Monday, April 21, 2014

Suffering in Silence: Psychological Disorders and Soldiers in the American Civil War

By Sarah A.M. Ford
Kutztown University of Pennsylvania


Did soldiers of the American Civil War suffer from post-traumatic stress disorder and other psychological disorders? It has only been several decades since mental illness attributed to war conditions was clinically recognized. Recent research has shown a strong positive correlation between war time events such as witnessing the death of comrades, friendly fire or IED explosions and post-traumatic stress disorder.

With a conflict as devastating as the American Civil War, it would be logical to hypothesize that Civil War soldiers were subjected to events that put them at risk similar to today’s soldiers. There is a strong relationship between attributing events during the Civil War and psychological affects; for instance revolutionary weaponry developments, medical procedures, psychological warfare, and hand to hand combat could have invoked psychological ailments. Data compiled from diaries and letters will affirm the presence of psychological disorders in soldiers who fought in the war. From this body of evidence, it is clear that soldiers of the American Civil War did indeed suffer from post-traumatic stress disorder and other psychological disorders.

The most common disorder that results from exposure to combat is called post-traumatic stress disorder or more commonly known as PTSD. According to the Diagnostic and Statistical Manual of Mental Disorders, there are several categories of symptoms for PTSD. The symptoms include the experience of actual harm or threats to be harmed physically and or emotionally, intrusive symptoms that include flashbacks, disturbing dreams or memories, negative changes in cognition, the avoidance of stimuli associated with the event and changes in arousal levels. In order for there to be a diagnosis, symptoms must be present for over a month and the level of stress has to be significant enough where everyday activities are negatively affected.

Another common and relatively novel disorder is Traumatic Brain Injury (TBI). This is a neurological disorder that inhibits cognitive functioning as a result of an injury to the head. Symptoms include moderate to severe amnesia, headaches, changes in personality and accumulating more sleep than normal.3 This disorder is becoming widely recognized and diagnosed more frequently in veterans today. Over 30 percent of all casualties in Operation Iraqi Freedom (OIF) and Enduring Freedom (EF) were associated with the head or neck area.

As many as ten to twenty percent of OIF/EF veterans have been diagnosed with TBI. It is plausible to assume that Civil War soldiers, who were not provided helmets, would have suffered from TBI if they experienced in injury to the head or neck region. General Anxiety Disorder and Depression are both common psychological disorders that plague many veterans today. Soldiers who experience traumatic events, such as the death of a comrade or innocent civilians, may experience depression as a result. It is logical that countless men of the Civil War era may have suffered from depression or general anxiety disorder.

The first mentions of symptoms correlated with PTSD dates back three thousand years ago; four thousand years before it would be clinically recognized. Ancient Egyptian Hieroglyphics depicted the emotions and fears soldiers felt while in combat. The Greek historian Herodotus wrote, in 480 B.C, of a Spartan soldier who was taken off the front lines due to his trembling and later took his own life in shame.

In the seventeenth century any disorder associated with depression or changes in personality was termed melancholy or nostalgia. Symptoms similar to PTSD were called Soldier’s Heart and Da Costa Syndrome during the mid and late nineteenth century.

The catalyst for the recognition of PTSD was the outbreak of World War One. The Great War had some of the worst casualties in human history as a result of revolutionary weaponry that redefined warfare. The psychological effects of this war were often seen in the returning veterans as many experienced involuntary ticks and shook unaccountably. This later would be termed Shell Shock.

While not to the extent of the First World War, The Civil War had revolutionary weapon and technological developments that negatively affected soldiers physically and mentally. This included the Minie Ball, a cylinder shape bullet that was more aerodynamic, making it more precise and effective. Instead of a round bullet that would break the bone, the Minie Ball would completely shatter it.

Another technological development that changed the world as well as warfare was the railroad. For the first time in human history, mankind would not have to rely on horses or their own two feet to transport them. This drastically changed warfare by allowing supplies and troops to move into the most remote areas at record speeds. This meant that more soldiers were exposed to significantly more carnage than past wars. A soldier was no longer confined to a specific geographical location allowing them to fight in more battles. Witnessing this novel amount of gore would have been a severe trauma that could have produced anxiety and other psychological symptoms associated with PTSD.

The Civil War is unique in that it took place during a time of great weaponry and technological developments but it was only decades shy of medical advancements that could have saved countless lives. Disease rather than bullets proved to be a significant factor in the death toll of the Civil War. For every one death in combat, there were two deaths caused by disease. The lifesaving technique of sterilization was a foreign concept to Civil War physicians and as a result thousands of soldiers succumbed to infections.

