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FARAI CHIDEYA, host:

This is NEWS AND NOTES. I'm Farai Chideya. Many active duty soldiers and veterans of the war in Iraq and Afghanistan are dealing with their own personal battles. Some have come home with nightmares, flashbacks and emotional hypersensitivity. Some are also diagnosed with post traumatic stress disorder, or PTSD. Today, we continue our series on mental health with a closer look at the disorder and the men and women of the military.

In a few minutes, we'll talk to Robert Jenkins. He's an attending psychologist at the Men's Trauma Recovery Program, at the National Center for PTSD in the Menlo Park, a division of the Department of Veterans Affairs. Right now, we have June Moss. She served as a staff sergeant in Iraq in 2003. Two years later, the Army released her on an early medical retirement because of PTSD. Welcome, June.

Ms. JUNE MOSS: Hello.

CHIDEYA: So I really want to thank you for coming on and telling us about what you've been through. Let's start with your service. How long had you been in the Army before you were deployed to Iraq in 2003?

Ms. MOSS: I had been in approximately, I think, nine or 10 years.

CHIDEYA: And was this the first time that you went to war? How long did you end up staying in Iraq?

Ms. MOSS: This was my first war experience. I was in Iraq for approximately eight months, but it wasn't my first deployment, serious deployment.

CHIDEYA: What do you mean it wasn't your first serious deployment?

Ms. MOSS: Well, I went to Kosovo in '99, and that was prepared - that experience prepared me for Iraq, actually.

CHIDEYA: What was it like in Kosovo? Let's start there. I mean, what was - did you feel safe? Did you feel protected? What was your daily life like?

Ms. MOSS: Being there, I felt a lot of mixed emotions. We were pretty much inside of the parameter most of the time when I was in Kosovo, so I did feel safe. That experience was just - it wasn't horrific like being in Iraq. I wasn't being shot at, or I wasn't around explosives on a constant level.

CHIDEYA: Now when you went to Iraq, what was your job?

Ms. MOSS: I was a light-wheeled vehicle mechanic actually. I got to fix a lot of Humvees, deuce-and-a-halves, a lot of heavy trucks.

CHIDEYA: And what were your days like in terms of, again, feeling safe or being under fire? Were you ever, were you ever in a position where you felt that your life was in danger?

Ms. MOSS: My life, I felt my life was in danger from the time we crossed into the border of Iraq. From that day on until we left there, I did feel immediate danger. I didn't feel safe at all. And even after we returned, I still felt unsafe.

CHIDEYA: Let's - before we turn to what happened when you returned, what kind of facility were you in? Were you in a walled compound? Were you out in the, you know, open desert? I mean, how much did you feel protected by your surroundings?

Ms. MOSS: Well, as we were traveling, we were out in the desert, obviously, and we had a parameter set up. And pretty much everyone was inside of the parameter. When we felt still a level of being unsafe and then when we moved closer to Iraq, we were in a walled compound, but that still didn't make you feel as you would be sleeping in your own bed back in the United States.

CHIDEYA: What was the moment that you felt the least safe?

Ms. MOSS: Entering the border of Iraq. When I initially passed the border, that's when initially started feeling unsafe. Even though we were trained and we were ready, still, no matter the amount of training you have, it doesn't prepare you for, until you actually are in it.

CHIDEYA: So you have two children.

Ms. MOSS: Yes, I do.

CHIDEYA: How old were they when you left for Iraq?

Ms. MOSS: My daughter Brianna was six, and my son Jacob was five.

CHIDEYA: Do you think they understood what it meant for you to deploy? Do you think they understood what it meant for you to be going away?

Ms. MOSS: Well, I explained to them - and they were very young, but they were very smart. And I told them that mommy was going to help some people rid a bad man. And they understood that.

CHIDEYA: So did you get to talk to them at all, either on, you know, SAT phone, letters, emails, while you were gone?

Ms. MOSS: Yes, we did get to send them emails and letters. It wasn't every day that I got to talk to them because there would be a two hour wait for the telephone. Everybody was waiting to call their family, and you only get to spend maybe five, 10 minutes on the telephone because there were so many people waiting. So I got to talk to them as often as I could.

