Did Ancient Soldiers Get PTSD? DOCUMENTARY

In modern warfare, it is quite common to hear about combat veterans who return home bearing more than just physical scars. The psychological trauma of their experience can often be the most haunting and is most often brought up in the context of PTSD. This has a serious impact on their re-entry into society and has been getting increased medical attention over the last few decades. But what of the soldiers in our past? Humans have waged war for millennia, often under the most brutal of conditions, stirring death literally in the face within the confines of close hand-to-hand combat. This raises the question, to what degree did our ancestors also suffer from PTSD? A big thanks to Surfshark VPN for sponsoring this video. They've got your back when it comes to the dangers of the internet like surveillance, data mining, theft, and locked content. In addition to top-of-the-line industry offerings, Surfshark VPN's awesome features also include Multihop, which lets you connect using two different servers for increased security, Whitelister, which allows apps or sites if you're choosing to bypass the VPN for things like banking, CleanWeb, which blocks malware, trackers, phishing, and ads, Killswitch, which protects against accidental exposure if the server connection gets interrupted, and NoBordersMode, which maximizes your access in the most restrictive of regions. In addition, Surfshark VPN has very generous user terms with unlimited devices, 24-7 customer support, and a 30-day money-back guarantee. Try it today by clicking the link in the description below and using the promo code INVICTA to get 85% off plus 3 extra months for free. Before we get started, we must first discuss the term PTSD. This stands for Post-Traumatic Stress Disorder. According to the U.S. Veteran Affairs website, PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening event like combat, a natural disaster, a car accident, or sexual assault. A more detailed explanation and diagnostic criteria is captured in the American Psychiatric Association's DSM-5. Here's a summary. The diagnostic criteria identify the triggers to PTSD as exposure to actual or threatened death, serious injury, or sexual violation. The exposure must result from one or more of the following scenarios in which the individual directly experiences the traumatic event, witnesses the traumatic event in person, learns that the traumatic event occurred to a close family member or close friend, or experiences firsthand repeated or extreme exposure to aversive details of the traumatic event. The disturbance, regardless of its triggers, causes clinically significant distress or impairment in the individual's social interactions, capacity to work, or other important areas of functioning. It is not the physiological result of another medical condition, medication, drugs, or alcohol. Regarding the symptoms, the DSM-5 describes four distinct clusters of behavioral symptoms. 1. Reexperiencing, 2. Avoidance, 3. Negative Cognitions and Mood, and 4. Hyperarousal. Reexperiencing covers spontaneous memories of the traumatic event, recurrent dreams related to it, flashbacks, or other intense or prolonged psychological distress. Avoidance refers to avoiding trauma-related stimuli such as distressing memories, thoughts, feelings, or external reminders of the event. Negative Cognitions and Mood represents myriad feelings from a persistent and distorted sense of blame of self or others, to estrangement from others or markedly diminished interest in activities, to an inability to remember key aspects of the event. Finally, Hyperarousal is marked by aggressive, reckless, or self-destructive behavior, sleep disturbances, hypervigilance, or related problems. Thus we see that PTSD has become something quite specifically defined by the modern medical community. However, this concept has really only come into focus within the last century, despite trauma being a near-constant feature of the human condition since our earliest days of being stalked by predators in the night. But before we look specifically at the cases related to ancient warriors, I wanted to quickly review the emergence of PTSD as a classified medical phenomenon. The first real attempts to formally grapple with problems related to trauma start around the 1800s during the large-scale military conflicts of the period including the Napoleonic Wars, the American Civil War, and the Franco-Prussian War. For instance, physicians were increasingly paying attention to reports from soldiers who wrote about missing home, feeling sad, having trouble sleeping, and experiencing anxiety. Such phenomena were sometimes described as being caused by a psychological state of nostalgia. Other times, doctors associated them with physical injuries. For instance, it was common to say that those who suffered from anxiety, a rapid pulse, and trouble breathing had a soldier's heart, which was believed to result from overstimulation of the heart. Another common diagnosis was something called railway spine, which suggested that symptoms manifested as a result of injury to the central nervous system, which appeared to occur in The early 1900s brought yet more trauma with the advent of the World Wars. The nature of combat had evolved quite a lot by this point, with longer-lasting fights that featured increasingly destructive weaponry such as artillery. During World War I, for example, there was a massive problem of soldier burnout at the front, with many troops suffering crippling symptoms which included things like insomnia, panic, and paralysis. Initially, this was identified as shell shock, owing to the idea that perhaps explosions were causing hidden brain damage. But as the symptoms continued to manifest in a wide variety of cases that did not involve artillery, it became more generally referred to as a sort of war