Combat Neurosis

The preferred term to describe mental disturbances related to the stress of military combat; also known by such alternative terms as combat fatigue syndrome, shell shock, operational or battle fatigue, combat exhaustion, and war neurosis.

Combat neurosis describes any personality disturbance that represents a response to the stress of war. It is closely related to post-traumatic stress disorder, and is often characterized under that term. Symptoms of the disturbance may appear during the battle itself, or may appear days, weeks, months, or even years later. An estimated ten percent of all personnel who fought in World War II experienced symptoms of combat neurosis, known then according to the American Psychiatric Association as "gross stress reaction." (The term was applied to personality disturbances resulting from catastrophes other than war as well.) More recently, considerable attention from both the general public and the medical community has focused on the combat neuroses experienced by those who fought during the Vietnam and Persian Gulf Wars. There is no specific set of symptoms that are triggered by war or combat; rather, in most cases, the disturbance begins with feelings of mild anxiety.

Symptoms of combat neuroses vary widely. The first signs are typically increased irritability and problems with sleeping. As the disturbance progresses, symptoms include depression, bereavement-type reactions (characterized as guilt over having survived when others did not), nightmares, and persistent, terrifying daydreams. The inability to concentrate and loss of memory are also common. Emotional indifference, withdrawal, lack of attention to personal hygiene and appearance, and self-endangering behaviors are also possible signs of combat neurosis. Individuals suffering from combat neurosis often react to these symptoms by abusing alcohol or drugs.

Combat neuroses can be a severe mental disorder and the potential success of treatment varies considerably. Some patients are treated successfully with antidepressant and anti-anxiety medications. For a small percentage, however, hospitalization may be required.