The omnipresence of decay and death of thousands of sick men only added to the carnage witnessed not only by soldiers but nurses and doctors. On a daily basis, medical teams witnessed horrific wounds, ghastly amputations and men succumbing to their injuries and illnesses. Procedures and surgeries performed by army surgeons and physicians also left Civil War veterans literally scarred for life. The survival rate for a man going into surgery was roughly eighty percent depending on the location of the wound. The fatality rate was directly related to the proximity of the injury to the core of the body.

Anesthetics, like ether and chloroform, were used for many surgeries which made the procedures much more humane.Though the fear of having to endure surgery invoked great anxiety, the fear of life after surgery was an even greater anxiety to face.

In a society that relied on physical labor for maintaining a livelihood, living without a limb meant a lifetime of unemployment. Farmers, mill workers, railroad workers or dock workers were all required to be physically able to complete the tasks required of them. An amputee could not continue working in the physical labor market. To make matters worse, majority of the men who fought in the Civil War were from lower economic classes. The socioeconomic status of an amputee would have been lowest amongst the ranks partly because there would be very few jobs that could accommodate their special needs. The anticipation of failure to provide for themselves and their families conjured major stress and anxiety.

The biological needs of humans are crucial for both physical and mental health. If humans are bereaved of biological necessities then they are at greater risk of psychological ailments. In war, especially the American Civil War, even the most basic of human essentials, such as food, water and shelter, are unavailable to soldiers putting them at an elevated risk of psychological danger.

Food supplies were frequently limited and insufficient for the amount of calories a soldier would expel. The water was often contaminated with germs making soldiers sick. Septic water is especially dangerous because it carries many diseases like cholera and dysentery. A diary entry by Union soldier Henry Tisdale implies that he got sick from drinking the water at his camp “Unwell today for diarrhea, causing me to feel weak. Think it caused by drinking too much of the aqueduct water we have here.”

Not only were the soldiers on alert for enemy attacks but also had to worry if their next drink or meal was going to make them ill. Due to the insufficient and inadequate food and water, many soldiers did not have the caloric intake needed to support straining activities. Union soldier Cornelius Platter wrote “3 mile to our right and went into camp 8 mile South East of Jonesboro at 8 oclock -- This has been the hardest days march we have had. Distance marched 22 mile.”

A malnourished soldier would have had difficulties executing long endurance orders like this and would have been pushed to the brink of exhaustion. On top of malnutrition, each soldier was subjected to the weather and its unforgiving nature. Evolutionary instinct would be to seek shelter from the elements, but this cannot be done in war. Joseph Waddell from the Indiana Volunteer Division wrote “Off early and marched to Black River a hard rain late in the evening two men killed on the road with lightning.”

Soldiers had very little protection, which would have affected their sense of safety. With unavailable resources and basic needs going unmet, these men were at an elevated risk of developing psychological disorders.

Arguably one of the most intense contributing factors to psychological effects and disorders were the prisoner of war (P.O.W) camps. Some of the most detestable incidences in the war occurred inside these camps. Psychologically, people are put in situations with numerous traumas, such as ubiquitous death, fighting and abuse, making P.O.W camps a minefield for psychological disorders.

Camps like Salisbury, Libby, Douglas and the most notorious Andersonville were overpopulated and did not have proper supplies for the number of prisoners it contained. At one point, Andersonville detained thirty-two thousand men but the original capacity was for only ten thousand men. When Sherman’s soldiers liberated Andersonville, they found some prisoners completely emaciated. At the end of the war when supplies were scarce, rations were withheld. “No rations issued yesterday to any of the prisoners and a third of all here are on the very point of starvation...”

Prisoners would fight, even kill, other prisoners for whatever they might have in their possession that could aid in their survival. “Have just seen a big fight among the prisoners; just like so many snarly dogs, cross and peevish.”

The fight to survive in hellish places like Andersonville, Libby, Salisbury and Douglas was exceedingly stressful. Witnessing the intense trauma of death on a daily basis was more than enough to produce PTSD.

A unique factor of the Civil War was that units were very often created by geographical location. A town’s entire male population, brothers, friends and neighbors, would fight together. A Union soldier from Michigan found the body of his best friend who was shot and killed. During the chaos of battle, the soldier kneeled down to clear the blood off his friend’s face, while bullets and shells exploded around him. He had lost his sense of urgency and experienced heightened arousal level, which put him in physical danger. This is an example of a soldier’s psychological state putting them at physical risk.

This psychological state would be even more compromised when a soldier fought their own kin. The famous motto of the Civil War was Brothers Fighting Brothers. Families were torn apart by this war as brothers would often fight on opposing sides. James and Alex Campbell were two brothers who fought on opposing side. When war broke out, James went to the Confederate Army with the Union Light Infantry also called the 42nd Highlanders and Alex went to the Union 79th Highlander Regiment. At the Battle of Secessionville in eighteen sixty-two, the two brothers were fighting against each other. Not only would losing the support system of a family member be stressful but the thought of intentionally killing a relative would be a severe psychological trauma that could generate PTSD.

