How does service in combat affect the psychological state of those who are subjected to wartime deployments?

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What has been categorized over generations and a multitude of wars as “shell shock,” “combat neurosis,” and “battle fatigue” has finally found a more psychologically appropriate nomenclature in the study of what is now called “post-traumatic stress disorder” (PTSD), a phrase attributed to the American Psychiatric Association.  Manifestations of PTSD have been around for as long as war, which is to say, forever.  It became more prevalent during and following the Vietnam War, when many American soldiers were returning home visibly emotionally scarred by their experiences in that strategically and emotionally complicated conflict.  At least with World War II and Korea there had been a sense of a definable mission: the defeat of Nazi Germany and Imperial Japan in the case of the former and the liberation of South Korea below the 38th Parallel in the case of the latter.  In Vietnam, there was no easily identifiable end-state – no sense that a finite point existed at which “victory” could be declared and the soldiers brought home.  Combined with the nature of warfare in Southeast Asia – dense jungles and hills alternating with thick valleys of tall grass in which a determined, well-motivated and armed enemy could launch endless ambushes – this sense of limitless combat contributed to the large number of veterans experiencing some level of PTSD.

While the war in Vietnam illuminated the enduring legacy of subjecting tens of thousands of young men and women to protracted periods of conflict, the problem of PTSD both preceded, as noted, that particular war, and continues to manifest itself in the conflicts of the 21st Century, as seen in the difficult emotional adjustments made by soldiers returning from Iraq and Afghanistan.  Combat neurosis, or PTSD, manifests itself in increased instances and levels of anxiety and depression, with self-imposed social alienation and guilt over having survived when so many of one’s friends and colleagues did not come home.  The horrors of watching friends to whom one has grown close through the physical and mental ordeal of basic training and service in combat being torn apart by mortar or artillery shells, landmines, or high-caliber bullets from automatic weapons cannot help but adversely affect the mental state of those subjected to such experiences, and the problem of survivor’s guilt compounds the mental burden associated with military service in times of war.

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