Invisible Wounds: Mental Illness and Civil War Soldiers, by Dillon J. Carroll, Book Review

By Lorie Castro

            The book Invisible Wounds: Mental Illness and Civil War Soldiers by Dillon J. Carrol, is an academic military and social study on mental illness, how people were treated, and how society and hospitals treated them during, and after, the American Civil War which took place from 1861-1865. Carroll also engages in related issues, such as violence and addiction, pertaining to the American Civil War. Author Dillon J. Carroll is a Professor at Butte College. He received his Master’s in History at Chico State University and his PhD in philosophy at the University of Georgia. Besides his book, Invisible Wounds, early in his career he also published a piece in the, “The New York Times,” called, “The Civil War and P.T.S.D.”

Carrol takes an in-depth look at the possibility that soldiers suffered from PTSD-like symptoms. Carroll writes that his book is, “A hybrid story: part history of medicine, part social history, and part military and institutional history.”[1] In his book, Carrol writes with a social lens to understand the social behaviors and context of the soldiers, war, and asylums. Besides history, his LinkedIn states that he also teaches, “History of Medicine, History of Sexuality, History of Gender, History of the World Wars, and the American Civil War and Reconstruction.”[2] This shows his broad areas of knowledge and the variety of methodology he is familiar with. In an interview, Carroll discloses that his book Invisible Wounds was in the making for ten years.

            Carroll’s central argument in his book Invisible Wounds is that the American Civil War traumatized the minds of its participants. He supports his argument with primary sources and excerpts from journals, diaries, and doctors. He writes his book with a social lens in order to get a true understanding of what the individual soldier, the doctors, and families, were experiencing. With his book, the reader gets a unique insight into the mind of the soldier but also how he copes. Carrol discusses different coping mechanisms that soldiers would use to tackle their illnesses such as writing letters, fraternity, religion, desertion, humor, drugs, and alcohol. Carrol writes that Civil War soldiers were, “Active agents who exercised a variety of coping strategies to deal with the hard hand of war.” [3] 

            Carroll’s use of sources is effective. His use of asylum records, such as St. Elisabeth’s in Washington D.C. and Milledgeville Insane Asylum in Georgia, combined with soldier diary entries and letters gives a thorough insight into the thoughts and behaviors of the men who struggled with mental illness. His use of contrasting records shows both sides of the struggle. The reader can feel, and sympathize, with the soldier, but also with the doctor who must attempt treatment in an era when it wasn’t clearly, or confidently, understood what that treatment might be. Attitudes of mental illness were primitive and prejudiced. Carroll explains that doctors thought that lack of morals, masturbation, and financial shortcomings were typically believed to be the cause of mental illness in the south. [4] Consequently, treatment was morality based. Carroll explains how the doctors scrambled to understand mental illness among their patients, using their hospital and written evidence to support his case. The studies and observations of these doctors would later help connect the dots on how to treat the mentally ill. Carroll’s use of letters and diary entries give a first-hand look into the thoughts of the soldiers and family members. Their worries and sadness permeate through time and give credence to the idea that soldiers indeed suffered from a variety of PTSD-like symptoms. Likewise, his book gives good insight into the doctor’s and family’s point of view and their efforts to treat patients and loved ones.

            Carroll wrote a very articulate and organized book on mental illness and the American Civil War. His chapter organization makes sense and makes for scaffolded reading. Starting with a chapter on the soldier’s experience, a chapter on the mental hospitals themselves, and leading up to the soldier’s mental illness and being institutionalized, the reader gets the backstory needed to fully understand Carroll’s argument. Case studies on patients paint a vivid picture of the mental anguish caused by the war. Carroll divides up these case studies in individual chapters for Union veterans, Black veterans, and Confederate veterans. In his last chapter, Carroll traces and explains the rise of neurology and how it began with a Civil War doctor who had spent years treating soldiers. He describes a unique study that Doctor John Mitchell conducted on soldiers by way of questionnaire. It revealed that soldiers were still living with pain, feelings of inferiority, nightmares, and flashbacks many years after the war. Carroll ends with the prevailing thought that, “The panoply of trauma was likely much more far reaching than many historians have realized.” [5]

            Author Dillon J. Carrol gives a good presentation of facts regarding mental illness in the Civil War. While the book is rich in historic and compelling detail, the book’s prevailing weakness is that the reader is left with very little insight on mental illness in the western and border states. This may have to do with lack of available records. Therefore, the book makes for a more regional study of the eastern and southeastern asylums and soldiers. More research and evidence need to be presented to make this a comprehensive study. Despite this, Carroll brilliantly paints a picture of passionate soldiers who eagerly went off to a war they believed would be a simple three-month ordeal, “Perhaps even bloodless.” [6] Soldiers’ expectations of glory and heroism were fleeting, though, after their senses were overpowered with the sights, sounds, smells, and taste of war. Soldiers were not prepared for the reality they faced, or the lifelong consequences they would endure. Carroll takes the reader on an expedition along-side soldiers from their heroic and fearless beginnings to their final moments, often times alone in an insane hospital without a single mourner to see them buried.

            Carroll’s book is an excellent addition to Civil War literature. The subject of mental illness was taboo during a soldier’s lifetime; it revealed what doctors considered moral and psychological flaws. Carroll, however, respectfully explains the symptoms and how they manifested differently, yet similarly, within each case study. His treatment of the subject matter was reverent and his study is a significant contribution to the growing field of scholars interested in mental illness during the American Civil War. His book is engaging and adds new understanding to the topic of the Civil War.

Copyright © 2025 by Lorie D. Castro

All Rights Reserved

[1] Dillon J. Carroll, Invisible Wounds: Mental Illness and Soldiers During the Civil War (Louisiana: Louisiana State Press, 2021), 5.

[2] Dillon J. Carroll, “Dillon Carroll, Ph.D.” LinkedIn. https://www.linkedin.com/in/dillon-carroll-ph-d-725a8748/

[3] Carroll, Invisible Wounds, 99.

[4] Carroll, Invisible Wounds, 165.

[5] Carroll, Invisible Wounds, 242.

[6] Carroll, Invisible Wounds, 13.