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Sunday, December 14, 2014

PTSD and the Civil War

New York State Lunatic Asylum, Utica, NY, date unk, prob. late 19th century
August 13, 2014 12:15 pm
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August 13, 2014 4:34 pm NYTimes

Disunion follows the Civil War as it unfolded.

Daniel Folsom, a tinsmith from northern New York, enlisted in the Union Army just days after the fall of Fort Sumter. His exemplary service through years of long marches and hard battles led to two promotions, but during the Battle of Fredericksburg in late 1862, something changed. Folsom seemed uneasy. He was still troubled months later when the regiment mustered out. He returned home, opened his own tin shop and tried to focus on work.

As time passed, Folsom's motivation to work waned. He neglected the tin shop and wandered, aimless, around the village. In July 1863, when the first men in his neighborhood were called by the draft, Folsom snapped. Terrified that he would be sent back to the Army, he became sleepless and manic, and then fell into a severe depression. When he attempted suicide, his family had him committed to the State Lunatic Asylum in Utica. In the asylum, the young veteran grappled with his paranoia and guilt. At times, he begged the attendants to kill him.

Eventually, Folsom slowly began to improve. "I am not injoying myself much at presen," he wrote to his sister in the spring of 1864. Still, he assured her, he had recovered, and implored her to persuade their father to retrieve him from the asylum. Folsom was especially concerned about finding work. It seemed to him that the longer he was institutionalized, the less likely it would be for him to succeed in business. "I should like to get out of this city [and] go into business iff I stay here any longer the world will be a blank," he wrote. "I really think there is a chance for me yet."

Civil War veterans in 1884, with William T. Sherman in the front row center Credit Library of Congress

Folsom was not alone: Tens of thousands of veterans damaged by the war had to learn how to live and work with their wounded bodies. In much the same way, Folsom had to adapt to life with a wounded mind. His illness – what today we would likely call post-traumatic stress disorder – had damaged his reputation, but he might be able to prove himself through clean living and dedication.

Folsom's difficulty was compounded by a stigma that held that mental illness was a personal failing and should be kept secret. That stigma has proved difficult to kill. Even today, the case files of the men and women treated in New York State's asylums during the 19th century are restricted in the name of patient privacy. Thus, the names of the soldiers in this article have been replaced with pseudonyms, and other identifying markers have been removed.

The psychological implications of the Civil War have been long debated by historians. Statistically speaking, insanity was not a major cause of discharge for the Union Army. "The Medical and Surgical History of the War of the Rebellion," an official report by the War Department, lists only 853 discharges by reason of insanity during the war years, accounting for less than 1 percent of total discharges. Terms used to describe mental illness during the 19th century, however, such as neuralgia, nostalgia, headache and sunstroke, were counted separately, which suggests the possibility of a higher number. Of course, officers wanted to maintain as strong a fighting force as possible, so soldiers could be discharged for insanity only if their commanding officers, in addition to medical staff members, agreed that their symptoms were obvious and disruptive. Only the most disturbed soldiers, therefore, received discharges. Moreover, after the autumn of 1863, soldiers could be discharged for insanity only after the physicians at the Government Hospital for the Insane in Washington examined them and declared them too insane for duty.

There are no statistics that can tell us how many soldiers experienced moments of panic and helplessness, or how many feared they might be losing control. There is also nothing to teach us about the experiences of most of the soldiers after they were discharged. Asylum records, like those of Daniel Folsom, allow us a glimpse into the lives of such veterans and to see the ways the traumas of war affected their ability to navigate the day-to-day obligations of their lives.

Folsom, as it turns out, was fortunate – as he indicated to his sister, he did still have a chance. As a postscript to his letter, he made a promise: "I shall try and be a man." His way of keeping his word was by re-enlisting in the Union Army upon his release, hoping to reaffirm his manhood through battle. He received a commission as a first lieutenant in a New York regiment. When the war ended, Folsom enjoyed success as a tinsmith. He even married and fathered six daughters.

For other soldiers, the distress of war had more sinister consequences. Many soldiers had difficulty letting go of the rage that had been vital in battle. When they returned home, this anger was sometimes channeled into domestic violence. Clinton Moore came home bitter and restless after he was discharged. He drank heavily, beat his wife and terrorized his neighbors. When the local constable came to arrest him, Moore hurled a stove down the stairs and wounded the officer in the head. The disgruntled constable, upon finally delivering Moore to Utica, described the former soldier as "3 parts ugly and 1 part crazy."

Moore soon escaped. He returned home and spent the next several months menacing his family and neighbors before returning to Utica. After his return, Moore seemed ready for a change. He wrote to Dr. John P. Gray, the superintendent of the asylum, promising he would find honest work if he could only be released, even insisting that he would "let Licker alone entirely." Unwilling to wait for the superintendent's assent, Moore escaped again in late summer, and from that point disappears from historical record. Whether he was able to change or find work is unknown.

Some soldiers were entirely undone by the war. Andrew Hamilton returned home a changed man in June 1864. He had survived the horrors of Chancellorsville and Lookout Mountain and bouts with camp diseases. He had survived prison and hundreds of miles of marching, but when he got home, though his body seemed strong, his mind was altered. He raved about the war. He had insomnia and refused to eat. Hoping for a cure, his family committed Hamilton to the asylum at Utica.

Utica Crib, Utica Lunatic Asylum!
Attendants confined the frantic young man to a "Utica crib," a bedlike wooden cage used to restrain and ostensibly calm patients. But Hamilton could not be soothed. He beat against the bars until his arms and legs were bruised. He shouted orders to phantom soldiers and drove teams of invisible horses. By mid-July, at only 23 years old, Hamilton was dead. 

During the dark days of war, soldiers fantasized about their return home, imagining it would be the moment their troubles would end. Daniel Folsom certainly did. "I thought I had got through the hardest of my life when I got through solgerin'," he wrote his sister. But for Folsom, and the many other soldiers who bore the psychic scars of war, their troubles had only just begun.

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Sources: Jeffrey Allen Smith and B. Christopher Frueh, "Minds at War," New York Times Disunion, March 20, 2013; Eric Dean, "Shook Over Hell: Post-Traumatic Stress, Vietnam and the Civil War"; Joseph K. Barnes, "The Medical and Surgical History of the War of the Rebellion"; New York State Archives, "Utica State Hospital Patient Case Files, 1843-1898;" and genealogical records of the Church of Jesus Christ of Latter-day Saints; 1880 United States Federal Census.

Sarah Handley-Cousins is a graduate student in history at the University at Buffalo.