BLOG: PTSD in Civil War Times

2 days ago
7 min read

I was raised in an extended family of soldiers. My father served in WWII's Pacific Theater. Though the Veteran's Administration labeled him as a "combat soldier", he worked those years as an airplane mechanic most of the time. That being said, however, he was also given sentry duty at times, and recalled a bullet whizzing past his head and seeing a Japanese soldier bolting into the jungle.

I've had numerous cousins serve in the armed forces. My first cousin, with whom I'm very close, was an Air Force colonel. His son is a veteran of the war in Afghanistan and served in the US Army. I hail these men in my life as heroes, because they stood for freedom. That means a great deal to me.

Dad used to tell me stories about his years in the War. At one point, he was even interviewed, and the recording placed in a compilation of WWII veteran "voices" to be heard through posterity. Unlike some returned veterans, I think he found it cathartic to talk about it, and I was always interested. Finally, I persuaded him to write down his memories in a sort of family memoir, dedicated to Mom and me. It wasn't publishable material, but it's something I'll always treasure.

This week, I have a very special guest. Author Susannah Willey's new novel is called NOSTALGIA. It's the story of a doctor who lived among soldiers in the Civil War with PTSD. However, in an age when admission of fear in battle or having flash-backs afterward could be called cowardice, Willey's story focuses on how the disorder we now label as PTSD was once known as "nostalgia." Below, Susannah Willey has been kind enough to share a truly informative and fascinating blog on this post-war trauma from which so many people suffer. I hope this history will both interest many of you and offer an eye-opening look at how far we've come in our understanding of a condition the deserves attention and special care. Thank you, Susannah, for sharing this information with us.

What Did Post-Traumatic Stress Disorder Look Like In Civil War Times?

By: Susannah Willey

It “Didn’t Exist.”

If I were to ask you what the acronym “PTSD” stood for, of course you’d know. Who hasn’t heard of post-traumatic stress disorder? I’ll bet many of you know someone who struggles with the condition.

PTSD has existed, albeit without recognition, for centuries. The medical community has long recognized the physical symptoms of rapid heartbeat, insomnia/nightmares, and shortness of breath experienced by combat soldiers and veterans, a condition known as “irritable heart.” Compared to the long history of emotional and psychological damage seen in PTSD, the disorder has only recently become a legitimate diagnosis.

During the American Civil War (1861-1865), some doctors referred to soldiers exhibiting signs of PTSD as having "nostalgia," meaning severe homesickness. The recommended treatment? No worries, it will go away eventually.

But sometimes it didn’t. Many soldiers succumbed to the stress of PTSD, suffering flashbacks that placed them back on the battlefield and often provoking violent behavior.

The answer from the military? An accusation of malingering,(1) trying to get out of military service, a court-martial. Those who deserted and were subsequently caught often faced a firing squad.

What might have been even worse than the physical and psychological trauma of PTSD was the stigma attached to it.

Returning Civil War veterans often turned to drinking to cope with the effects of PTSD. Their communities labeled them as drunkards; they could not keep a job or sustain healthy relationships. People often ridiculed and shunned them as weak, lazy, or failures. It didn’t matter how that soldier performed in the war. He could have shown dedication, loyalty, and even heroism. But the label of “cowardice” condemned him to existing in a community that scorned him.

Fifty years later, a new generation of soldiers experienced war trauma in World War I. Still not fully recognized by the military or medical community, only the name had changed. They called it “shell shock.” Considered a legitimate injury—physical nerve damage from exploding shells—others ridiculed it, referring to it as weakness, or “male hysteria.” The treatments of the day were electric shock therapy and a return to combat in the belief that staying busy would distract the soldier from his worries. Victorian-era mores expected men to exhibit stoicism, "manliness," and courage; those who didn’t comply were shamed for their “hysterical” behavior.

Clinicians such as Lewis Yealland reflected the extreme reaction by the medical profession to “shell shock.” He (2) stated in his Hysterical Disorders of Warfare, 1918, that shell shock was a form of personal failure regarding a man’s masculinity and thus required harsh measures to restore the soldiers back to their former selves. Yealland enforced treatments such as electroshock therapy, cigarettes put out on patients' tongues, and hot plates burning the backs of patients' throats.

World War II wasn’t much better for traumatized veterans. By then, doctors knew the condition as “battle fatigue” or “combat stress reaction” (CSR). But military leaders like General Patton condemned these men as cowards. Some soldiers received military discharges for combat exhaustion, but many military leaders "rested" their soldiers and expected them to return to combat. World War II veterans returned home with stories of their derring-do in combat, wearing them as a badge of courage but unwilling to talk about the realities of their experiences. They too feared scorn and the shame of being labeled as unmanly or effeminate.

The Vietnam War era might have been the worst for soldiers suffering from PTSD. Those who believed the war was unjust confronted many soldiers with angry protests and rejection. People labeled them “baby killers,” considering them unstable, violent, or broken. Imagine the veteran returning from Vietnam, struggling with images of the atrocities he saw, IEDs and other modern devices exploding in front of them, friends dead and dying, only to return home to ridicule, derision, and downright hatred.

But reprieve was not far away. Vietnam veterans, suffering from chronic nightmares, flashbacks, and rage, advocated for change. By 1980, the DSM-III (the standard manual of practice for psychology professionals) officially recognized PTSD as a legitimate disorder, acknowledging the traumatic nature of war.

