Forty-five years ago, the medical establishment in America grasped the severe psychological injury that soldiers could sustain from exposure to the violence of war. We are just now starting to understand that the same is true of residents of violent urban neighborhoods, and that their trauma is both a public health and a public safety issue.
8th century B.C.: Homer chronicles Odysseus’ rage, violence and inability to adjust to civilian life upon coming home from war in “The Odyssey.”
Ulysses and the Sirens. From the House of Dionysus and Ulysses at Dougga. (Fine Art Images/Heritage Images/Getty Images)
416 B.C.: Euripides describes symptoms of post traumatic stress in “The Madness of Heracles.”
1600: First performance of Shakespeare’s “Henry IV,” in which Kate recounts depression, isolation and nightmares suffered by her husband, rebel leader Hotspur.
1600s and 1700s: European physicians first call PTSD symptoms a medical disorder.
1861-85: American Civil War
Soldiers are diagnosed with “soldier’s heart,” thought to be caused by exertion or a too-tight knapsack, or with “nostalgia,” which was blamed on malingering.
Civil War battle by F. C. Yohn. (Library of Congress)
1914-18: World War I
Soldiers with PTSD are diagnosed with “shell shock,” thought to be caused by physical damage to the nerves from shock waves of explosions.
1939-45: World War II
Beginnings of the acceptance that every service member is at risk for PTSD, then called “combat exhaustion” or “battle fatigue.” But this is not
universally accepted. Gen. George Patton slaps two soldiers recuperating in a military hospital, telling them they “haven’t got the guts to fight.”
Gen. George S. Patton Jr., commander of the U.S. Third Army in Europe, pays a visit to the army’s Walter Reed Hospital in Washington, June 14, 1945, reaching down to shake hands with his son-in-law, Lt. Col. John K. Waters who is recuperating after almost three years in a German prison camp. (AP Photo)
1952: The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders I includes a diagnosis for “gross stress reaction,” similar to PTSD but assumed to disappear once the sufferer is removed from battle.
A grief-stricken American infantryman whose buddy has been killed in action is comforted by another soldier during the Korean War in 1950. (Sfc. Al Chang, U.S. Army)
1968: During the height of the Vietnam War, DSM II eliminates this diagnosis.
A wounded U.S. paratrooper grimaces in pain as he awaits medical evacuation at base camp in the A Shau Valley near the Laos border in South Vietnam on May 19, 1969 during the Vietnam War. (AP Photo/Hugh Van Es)
1980: DSM III uses the term “post traumatic stress disorder.”
2015: More than 1 in 10 Vietnam-era veterans still suffer from PTSD. 2.4 million soldiers have returned home from Iraq and Afghanistan. Because many did multiple tours of duty and were subjected to higher rates of traumatic brain injuries caused by explosives, rates of PTSD among these soldiers outstrip those of the Vietnam War.
U.S. Marines fill out research consent forms before taking psychological tests at the Marine Corps Air Ground Combat Center in Twentynine Palms, Calif., Sept. 29, 2009. (AP Photo/Jae C. Hong)
2015: Ongoing research in low-income neighborhoods of American cities finds that residents have higher rates of PTSD than combat veterans.