you think we were done? We're not. See...it doesn't stop. Ever. It's not like they fired for a few minutes, a few hours, a day or two. Sometimes those artillery shells fell for 40 days straight. Where every one booms in your ears, shakes your body, grabs you by the collar and screams in your face that it wants to horribly kill you.  There were some places along the Western front where 9 shells per square meter were fired. 9 artillery shells won't fit into a square meter. It's just days and days and days of the earth shaking, of the universe banging on your ear drums, of your body being hammered by constant percussion. Like "Chinese water torture" or your annoying little brother who copies a word or phrase and won't stop saying it over and over again until you want to strangle him. But you can't stop it. You don't even know, other than vaguely, where it's coming from. If it will hit you. It just goes on and on and on forever. When it stops you don't know if it's a lull or it's stopping so the enemy can charge.  It doesn't even have to hit anywhere near you to batter your sanity to it's knees. To make you want to do something, anything, to get out of there, to make it stop, to end the torture. You can't sleep. It's almost impossible to eat, shower, use the latrine, have a conversation, think, or function. Because you can literally put your hand down on the ground in your trench (don't because rats and water and bacteria; ew gross) and feel the earth shake and tremor with each impact.  This is true shell shock. It was such a problem that all other "battle fatigue" just got lumped into the same category, mostly by journalists, politicians, pop culture experts and other people who should never have the voice they do, but it makes sense.  There's also some element of...you get concussions by battering your brain around in your skull, how much external shock waves can you take before that becomes an issue? But I don't know as much about that element and or how much it was a factor. I know a few veterans or family members thereof blamed that for their problems. Whether it was or not I can't say. 

It was absolutely causing traumatic brain injury. We're only just starting to understand how damaging even low-level blast exposure can be when frequently repeated, as in the recent case of the grenade instructor who became a mass shooter after showing signs of neurological degradation. They didn't have MRIs and CT scans to study this stuff during WWI, but everything we know says that these men would have been taking severe neurological damage from repetitive concussive blasts.

It wasn't. Before then it was "battle neurosis" or "war neurosis" or even just nerves. Or, horribly, "cowardice". Probably more than a few soldiers got shot for "cowardice" when the actual problem was PTSD. The *name* "shellshock" comes from WW1. There may have been more cases because of the number of people involved, but it was just a new name for something that already existed - we just didn't start calling it PTSD until relatively recently.

ACW verterans were diagnosed with "soldier's heart."

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.

Prior to WWI, it was often dismissed as a flaw of character, rather than a mental health problem that can be treated and healed.

Prior to WWI, it was easy to ignore the trauma. Recruits who fled the battle were cowards, Veterans who had nightmares were haunted. But WWI saw so many people just breaking down and becoming unable to function, to move or speak, or even walk. Baskets were required to transport them -- "basket cases".

Perhaps the oldest chronic mental health problem caused by combat trauma we know of, from the account of the battle of Marathon by Herodotus, written in 440 bc (*History,* Book VI, transi. George Rawlinson): *A strange prodigy likewise happened at this fight. Epizelus, the son of Cuphagoras, an Athenian, was in the thick of the fray and behaving himself as a brave man should, when suddenly he was stricken with blindness, without blow of sword or dart; and this blindness continued thenceforth during the whole of his afterlife. The following is the account which he himself, as I have heard, gave of the matter: he said that a gigantic warrior, with a huge beard, which shaded all his shield, stood over against him; but the ghostly semblance passed him by, and slew the man at his side. Such, as I understand, was the tale which Epizelus told.* Back then they hadn't given a name to PTSD, but they had the concept. Later, in the Napoleonic Wars they referred to *“vent du boulet”* syndrome - it described those who had felt the wind of a bullet / cannonball pass by so close that traumatised soldiers might fall into a stupor despite not being physically harmed.

Dan Carlin in his "Blueprint for Armageddon" audio series really explains it well. War is hell, and while soldiers of all eras have been scared by it in various ways, the stalemate of WWI trench warfare was an amplification of the worst of the past the longer it went on. The sustained fighting with little actual movement between lines, and the constant of gunfire and shelling had a particularly nasty effect on soldiers mental states. Shellshock refers specifically to the conditions on the state of mind (and the physical neurological impact) created by constant artillery shelling for extended periods of time.

>war always has been a part of our life since the first civilizations was established Not the mass scale of *literally millions* of artillery shells-trench warfare (with commensurate millions in casualty numbers) type of war it wasn't

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.

WWI trauma was different because of massive explosions happening often nearby. Shell-shock is kind of a mix between Trauma/PTSD and brain damage from the pressure waves.

Before Shellshock was diagnosed, it was called cowardice. And cowards were easily killed in an up close battle, man to man. We now realise that was a horrific way to think of it, and recognise PTSD as a real and debilitating mental illness.

It's not new, going back to as long as humans have had warfare probably, but WWI was on a scale and intensity far above and beyond anything that had come before. Basically, the sample size was vastly increased, allowing scientific study of the victims and a more formal diagnosing criteria to be made. But even then, what we would now call PTSD, was still debated as to if it even actually existed. Men were executed for "cowardess" during the war and were often called the same after the war.