neurosis. Medical treatment varied, and could range from a couple days rest in the rear, to hydrotherapy, and even electrotherapy. The following interwar years saw increased medical attention on the war neurosis, which seemed to still haunt many veterans. It proved of particular interest to military leaders who knew that this was an issue that would surely arise in future conflicts. And indeed, the Second World War would see a huge resurgence in issues as soldiers became weary and exhausted following prolonged combat surges. This sort of psychological strain proved so severe that it is estimated nearly half of all US military discharges were due to some form of combat exhaustion. The medical community which inspected these cases no longer used the term shell shock, and instead applied the more broad term of combat stress reaction. Their studies were largely guided by the influential theory of behaviorism in psychology, which tended to focus on the specific environmental stimuli. Preventing CSR was therefore a matter of reducing stress factors in the wartime environment by promoting close relations within units, for emotional support, and treating casualties with principles of proximity, immediacy, and expectancy. However, there was still very little understanding of what to do with long-term symptoms, and very little medical infrastructure in place to keep up with the demand. Towards the end of the war, the US Veterans Affairs therefore began establishing many clinical psychological training institutions at major universities to birth a new wave of graduates who could help tackle the issue. In 1952, the American Psychiatric Association produced the first Diagnostic and Statistical Manual of Mental Disorders, which included gross stress reaction. However, while this was a step in the right direction, the diagnosis still failed to properly understand the full scope and duration of the issue at hand. Three years later, the US entered the Vietnam War in 1955, which would last nearly two decades. Once again, participants fell victim to the psychological damage of the war. Studies at the time for instance show that 10% of mobilized American men were hospitalized for mental disorders, and of those that underwent at least 35 days of uninterrupted combat, 98% manifested psychiatric disturbances. The scale of the issue was not just something that doctors dealt with, but now the general public did too. For example, in pop culture it proved increasingly common to see the crazy Vietnam veteran character show up in all kinds of media. All of this attention, and the further study of returning veterans, holocaust survivors, sexual trauma victims, and others, eventually led to the first appearance of the term post-traumatic stress disorder in 1978, which was soon officially codified in the 1980 publication of the DSM-3. Its inclusion was the sign of the increasing medicalization of mental illness, and the general maturation of the field of psychiatry. Over the following years, there would be much more research on the subject of PTSD, which continues to this day. The shift to asymmetric combat in recent wars, and the rise of terrorist incidents at home have generated even more cases to study. But perhaps one of the most important findings of recent years is the general prevalence of PTSD, which extends far beyond those with military experience. For instance, the VA cites recent data that shows that about 4% of American men and 10% of American women could be diagnosed with PTSD in their lifetime. This realization is vital to the de-stigmatization of PTSD and the way we approach mental health in general. It's in this context that researchers have looked to the past for clues as to how such mental issues have manifested in history. Right off the bat, we have to set some things straight. It is generally bad medical practice to make a diagnosis without seeing or interviewing a patient. Identifying PTSD in a living, breathing patient is hard enough as it is, and doing so for those in the past is quite daunting. With enough documentation, such assessments might be made tentatively, but for the sort of evidence we get dating back more than a few hundred years, we can only ever be considered highly speculative in our analysis. That being said, it is still worth taking a look at some of the evidence researchers commonly consider. Some of the earliest records of note come from ancient Assyrian medical texts that describe patients who experienced depression, slurred speech, loss of cognitive function, and vivid nightmares. Here's a particularly detailed passage. Quote, if in the evening he sees either person living or dead, known or unknown, or anybody or anything, and becomes afraid, he turns around. But like one who has been hexed with rancid oil, his mouth is seized that he is unable to cry out to one who sleeps next to him. Something of medical interest is clearly going on here, despite the claims of ancient Assyrians that it was vengeful ghosts and spirits to blame. Perhaps some form of trauma is at work, owing to the brutal nature of Assyrian warfare and their intense three-year rotational cycle of recruitment. But again, we can't know for sure. Other often cited examples come from classical antiquity. In Greece, for example, we have an account from Herodotus describing the experience of a hoplite who faced the Persians at Marathon in 490 BC. Quote, there fell in this battle of Marathon on the side of the barbarians about 6,400 men, on that of the Athenians 192. Such was the number of the slain on the one side and the other. A strange prodigy likewise happened at this fight. Epaziles, the son of Kouphagoras, 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 him, but the ghostly semblance passed him by and slew the man at his side. Such, as I understand, was the tale which Epaziles told. From Xenophon, we hear of a Spartan commander who had