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PTSD from the Civil War to the present

Local scholar offers historical perspective

“Nostalgia” was a common medical diagnosis for depression and PTSD. Photo credit:

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During the past decade-and-a-half, post-traumatic stress disorder (PTSD) has become commonplace in language and in society. PTSD is a mental health condition that occurs when someone witnesses or experiences a severely traumatic event.

It also comes with some history.

Dr. Russell Hicks will discuss the disorder in a presentation entitled "Veterans of the Civil War and PTSD," on Sunday, March 18 at 2 p.m. in Quarters 2 at historic Fort Steilacoom on the grounds of Western State Hospital in Lakewood.

A graduate of the University of Southern California School of Medicine, Hicks served as chief of the Department of Psychiatry at the Madigan Army Medical Center and retired from active-duty in 2004. While a medical student, Hicks worked with a professor who was a medical historian. In turn, Hicks became interested in Civil War medical history.

He currently teaches in the Brandman University program for marriage and family therapists with an emphasis on substance abuse disorders and psychopharmacology.

Sunday's presentation will describe mental health in the mid-19th century as it relates to PTSD, and it will also trace the history of the disorder to the present.

"My interest in Civil War medical history has led me to the appreciation that soldiers are changed by their combat experiences, and throughout recorded history there have been descriptions of what is now labeled as PTSD," he wrote in an email.

While not going into further detail about his presentation, Hicks did allow that he would reference his experience of treating soldiers only as a way of interpreting the medical literature following the American Civil War.

"Nostalgia was the term used in the mid-19th century to describe depression and PTSD, and I will compare the literature of the 1860s to present psychiatric diagnostic terminology," continued Hicks.

In the late 1600s, European physicians began to describe soldiers who exhibited symptoms of despair, homesickness, sleeplessness and anxiety. One of them, Swiss physician Dr. Johannes Hofer, first coined the term nostalgia to describe the phenomenon.

During the American Civil War (1861-1865), nostalgia became a common medical diagnosis.  Some military doctors viewed it as a sign of weakness, and public ridicule was often the recommended cure.

After the Civil War, Dr. Jacob Mendez Da Costa studied veterans suffering from nostalgia and discovered that many of them suffered from physical issues unrelated to wounds, such as palpitations, constricted breathing and other cardiovascular symptoms.

Believing these manifestations stemmed from overstimulation of the heart's nervous system, the condition became known as "soldier's heart," "irritable heart," or "Da Costa's syndrome."

These symptoms became apparent again during World War I and World War II. During the former conflict, it was described as shell shock; during the latter, it was described as battle fatigue.

In 1952, the American Psychiatric Association (APA) added "gross stress reaction" to its first Diagnostic and Statistical Manual of Mental Disorders, or DSM-I, to describe the condition. After more study, the APA included PTSD as a definable condition in its 1980 DSM-III.

"We need to study history so we can understand our present experiences in the context of history and not as isolated events," concluded Hicks.

Veterans of the Civil War and PTSD, 2 p.m., Sunday, March 18, Quarters 2 at historic Fort Steilacoom, 9601 Steilacoom Blvd. SW, Western State Hospital, Lakewood

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