Acute and chronic war neurosis occurs in connection with life threatening experiences during wartime. Patients suffer from alienation of the self, social withdrawal and difficulties in interpersonal relationships, irritability, recurrent dreams and flashbacks repeating the details of the experience, and severe anxiety.
Mental attrition amongst combat troops leads inexorably to mental breakdown, not just for the weak, or sensitive, or over-imaginative, but everyone. Each moment of combat imposes a strain so great that all men will break down in direct relation to the intensity and duration of their experience, usually within between 200 and 240 days. Psychiatric casualties are as common and inevitable as gunshot and shrapnel wounds in warfare. For every front-line soldier in the second world war there was the slowly dawning and dreadful realization that there was no way out, that it was only a matter of time before they got killed or maimed or broke down. Many wished for it.
To find oneself expendable is difficult to accept, especially those from a culture that values life and the individual. To find oneself in a situation where your life seems of little value is the ultimate in loneliness. The passing of time only shows that there was less coherent meaning in the events of wartime than were hoped.