It took longer for public recognition. A young adult in the 1970s, I clearly remember the overt disgust for a soldier who came home from Vietnam and “pretended” to have a resulting psychological disorder.

But those who knew the truth of war’s savagery refused to concede, and eventually society recognized and accepted PTSD. Treatment of PTSD’s emotional and psychological effects is now common, and recognition of the condition has expanded beyond military experience to include other causes of extreme trauma. The Department of Veterans Affairs has established treatment centers that specialize in the treatment of PTSD and the ongoing support of its sufferers.

Having several military ancestors and authoring a novel about PTSD in the Civil War, this subject has become important to me. During March and April, I will donate all proceeds from my novel, Nostalgia, to the local Vet Center in Canandaigua, NY, to help soldiers affected by PTSD. More information is available on my website at https://utterloonacy.com/books-2/.

References:

Darren. “20 Brutal Realities Vietnam Vets Faced When They Returned To Regular Life.” History Collection, 12 June 2025. historycollection.com/20-brutal-realities-vietnam-vets-faced-when-they-returned-to-regular-life/. Accessed 11 Mar. 2026.

Friedman, Matthew J. "History of PTSD in Veterans: Civil War to DSM-5." PTSD: National Center for PTSD, U.S. Department of Veterans Affairs, 26 Mar. 2025.U.S. Dept. of Veterans’ Affairs. www.ptsd.va.gov/understand/what/history_ptsd.asp. Accessed 11 Mar. 2026.

Stokes, Eleanor. "Shell Shock: The First World War, Masculinity and Mental Health." New Histories, vol. 12, 2020, newhistories.sites.sheffield.ac.uk/volumes/2019-20/volume-12/shell-shock-the-first-world-war-masculinity-and-mental-health. Accessed 11 Mar. 2026.

Footnotes:

(1) According to WebMD (https://www.webmd.com/a-to-z-guides/what-to-know-malingering), malingering is defined as “pretending to have an illness in order to get a benefit... also when someone intentionally or knowingly exaggerates symptoms of an illness for the same purpose. Malingering is an act, not a condition.”

(2) https://newhistories.sites.sheffield.ac.uk/volumes/2019-20/volume-12/shell-shock-the-first-world-war-masculinity-and-mental-health

ALL ABOUT THE BOOK!

🎖️ AWARD-WINNING HISTORICAL FICTION 🎖️5-Star "Award of Excellence" - Historical Fiction CompanyBefore

PTSD had a name, they called it "nostalgia"—and Dr. Jim Banyon was the only one who believed it wasn't cowardice.

1862: The Civil War rages, and Union Army surgeon Jim Banyon arrives on the battlefield hungry for glory. But bullets and cannon fire aren't the only killers stalking his hospital tent. Soldiers return from combat with wounds that don't bleed—invisible scars the army dismisses as weakness. Jim recognizes what no one else will: these men are suffering from something beyond cowardice, a psychological trauma that's as deadly as any bullet.When he dares to defend these "broken" soldiers, Jim faces an impossible choice: advance his career by staying silent... or risk everything to save the men nobody else believes are worth saving.

Based on the military service of the author's Civil War ancestors, NOSTALGIA is a gripping exploration of battlefield medicine, moral courage, and the invisible wounds of war that wouldn't have a name for another century.

Perfect for readers who love:

✅ Civil War medical history with psychological depth

✅ Moral dilemma fiction (conscience vs. career)

✅ Award-winning literary historical fiction

✅ Based-on-true-story military novels

✅ Character-driven war fiction that questions authority

For fans of: Charles Frazier's Cold Mountain + Geraldine Brooks' March + medical drama depth of The Nightingale

⭐⭐⭐⭐⭐ "Tackles the less explored emotional experiences of war with authenticity and heart."📚

From the award-winning author of WAR SONNETS (2023 HFC Book of the Year, Bronze Award Winner for General Fiction)

Discover the untold story of Civil War "nostalgia"—the 19th century term for what we now call PTSD.

ALL ABOUT SUSANNAH

Susannah Willey is the award-winning author of War Sonnets (July 2023, Utter Loonacy Press). Awarded a five star “award of excellence” by the Historical Fiction Company, War Sonnets was also awarded third place in the General Fiction Category of its 2022 Book of the Year awards.

Susannah Willey was born in 1952 in the small town of Ira, New York where her family settled over 200 years ago. She received a degree in Instructional Computing from SUNY Empire State College in 1998 and a degree in Instructional Design from Boise State in 2002. She and her partner make their home in Central New York in the foothills of the Adirondacks. A baby-boomer and a first-generation computer geek, nature photography and hiking are among her passions and, like all good grannies, she knits.

Susannah loves to tackle the less explored emotional experiences of war. Her rich family history often serves as the foundation for her historical novels. Her first novel, War Sonnets, was inspired by poetry written by her uncle about his experiences in the Pacific War during WWII. Her latest novel, Nostalgia, follows a Civil War surgeon and is loosely based on the military service of two ancestors. Nostalgia was short-listed for the Historical Fiction Company’s 2025 Book of the Year.

Stay connected with Susannah—and stay informed about special deals, giveaways, new releases and other fabulous reader perks—by subscribing to her blog at Utterloonacy.com

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