What would this stress disorder might have been called?

November 15, 2022 10:36 AM

My father was born during some bombings in London in 1940 and then when he was ten years old he was in a taxi going to school that hit and killed another school child. When he went to take his exams he wasn’t able to answer any questions and “they” said it was because of the stress and (so) then my grandparents emigrated to America. What would he have been diagnosed with? What diagnoses were common at that time for ptsd or that type of thing?
posted by pairofshades to Health & Fitness (15 answers total)

It would most likely have been called a "nervous breakdown". My parents (b.1920s UK) used this term widely to describe any/all kinds of mental illness or trauma.
posted by essexjan at 10:55 AM on November 15, 2022 [7 favorites]

Shell shock might have been used then.
posted by Melismata at 10:58 AM on November 15, 2022 [5 favorites]

"Shock" more generally; I think shell shock may have been used specifically for war veterans.

Note that in the civilian world, psychiatric diagnoses weren't codified in a modern way until the DSM-III (1980).
posted by basalganglia at 11:02 AM on November 15, 2022 [8 favorites]

Back in WW2 they are called "battle shock" or "shell shock" (usually from artillery barrages) or even "war neurosis". One French neurologist termed it "traumatic hysteria" in the late 1800s, but the term hysteria was first coined for women and was believed to came from the uterus, and "traumatic hysteria" was linked to "feminine weakness" ever since.
posted by kschang at 11:15 AM on November 15, 2022 [2 favorites]

Response by poster: Thank you everyone, I probably need to discuss this with him one more time (with the caveat that he has very few childhood memories LOL- NOT) but I definitely got the impression that there was a meeting at the time, and a doctor had given his definite opinion that there had been a cause and effect, so I wondered what the terminology might have been for the children at that time. Thank you everyone!
posted by pairofshades at 11:29 AM on November 15, 2022 [1 favorite]

"Traumatic neurosis" or "post-traumatic neurosis" might also have been diagnosed.
posted by lapis at 12:13 PM on November 15, 2022 [1 favorite]

According to the Wikipedia page on PTSD: the 1952 edition of the DSM-I includes a diagnosis of "gross stress reaction", which has similarities to the modern definition and understanding of PTSD.
posted by muuratsaari at 12:49 PM on November 15, 2022 [2 favorites]

From at least my higher-level history of psych/psy studies, only the military (US, I don't even know if the UK had the time or resources) had anything like comprehensive diagnosis coding, and family and other civilian doctors had a good bit of leeway to maybe put something specific in their notes but use much gentler or vaguer terminology to the family. It could have been anything from "nervous exhaustion" to "sensitive digestion", or some other symptom-specific phrasing. Literally every patient through the doctor's door over the age of 5 would be suffering from post-traumatic stress, and we didn't yet have much language around "intergenerational trauma" but doctors were smart, if overwhelmed.

Poking around, this looks interesting though I didn't have time to finish reading, and this on family welfare and social work.

I think I'd let it go, if it were my dad (and my family adopted a formal Don't Ask policy regarding my grandfather who earned a Purple Heart in the Bulge), as he likely cannot answer and probably doesn't want to be asked. It was, to put it lightly, a crushingly hard time.
posted by Lyn Never at 12:54 PM on November 15, 2022 [6 favorites]

In books about WWI (and I'm talking about fiction) I've seen it referred to as neurasthenia or battle fatigue. Not sure how long that terminology would have persisted into the next war.
posted by Lawn Beaver at 2:27 PM on November 15, 2022 [1 favorite]

"War neuroses" was another somewhat more expansive term that was in vogue for a while, intended to rope in what we would now call all traumatic reactions to living through war (though possibly more narrow in its original usage, as in combat or bombing or other violence of some sort).

I'm not sure what terminology would have been used at that time to connect that to the trauma of a car accident other than 'shock.'
posted by snuffleupagus at 6:49 PM on November 15, 2022

WRT the accident and exams: Nervous shock, or psychogenic amnesia
posted by Iris Gambol at 7:30 PM on November 15, 2022

In London during WW1 my great grandfather was diagnosed with "Nervous Exhaustion".
posted by Dynex at 8:58 PM on November 15, 2022 [1 favorite]

Non-combat survivors of a traumatic experience at that time likely would have been diagnosed with "neurasthenia," coined by the American neurologist George Beard (1869) to describe the exhaustion of the nervous system. The term neurasthenia has a long history in Western psychiatry and medicine. In 1940, Freud's work and the work of Charles Meyers, who coined the term "shell-shock," were establishing ground. In 1941, Abram Kardiner proposed that the various civilian and military versions of what we now call PTSD were the same condition.

But before then and during that time, "neurasthenia" was essentially an amorphous concept covering all neurotic disorders, characterized by a persistent and distressing inability to function after a very strenuous mental effort or event, including persistent and distressing physical and mental weakness and exhaustion prohibiting even minimal effort. "Neurasthenia" remains a diagnosis today to describe chronic fatigue syndrome.

Related, in 1948 the International Classification of Diseases (ICD) produced by the World Health Organization, included a section of mental disorders in its ICD-6 version for the first time. The mental health section was based on diagnostic manuals developed by the American Armed Forces and Veterans Association. The first PTSD-like diagnosis was called acute situational maladjustment. Three kinds are listed: abnormal excitability under minor stress; combat fatigue (inability to perform in combat); and operational fatigue (inability to perform basic non-combat operations). "Fatigue" -- aka neurasthenia -- was a primary diagnosis requirement along with "excitability."
posted by desert exile at 5:40 AM on November 16, 2022 [4 favorites]

desert exile, I believe neurasthenia is deprecated in ICD-11 and the ICD-10-CM coding now excludes it when diagnosing postviral and related fatigue syndromes. That latter change happened on October 1st of this year. "ME" or "ME/CFS" are preferred by the patient population concerned.
posted by jocelmeow at 4:33 PM on November 16, 2022

"The diagnosis of neurasthenia never caught on in Britain" (William James called it "Americanitis") and in this examination of a London hospital's records, "After 1941 neurasthenia disappears altogether and is not even a sub-category of the psychoneuroses (apart from one case in 1944) " [...] "Neurasthenia did not disappear, but was reclassified into psychological diagnoses."
posted by Iris Gambol at 4:39 PM on November 16, 2022