Embedded Files
Carver Hospital, Washington, D.C.
Healing Wars addresses mental health of service members and veterans throughout both the Preamble and the stage performance. Today, we are used to seeing topics of mental health, PTSD, self-care and the like in relation to both military and civilian life. It is a well-known fact that war can cause trauma to the brain and body which necessitates medical treatment and, generally, this treatment is accepted as a good thing. This has not always been the case - during the Civil War, matters of mental health were deeply misunderstood.
mental health and war
mental health and war
The American Civil War witnessed a revival of nostalgia, a mental disorder that had created problems for armies for centuries. The origins of nostalgia are difficult to track, but have been traced to as early as 1569, when a Swiss officer reported than one of his cadets had succumbed to homesickness. The first to use the term "nostalgia" was Johannes Hofer, a medical student in Germany in 1688. He described the symptoms as anorexia, insomnia, slow fever, irritability, anxiety, and a general wasting away of the organism. Other symptoms included suicidality, cardiac arrests, and brain inflammation. The basis of the disease was a separation from a homeland and loved ones, an overwhelming desire to return to the place from whence one came - homesickness.
Nostalgia was medically recognized by Civil War surgeons and officers. The official records in the federal army during the Civil War reveal 5,213 cases of nostalgia and 58 deaths from the condition among white troops, and 334 cases and 16 deaths for non-white troops between May 1861 and June 1866. Occurrences of nostalgia decreased as the war went on, which is attributed to incoming soldiers having a more realistic view of the war and its duration as the years passed. Though the number of cases and deaths is small relative to casualties from fighting or disease, nostalgia perplexed military leaders for the entire duration of the war, and was a catalyst for disease related deaths. Those suffering from nostalgia were more susceptible to other diseases due to a decrease in immune system efficiency. As such, Civil War officers were committed to reducing nostalgia in the army as much as possible. (From Nostalgia and Malingering in the Military During the Civil War by Donald Lee and Godfrey Tryggve Anderson)
A handful of songs were thought to promote nostalgia, and thus were forbidden by many officers. Below are two of these songs, "Somebody's Darling" and "Home, Sweet Home."
In the aftermath of the Civil War, medical researchers sought to learn more about nostalgia and other combat-related disorders.
In 1862, an American physician named Jacob Mendes Da Costa identified a psychiatric syndrome present in Civil War veterans which he named "Soldier's Heart," or "Da Costa's syndrome." The condition presents a set of symptoms similar to heart disease, including chest pain, palpitations, sweating, shortness of breath, and fatigue upon exertion. In 1871, De Costa reported the results of his study of 300 Civil War soldiers during which he identified patterns of the condition.
The typical case of soldier's heart involved a man who was on active duty for several months before contracting an annoying bout of fever or diarrhea. The soldier would be hospitalized, and upon return from their short stay, would find that he could not keep up with his comrades without feeling out of breath, dizzy, or having chest pains. The effected soldiers would appear generally healthy upon examination. Less common, though still of concern, was a unique case of soldier's heart in which the grieving mother of a soldier killed at war would present the symptoms of Da Costa's syndrome.
Professionals today still don't know too much about soldier's heart. The condition is known to represent several different disorders, some of which have a known medical basis, but otherwise joins the long list of stress-related combat disorders.
Portrait of Da Costa by Thomas Eakins
letters of longing
letters of longing
Letters from loved ones at home were essential to the wellbeing of a Civil War soldier, to the point that newspapers published pleas for women at home to write to their husbands as a matter of saving them from disease. Over 180,000 letters were shipped daily throughout the Union's military post office system, but these letters from home were received sporadically. Slow transport methods, less-than-perfect management systems, and the frequent movement of a soldier contributed to the infrequency of mail deliveries. Below are samples from letters which demonstrate soldiers' longing for communication from the lives they left behind.
"My Dear Sister: It is now two or three days since I received your last letter written at home and mailed from Batavia. That makes the third or fourth letter I have received from you since I left home. I am thankful to hear from you at all and therefore do not complain. The home news generally gave me great pleasure... your news has almost wholly relieved my mind." (Ely S. Parker, November 21st, 1863)
"Dear Father, I again address you my accustomed weekly letter. I have not received anything from you for nearly two weeks, but your letters may have been lost in transit if written." (J. C. Chadwick, August 24th, 1864)
"Jane this is the fift letter I have rote to you and got no ancer yet Jane I don’t know what to think. Jane you sed you would write to me every week…if you node how bad I want to hear from you, you wood write to me." (Unknown Confederate soldier, September 1863)
ptsd AND WAR
ptsd AND WAR
Though nostalgia might be thought of as our earliest understanding of war-related post-traumatic stress disorder, nostalgia and PTSD are different. PTSD is a mental and behavioral disorder that can develop because of exposure to a traumatic event. Symptoms include disturbing thoughts, feelings, or dreams related to the events; mental or physical distress to trauma-related cues; an increase in the fight-or-flight response, and more, with symptoms lasting for more than a month after the event. Though warfare is not the only traumatic event that can trigger PTSD, it is perhaps the most common example within American media.
A large number of veterans are diagnosed with PTSD and are at a higher risk of suicide and self-harm.
About 11-20 out of every 100 veterans who served in the War on Terror have PTSD in a given year.
About 12 out of every 100 veterans who served in the Gulf War have PTSD in a given year
About 15 out of every 100 Vietnam veterans were diagnosed with PTSD in a 1980s study. It is estimated that 30 out of every 100 Vietnam veterans have had PTSD in their lifetime
About 1 in every 10-15 veterans suffers from a substance use order or addiction
One out of every three veterans seeking treatment for a substance use disorder also has PTSD
An average of 20 veterans die from suicide per day
A mask painted by a Marine who attended art therapy to relieve PTSD symptoms.
Statistics from the U.S. Department of Veteran Affairs. For more information about veteran PTSD and related issues, you can visit the National Center for PTSD.
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