CHIDEYA: So you might expect that, you know, when you got home, that things would be better. But it sounds like they were not, or at least things were not completely better. When did you first notice, once you had gotten home, that you didn't feel the way that you had hoped?

Ms. MOSS: It started - I got home in August of '03, and around late September, early October is when it really just hit me, the crying bits, the not sleeping, the constant checking my surroundings to make sure the house was secure, making sure my children were safe. That's when it pretty started then.

CHIDEYA: So you would wander around the house just making sure everything was locked down?

Ms. MOSS: Yes.

CHIDEYA: Did your children notice that something was different?

Ms. MOSS: They did notice. And when I would see them starting to check the doors, staring to come and say mommy, are you okay? That's when I noticed that I needed to get some help because I started seeing their behavior changing.

CHIDEYA: You were also married at the time, the time you deployed, and your husband also deployed. That must have been an incredible strain on your family. How did he end up dealing with the stress of deployment?

Ms. MOSS: Unfortunately, he turned to alcoholism. And he was - he wouldn't seek help once we returned. It was really hard on our family to go through that.

CHIDEYA: And when did you first reach out for help?

Ms. MOSS: Once I saw the kids really going through the changes, I started going to - I went to the doctor immediately and started getting help.

CHIDEYA: Now, in a second, I'm going to bring in Robert Jenkins who's at the national center for PTSD. But before we bring him on, tell me what kind of treatment they offered you? What was it like - when they offered you treatment, what kind of treatment was it?

Ms. MOSS: Well, in 2003 I was still active duty with the Army. So I was able to see a psychiatrist on a weekly basis, and as an outpatient. And I would go in to see him weekly - Dr. Morgan. He was great.

CHIDEYA: Well, let me bring in Robert right now. Robert, when you are listening to this story, about how hard it is to come back home, does it call up experiences for some of the patients you're dealing with?

Dr. ROBERT JENKINS (Psychologist, The Men's Trauma Recovery Program, National Center for PTSD): Yes it sounds very, very familiar and very typical of what we see at the VA when working with post traumatic stress disorder. It's fortunate that June was able to understand that she probably needed to reach out and get some assistance. Many people don't get the assistance as readily and as quickly as she sought to get it for herself.

CHIDEYA: And when it comes to someone who not only has - well, first of all, let's back up a little bit. PTSD is a term that is much more common now in terms of people using it in everyday conversation or reading it in the newspaper. But what exactly does it mean, ranging from, you know, one of the more manageable symptoms to some of the more extreme symptoms?

Dr. JENKINS: Well, post traumatic stress disorder is in the manual, under the anxiety disorders. And so, when you understand what post traumatic stress disorder is, people have to have been exposed to something that was life threatening. And they had to have had some kind of response to it that involves fear or concern about some horrific things that they were exposed to. And then from there, people have a lot of symptoms that many of us talk about. Sometimes you hear people talking about flashbacks.

That's re-experiencing the event as if it's happening right now, even though it may have been months or years ago - having problems falling or staying asleep, having problems of concentration, having what we call hyper vigilance, where you are scanning the environment making sure things are safe or you can't sit up in the middle of a restaurant. You have to sit up against the wall, or startle response. You may have heard people talking about startle response, where they hear a car backfire or fireworks, and they think they're back in their war zone theater where the bullets are flying or the IEDs are exploding.

So those are the kinds of things that people go through that interfere with their day-to-day functioning, or their functioning with their loved ones, or their functioning on their various occupations is that it keeps them unsettled. They're not quite able to feel like they're walking on solid ground, and they're very concerned about other people seeing them have the reactions, also. There's a real concern about looking different.

And so many people will try to keep the symptoms to themselves because they are concerned that people will begin to have concerns about them, will stigmatize them, and they will look not as normal as the other people that they're working with.

CHIDEYA: June, did you ever worry - you say that your husband didn't get help, and you did get help. Did you ever think, gosh, you know, I don't want people to find out about this. I don't want to talk about it. Obviously, right now, you are talking about it, and we're very grateful for that, but did you ever have a moment when you didn't want to be public about it?

