They also wrote of mental anxieties and traumas that bore striking resemblance to the era’s understanding of "shell shock"—but they largely suffered them without diagnosis or treatment. If a female ambulance driver or nurse could not stand the strain of war, she was simply sent home. Unlike the male soldiers, women were expected to be mentally incapable of handling the trauma of war, and high female attrition was hardly a concern. The tremendous effort put into “curing” men with shell shock—87 percent of British troops diagnosed with the condition were returned to front line service within a month—was due to the army’s need for combat-ready men. The supply of women was not rapidly diminishing.
However, the diaries and letters of women stationed on the front reveal countless instances of women discussing their "shock" and reaction to the emotional stress around them. One woman wrote of a friend who had gone temporarily deaf, and another who had trouble with her vision, as a result of the stress and strain of their work. Several novels, poems, and memoirs also explore the themes of mental instability among women at the front. In Helen Zenna Smith's Not So Quiet, a female ambulance driver is sent home from France on "sick leave" after she witnesses a friend dying at the front, but she receives no medical attention. In The Forbidden Zone,Mary Borden's memoir of her time as a nurse in France, she describes herself as becoming "delirious" and feeling like she "seemed to be breaking into pieces." She was sent home because officials felt she was "tired."