Psychological warfare has been a vital part of combat for thousands of years. Biblical writings of Gideon portrayed of soldiers blowing horns, let out a fierce cry and breaking objects as a result the Mindianite soldiers were so beside themselves with fear that they committed suicide. (Judges 7:1-22) The Civil War was no stranger to these psychological tactics.

The phrase “Rebel Yell” originates from the Civil War and was a weapon used to instill fear in the Union soldiers. Similar to the battle cries of the Native Americans, Confederate soldiers would yell, shout or chant certain phrases or noises to invoke fear in their enemies and many times it did its job. The sounds were described anywhere from Indian whooping noises to the shrieks of a wild animal and these yells implored great fear into the Federal soldiers. “....the Union troops were startled by the most hideous of modern war cries, known as the ‘rebel yell’…This was the first time the Vermont boys had heard that fiendish sound, and it is not too much to say that they were appalled by it for a moment, and thought their time had come to be ‘wiped out.” Fear is a great weapon in combat; unfortunately this great weapon is lethal to a soldier’s psyche.

Witnessing an event is just as catastrophic to the psyche as being a victim of a trauma. Many soldiers did not have to experience combat to receive the full effect of war. Thomas Smiley, a confederate soldier, described the horrifying event that he witnessed at the Battle of Chancellorsville to his aunt. “The large brick house at Chancellorsville took fire and burnt up with about two hundred wounded Yankees who were so badly hurt that they could not move and their own soldiers did not help them any. Later in the day the woods took fire and a great many more helpless men perished.”

At the battle of Seven Pines, a Confederate soldier was horrified not by fighting but from what he heard on that day. The soldier, lying wounded on the ground, described the cries and screams for help from the Union soldiers as they lay in the ditches too wounded to move. A heavy rain came and the water had accumulated in the ditches and the wounded men were slowly starting to drown.

Stories like this would find their way back to the small towns and cities, terrifying the men who were eligible for enlistment or conscription. Joseph Waddell wrote of a young man who was sobbing because he was called up by the draft. “I heard a sound of lamentation.... A negro woman informed me that it was a soldier crying because he had to go to the war!... Several men and women stood in the street, some laughing and others denouncing the recruit”.

Severe anxiety plagued the prospective soldiers as the news of the bloodshed and atrocious fighting trickled from the battlefield to home.

The amount of hand to hand combat in the Civil War left soldiers particularly vulnerable to PTSD, depression or any battery of psychological illnesses. This is the last major American war and one of the last major wars in the world to significantly utilize hand to hand combat. After the twentieth century, the technologies gained in World War One, such as planes, bombs and machine guns, did most of the heavy labor. While linear warfare was the fighting style of choice in the Civil War, almost every battle had some form of hand to hand combat . Union Naval Officer William Ferguson testified to Major-General Hurlbut as to what he witnessed when he arrived at Fort Pillow after the massacre “[There were] Bodies with gaping wounds, some bayoneted through the eyes, some with skulls beaten through, others with hideous wounds as if their bowels had been ripped open with bowie-knives…”

This archaic style of fighting is tremendously personal and has exceedingly negative effects on a person’s psyche. To defeat the enemy, one must look into their eyes and take their life. Hand to hand combat is arguably one of the leading causes in the development of PTSD.

The evidence of psychological effects and disorders as a result of combat is clearly illustrated in the suicides of the soldiers. Numerous soldiers took their own lives rather than live to see another fight. Many men wrote home telling their loved ones about the unfortunate souls that would rather die by their own hand then fight for a chance of survival. Jacob Stouffer wrote about his friend Absolam Shetter saying, “he had been in trouble and at times in a State of despondency-this with the troubles and Excitements around us-deranged his mind and on yesterday morning ended his existence by hanging.”

Newell Gleason, a lieutenant colonel, was described as a fearless leader but had experienced nervousness and anxiety after the Atlanta Campaign. Gleason had difficulty sleeping and battled with depression. In eighteen eighty-six, Gleason committed suicide as a result of his time spent in the Union Army. A majority of the suicide victims were Confederate veterans. Besides the fact that they lost the war, the South lost twenty percent of its population. Families were torn apart by this war. Fathers and mothers lost sons, brothers lost brothers and wives lost husbands. The men that were lucky enough returned from war found their homes and lands destroyed. They lost everything. The war and its surrounding events could have thrown the soldiers into a depressive state leading to psychological ailments.

Understanding events and conditions that contribute to PTSD and psychological disorders help to create a mental picture of the soldier’s experiences. These events are correlated to psychological disorders but neither confirm or deny a conclusion. Examining individual soldiers provides insight into the effects of the war. It also makes the connection personal and the event feel real instead of words on a paper. The next three case studies are the smoking gun evidence that there were indeed psychological disorders as a result of the Civil War. More importantly, they were all real people who were once very much alive and they were all victims of something far greater than themselves.