Ms. MOSS: Yes, very. My family didn't believe that going to the doctor was a good thing, that the doctor couldn't possibly help you. There's nothing that's that wrong with you that you would need the doctor or that you would need to take the medication, that just prayer alone and your family should just fix it. And I felt that all of that together, including the doctor and the medication, would be best.

CHIDEYA: But when you first started treatment, it didn't resolve all the problems, did it? I mean, what were some of the hardest moments for you? Well, first of all, you ended up leaving on a medical basis. How did - what was your reaction to that? Were you angry? Were you accepting as you were no longer on active duty?

Ms. MOSS: That was a very, very hard thing to do. I felt betrayed by the Army for some reason during that time because all I knew at the moment was the Army, 12 years of being with my fellow soldiers. And then once I did what I had to do and fought for our country and I came home, then it was as if, oh, you're sick now. We don't need you any more. So I did feel a sense of anger, a sense of abandonment and betrayal.

CHIDEYA: Is that common, Robert?

Dr. JENKINS: Yes, it is. There's a concern about - especially as people are going through the military and they're wanting it to be more as a career. And as they go through the process of being impacting by the war-zone experiences, it may impact upon their ability to function as a soldier or Marine that they wanted to be or the military expects them to be.

And so the military may work with them to transition out of the military, possibly to get the help that they need or to go into civilian life, and that can be very disheartening because, again, if a person is expecting to have a long-time career, they then have to deal with the loss of what they thought their dream was or their future was. And that's hard for them to then, again, re-stabilize because they're concerned about, well, what am I going to do now, as June was saying.

I haven't had any plans to not be in the military, so if I'm not in the military, what's my identity? Who am I going to be? How are people going to perceive me? Am I going to be perceived as a failure? Do I see myself as a failure? Are my family members or my children going to see me?

So it brings up all those issues. And then, of course, you still have to bring in food and have money for your family, also. So it brings up a lot of stressors that people have a hard time dealing with. And so at the VA, we're trying to work with people not only to begin to confront those issues, but also to figure out how to help them to make the transition into civilian life, also.

CHIDEYA: What is the biggest success that you think you've had in terms of, you know, knowing what to do for treatment now as opposed to, say, what would have been treatment 10 years ago or 15 years ago?

Dr. JENKINS: Is that for June or for myself?

CHIDEYA: It's for you. You know, I mean, in terms of you, as someone who's in the field, have things advanced in the kinds of techniques that you use?

Dr. JENKINS: Yeah, many things have advanced in terms of how we can work with people in a group setting, working with them to address their trauma issues and being able to help them, help the men and the women in a supportive way to confront their issues together so individuals don't feel that they're alone and that there's actually some commonality.

And so for many people with post-traumatic stress disorder, they experience it as a private experience. And we can have people come into, say, a residential program at the Trauma Recovery Programs, so both the men and the women, they're able to see that they're not alone, that they can have support, that they can struggle together, that they actually can have a future.

They begin to look at how they can get into vocational rehab or seek employment and begin to learn how to function in a civilian mode as well as understand what skills that they need to survive in a civilian mode.

So we've seen a lot of people begin to learn how to function in a better way in the years I've been working with post-traumatic stress disorder.

CHIDEYA: June, how's your life today? How have things unfolded? Are you and your children, do you feel emotionally secure?

Ms. MOSS: My life today? Oh, that's a good one. I do feel emotionally secure, to a degree. I'm still working on that. But as far as my kids, they're great. They are really therapeutic, and by the grace of God, I'm still here. I'm still standing. I'm still strong.

If it hadn't been for my faith and my belief and my family and the VA and my medical attention, everything, all that in the whole, I could not be here. I would not be holding a job. I would be homeless, just like, you know, like thousands that we have now.

So yes, emotionally, I'm doing a lot better than I was three years ago, five years ago - a lot better.

CHIDEYA: I'm glad to hear that. June, Robert, thank you.

Ms. MOSS: Thank you.

Dr. JENKINS: Thank you very much.

CHIDEYA: We've been speaking with June Moss. She served as an Army staff sergeant in Iraq in 2003. Also, Robert Jenkins. He's an attending psychologist at the Men's Trauma Recovery Program at the National Center for PTSD in Menlo Park. That's with the Department of Veterans Affairs. They spoke with us from the studios at Stanford University.

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