Most soldiers look forward to coming home from war. But few of them realize how much of the war they might bring home with them.

Some find they lost their sense of safety somewhere in a barracks, an Army truck, the sands of the Middle East. Even a return to relative peace doesn't ease the tension, the jumpiness, the need to keep looking over their shoulders.

And, for two women being treated for post-traumatic stress disorder at the Albuquerque VA's Women's Trauma Clinic, it wasn't always clear where they would find the "enemy."

A 43-year-old military nurse _ let's call her Sarah _ was on so-called "safe ground" when she encountered her first trauma. On active duty in Washington, D.C., in 1988, she met a man while both were receiving physical therapy.

"He became kind of obsessed with me," she said. "He tried to propose to me. I refused him, and he assaulted me. He beat me up pretty badly."

She sought help afterward, but was able to attend only three sessions at a rape crisis center before she was mobilized for Desert Storm in 1991. As she treated casualties of war, she encountered many female troopers who were victims of rape, she said.

"So many things happened," Sarah continued. "Three or four women were gang-raped; one was assaulted by a superior officer. One young lady was pregnant from an assault.

"We had to carry weapons to the showers to protect ourselves from our own men," Sarah said.

This kind of story isn't unusual, according to Diane Castillo, a psychologist and founder of the PTSD treatment program and the Women's Trauma Clinic at the New Mexico VA Health Care System.

About 90 women have come into the program "and we're just starting," Castillo said. Of the women under treatment for PTSD, 80 percent come as a result of sexual trauma, she said.

Kristy Haggins, a 50-year-old mother of three, said she had experiences in the current conflict in Iraq that made it hard for her to trust anyone.

"In 16 1/2 months there, I might have slept one week out of that," Haggins said.

When she was driving a truck in a convoy one day, a sniper's bullet hit the driver's window and another zinged off the side of the truck. Another time, an explosive device threw her truck into the air, smashing her head against the roof, her tailbone into the seat, and her knees into the dashboard.

After a traumatic event, almost everyone experiences some aftereffects. The people who are able to talk about it with others afterward are the ones most likely to avoid lingering symptoms. People who try to repress their feelings and memories are more likely to develop PTSD, Castillo said.

There are three primary symptoms, she said. One is re-experiencing the trauma _ flashbacks or nightmares.

Another is hyperarousal _ the person always is on alert, unable to sleep, irritable, angry. And another is avoidance _ that's where drinking and drug abuse come in, Castillo said.

"They start drinking to help their anxiety," she said.

Working long hours is another form of avoidance, she said.

In Desert Storm, Sarah took care of everyone else: the wounded, other nurses in her unit.

When she returned, she suffered from unexplained symptoms, such as joint pain, a rash, chronic fatigue, vision problems. Anger became her daily companion.

"I became a workaholic," she said. Since she couldn't sleep, she volunteered for the night shift and also worked as a travel nurse.

Sarah was working as a youth parole officer in San Antonio, Texas, when she was carjacked by youths who kidnapped and assaulted her.

That incident, combined with the earlier traumas, pushed her over the edge. She began drinking heavily, she said.

Haggins returned to Fort Bliss in July 2004. In December 2004, she was put in a psychiatric hospital for 15 days to address her substance abuse and PTSD, she said.

"I got tired of feeling that I wanted to blow something up. It was just rage. It started scaring me ... I thought about suicide a few times. I just wanted out. There were nightmares, not being able to sleep."

Before entering PTSD treatment, veterans must be sober for three to six months, Castillo said.

The treatment program consists of several different groups, most lasting about eight weeks. The first is a support group, where therapists can further evaluate a participant's needs while participants share their experiences and reactions, as well as learn to identify situations that trigger flashbacks, anger or other PTSD symptoms, she said.

The next group focuses on cognitive restructuring. Participants learn about how their thoughts create their feelings _ along with their sense of safety, trust, power, competence, and even self _ and how to recast those thoughts, Castillo said.

A final group focuses on the trauma itself, forcing individuals to relive it by writing it out and reading it out loud, then doing it over and over again for six weeks.

That experience helps people remember the event more fully, integrate it into their memory, and ultimately become desensitized to it, she said.

Because they can't see what's hurting her, Sarah said, well-meaning friends or relatives have told her to just "get over it," or pray about it.

"If I hadn't gone through this program, I'd be dead," she said of the VA PTSD treatment.

Haggins said she still isn't competent enough to handle her own affairs. Her sister oversees her financial situation.

"My family was expecting me to come back the same way I left," she said. "You're never the same...

"My (adult) son says, 'I just want my mom back.' I tell him, 'Honey, she's in there somewhere.' "

Source: Santa Fe