RENEE MONTAGNE, HOST:
Two long wars have left a legacy of psychological wounds among those who've served. Just consider this number: half-a-million veterans have made benefit claims with the VA for post traumatic stress disorder. Hundreds of thousands more who served in Iraq and Afghanistan are expected to file in the next year.
There are treatments, the most common involving medication and talk therapy. And then there are ways of coping that those suffering from PTSD come up with on their own.
Samara Freemark reports on one of them.
SAMARA FREEMARK, BYLINE: Once every month, Kyle Dubay drives to the Spartan Academy gym in a dusty strip mall in Tempe, Arizona, to meet up with his mixed martial arts team.
KYLE DUBAY: Hey. What's up, man?
UNIDENTIFIED MAN #1: How are you doing, brother?
FREEMARK: Dubay was an Army medic in Iraq. He did three tours during some of the worst fighting of the war. And many of the guys he's meeting tonight are also combat veterans. They're here for a fight night.
UNIDENTIFIED MAN #2: Am I going against you?
DUBAY: I don't know, man.
FREEMARK: Mixed martial arts is a cross between kickboxing and wrestling, two-minutes of often bone-snapping, teeth-crunching brawls. And Dubay has got the list of injuries to prove it.
DUBAY: See, I got an open dislocation of my finger. I tore my MCL. I've broken a rib, broken my nose, popped my shoulder the other night.
DUBAY: Everybody makes fun of me, because I just get hurt all the time.
UNIDENTIFIED MAN #3: That's what Kyle's known for.
FREEMARK: Kyle Dubay also has pain that's less visible. After his second tour in Iraq, he was diagnosed with PTSD. He suffered from insomnia, depression, anxiety, flashbacks. He slept with a loaded pistol on his nightstand and an assault rifle under his bed. He says he was always angry.
DUBAY: You feel it just spreading into your arms, into your fingers. And your pulse starts just racing and you just want to scream. And I didn't know how to get rid of it.
FREEMARK: First, he tried whiskey. Then he tried bar brawls. And then he did what the experts tell you to: He asked for help - not easy for someone coming from the bruising world of the battlefield. Dubay took his meds and he went to therapy, which helped him a lot. But it wasn't a total fix. Dubay says there was still this bad energy inside him, and he dealt with that the day he first walked into the Spartan Academy and started fighting.
DUBAY: I felt better. I felt happier, less stress, less anxiety. I felt great.
FREEMARK: Mixed martial arts isn't a replacement for other therapies. It's a coping mechanism, Dubay's own personal way to make himself whole.
Tonight, Dubay is fighting Justin Hayes, a vet who did a tour in Iraq as a Marine sniper. Hayes is scheduled for a PTSD assessment. For the meantime, while he waits, nights like tonight work for him.
JUSTIN HAYES: Hanging out with friends, beating the crap out of each other, there's nothing more fun than that. You got drama at home. You got school. You got homework. But when you're on the mat, nothing matters. You know, everyone has their own different way to cope with things, and I guess fighting's mine.
UNIDENTIFIED MAN #4: All right, Dan, you got the lineup?
FREEMARK: Dubay and Hayes enter the ring. They shake hands.
FREEMARK: The buzzer sounds.
UNIDENTIFIED MAN #4: Fight.
(SOUNDBITE OF BUZZER)
FREEMARK: And they go at it: Kicking. Punching, wrestling...
UNIDENTIFIED MAN #5: Take him down. Take him down. Take him down.
FREEMARK: ...strangling - they look like they're trying to kill each other.
Jeff Funicello is the coach here, and he says no matter how violent this all looks, what's going on is actually kind of...
JEFF FUNICELLO: Therapeutic, you know. I think it's just therapeutic for them.
FREEMARK: He says he's seen it again and again in the veterans who've passed through his doors over the last decade.
FUNICELLO: This is clearly not for everybody.
FUNICELLO: I mean, who wants to do this? These guys are nuts. But when they're in here, you find a way to put order to something that's disorderly. The anxiety, that buildup - boom - it goes away. And I think overcoming that makes them feel good.
FREEMARK: Spartan Academy isn't the only mixed martial arts group working with veterans struggling with PTSD. There's another one in San Diego.
Joe Westermeyer is a psychiatrist at the VA Medical Center in St. Paul. And while he's careful to say that mixed martial arts is decidedly not therapy, it could be therapeutic.
JOE WESTERMEYER: Part of PTSD involves a loss of control. And so, what I think people are doing is they're exposing themselves to fear, and then trying to re-exert that sense of being in control of themselves.
FREEMARK: The match ends. Hayes and Dubay leave the mat.
DUBAY: I'm pretty well gassed. That's a good fight, dude. It's tiring. I'm hurting.
DUBAY: Ah, my arms hurt.
FREEMARK: Tonight, they'll leave the gym with scrapes and strains and bruises, but they'll take with them some hard-won peace of mind.
For NPR News, I'm Samara Freemark.
(SOUNDBITE OF MUSIC)
MONTAGNE: And this story was produced in association with the Public Insight Network.