so long been exposed to war that he became violent and quick to anger, which made him ill-suited for civilian life. Quote, such conduct as this, in my opinion, reveals a man fond of war. When he may enjoy peace without dishonor or harm, he chooses war. When he may live in idleness, he prefers toil, provided it be the toil of war. When he may keep his money without risk, he likes to diminish it by carrying on war. As for Clericus, just as one spends upon a loved one or upon any other pleasure, so he wanted to spend upon war. Such a lover he was of war. From Hippocrates, we get a description of two civilians who may have also been victims of PTSD. The first female patient is said to have been gripped by fear, depression, and incoherent speech, while the second would quote, fumble, pluck, scratch, pick hairs, weep, and laugh but not speak. In the Roman era, we have additional accounts of how soldiers and civilians alike reacted to traumatic events. Some extend to describing entire communities as is the case of this passage from Livy describing the Second Punic War. Quote, the longer the war continued and the more men's minds as well as their fortunes were affected by the alternations of success and failure, so much the more did the citizens become the victims of superstition and those for the most part foreign ones. It seemed as though either the characters of men or the nature of the gods had undergone a sudden change. The Roman ritual was growing into disuse, not only in secret and in private houses, even in public places. In the forum and the capital, crowds of women were to be seen who were offering neither sacrifices nor prayers in accordance with the ancient usage. Unauthorized sacrifices and diviners had got possession of men's minds and the numbers of their dupes were swelled by the crowds of country people whom poverty or fear had driven into the city and whose fields had lain untilled owing to the length of the war or had been desolated by the enemy. Likewise, in the medieval era, we get accounts of clearly traumatic situations that could trigger a psychological reaction like PTSD. Here's a passage from the Journal of Geoffroy de Charnay. Quote, in this profession one has to endure heat, hunger, and hard work, to sleep little and often to keep watch, and to be exhausted and to sleep uncomfortably on the ground only to be abruptly awakened. And you will be powerless to change the situation. You will often be afraid when you see your enemies coming towards you with lowered lances to run you through and with drawn swords to cut you down. Bolts and arrows come at you, and you do not know how to best protect yourself. You see people killing each other, fleeing, dying, and being taken prisoner, and you see the bodies of your dead friends lying before you. Throughout the history books, you can find many other mentions of individuals displaying symptoms that one could potentially relate to PTSD. Things like depression, mood swings, paranoia, insomnia, shaking, loss of appetite, avoidance of crowds, and impulsive violence. With these examples, we get a sense of just how tantalizing such morsels of information can be, but also how inadequate they are in providing enough information to make any definitive medical assessments. At best, we can conclude that there was indeed a psychological toll of war beyond just the physical scars of combat. But whether or not this met our modern standards for PTSD is a subject of much debate. But even this general, vague conclusion brings with it a lot of contentious baggage to discuss. Who defines what is traumatic, and who decides what actions are symptomatic behavior? I'll provide some examples to clarify what I mean. Let's say for instance that today, you went out in the streets and saw someone slit the throat of a bull and take a shower in its blood. It's pretty safe to say that this sight would be shocking to most. But in the past, this might be the standard routine of your local priest performing a Torah bullion. Nothing out of the ordinary here. And what if today, you were to attend a funeral and see someone wailing uncontrollably at the top of their lungs, tearing at their clothes, their hair, and their skin? You might expect something was really wrong here. Well in the Roman era, and other eras, that sort of reaction was just expected, and one might even hire professional mourners to ensure that things felt just right. If you just sat there silently dabbing your eye with a cloth, perhaps something was wrong with you. Think also of the idea of public executions that today would shock most audiences, but in the past would draw huge crowds. For more on this particular subject, I recommend you check out Dan Carlin's episode on painfotainment. These examples hopefully expose just how relative the whole study of trauma and human reactions to it can be. What might be shocking to some, may not be to others, but either way, we all have our breaking points. Normal is very much a factor of your typical environment. There are all sorts of factors baked into this. Exposure to violence, ideas of morality, cultural expectations, education, and more. Our discussion thus far has been very western, and particularly American-centric. Attempting to project our own norms onto other cultures today, and especially those of the past, therefore risks high levels of bias. We would probably need a whole other episode to further explore this fascinating idea. For example, what would be considered traumatic for a knight with strict ideas of honor, or for a Roman soldier with strong societal expectations of pride and shame? Let me know if this is something you'd be interested in diving into in more detail. Anyways, I hope you enjoyed this episode. A huge thanks to our patrons for supporting the channel, and the many researchers, writers, and artists who made this video possible. See you in the next one.