Albert Frank was a soldier in the Union Army. At the Battle of Bermuda Hundred near Richmond, Frank was off the front line and sitting on top of a trench. He offered a drink from his canteen to a fellow soldier sitting next to him. While the soldier was taking his drink, a shell exploded and decapitated the man, covering Frank with blood and pieces of brain. Frank experienced a complete loss of cognitive functioning being unable to speak, communicate or understand his fellow soldiers. He was later found on the floor shaking and making bomb noises. The only thing he would say was “Frank is killed.”

He was taken to the Government Hospital for the Insane in Washington D.C and declared mentally insane. Witnessing such an intense trauma had affected Frank greatly. He was re-experiencing and reenacting the event and he associated himself to the trauma in a negative way saying he was the one killed. These are indicators of post-traumatic stress disorder.

Angelo Crapsey from Potter County, Pennsylvania eagerly enlisted in the Union army in 1861. Early in his military career, a sergeant in his unit committed suicide by placing his rifle between his knees and putting the muzzle in his mouth. This event would have a profound impact on Crapsey. As Crapsey started to engage in combat, his glorified perception of war began to fade away. “Rebels charged on us & we had to run, run for [our] lives…through an open field & we had showers of bullets sent after us.”

Crapsey became more withdrawn and the radiant spirit he possessed prior to the war disappeared. At the Battle of Fredericksburg Crapsey was taken prisoner and he spent time in at Libby Prison. While contained, Crapsey developed a case of lice infestation and frequently tried to rid himself of the pest even after they had subsided. After his release he fought at the bloodiest battle of the Civil War, Gettysburg. Upon his discharged, he returned back home to Pennsylvania were he experienced illusions, involuntary ticks and violent fits. On August 4, 1864, Crapsey said he was going out to hunt but instead stuck a gun in his mouth and shot himself; the same way the sergeant had done three years prior.

Major General Thomas Kane said that he “loved no one of his men more than Angelo. He came up to his ideal of the youthful patriot, a heroic American soldier.” Crapsey embodied the image of the ideal soldier and possessed a luminous spirit that was contagious. Unfortunately, he lost himself in the tremendous force that was the Civil War.

Just like the soldiers in the Great War, Angelo had experienced involuntary ticks and violent fits. World War One soldier’s ticks and fit were attributed to constant bombardment at battles like Verdun and Somme. Angelo fought at Gettysburg, the sight of the largest artillery bombardment in North American History. While the bombs never physically harmed him, they drove him to insanity. Angelo experienced a change in personality, diminished personal relationships, a loss of previous interest, flashbacks, disturbing memories, negative emotions and he associated the negative trauma to himself which created a sense of self hatred. It got to the point where Angelo could not find a way out of his own prison and the only solution was death. Angelo displayed numerous symptoms of post-traumatic stress disorder.

Dr. William Chester Minor was a surgeon in the Union Army for several years. Minor served at various battles including the Battle of the Wilderness, one of the most gruesome conflicts of the entire war. As a surgeon, Dr. Minor had seen the worst that war had to offer. He had experienced delusions and paranoid fits after the war and as a result Minor was diagnosed with soldier’s heart, an early form of PTSD.

In August of eighteen seventy-two, Minor shot and killed a man in the streets of London, England. According to his testimony, Minor claimed he had been experiencing a delusion where he was back on the battlefield and the man was an enemy soldier trying to kill him. The courts found him not guilty by reason of insanity and he was sent to Broadmoor Hospital, a notorious insane asylum in Crownthrone, England. Arguably one the most intrusive symptoms of PTSD are flashbacks. The person is experiencing an illusion or vision of the past trauma. They are essentially re-living the event allowing them to experience it all over again. Minor may have truly believed he was back on that battlefield and was fighting to preserve his life. William Minor’s incident could have been a result of post-traumatic stress disorder from his combat experience.

Did soldiers in the American Civil War suffer from psychological effects and disorders? Through revolutionary weaponry developments, horrific medical procedures, psychological warfare, and the great deal of ferocious hand to hand combat, there appears to be a great deal of evidence for psychological effects in civil war soldiers. The Crapsey, Minor and Frank case studies provide significant evidence of psychological disorders as a result of Civil War combat. With this body of evidence the question can be definitively answered; psychological disorders are present in soldiers of the Civil War as a result of combat and or its attributing factors. Without a shadow of a doubt the Civil War psychologically scarred and damaged its soldiers. Those brave men put their “sacrifices upon the altar of freedom” and endured a fate worse than death by living their lives in silent suffering. The presence of psychological effects and disorders are evident in the soldiers of the American Civil War.

Image: Government Hospital for Insane, Nurses Home, [Washington, D.C.]

From: armstrong.edu


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