Female veterans battle with stress syndrome

WASHINGTON -- There are times when Trinette Johnson's life seems to stall, when she finds herself staring at the ceiling fan in her bedroom, watching the blades spin, her mind hung on nothing -- not her receptionist job, not her fiancé, not her ailing father, or her four children.

Not even the war.

The war, of course, is always there somewhere, she said, an unseen force in her life, sometimes producing moments of blank detachment, sometimes stirring up anger like nothing she has ever known.

More than two years after returning from duty in Iraq, she has found herself yelling and cursing at other drivers on the road. Panicked in crowds. Seized with fear at the sight of highway overpasses and tunnels that might suddenly explode.

Doctors gave the 32-year-old Johnson, who served in the D.C. National Guard, a diagnosis of post-traumatic stress disorder, which has plagued thousands of US troops after combat in Iraq -- bringing on flashbacks, numbness, rage and anxiety, and leaving many at odds with their old lives, families, and jobs.

How women are affected after combat is only starting to be learned. This is the first war in which so many women have been so exposed to hostile fire, working a wider-than-ever array of jobs, for long deployments.

``This is a really unique experience, and we just don't know," said Ronald Kessler, a Harvard University professor and author of a landmark study of post-traumatic stress disorder.

For women who are mothers, combat-related PTSD may have added significance. Often, after war, ``it's not the same mommy who left," said Yale University associate professor Laurie Harkness, who runs a Veterans Affairs mental health clinic in Connecticut. Although the same can be said for fathers, she said, ``mothers in general are the emotional hub of a family."

For Johnson, it was a doctor at Walter Reed Army Medical Center who first uttered the letters PTSD, a defining moment that came after she spent nine months working the bomb-blasted roads near Baghdad as a truck driver for the 547th Transportation Company of the D.C. Guard.

Her job was hauling -- troops, supplies, equipment -- and security. She never had to fire her gun, but she transported dead Iraqis to their wailing relatives.

In one particularly bad period in 2003, a roadside bomb claimed the life of a 21-year-old soldier in her unit, Specialist Darryl T. Dent. Later, a roadside bomb severely wounded Johnson's best friend, Specialist Antoinette Scott, a mother of four.

That fall, Johnson was riding in a truck on a mission with her M-16 rifle pointed out the passenger-side window. Out of nowhere came a deafening blast. Her five-ton truck swerved and nearly flipped. A bomb, hidden along a guardrail, had detonated as her convoy drove by.

Johnson received a Purple Heart for hearing loss in her left ear but stayed in Iraq for several more months, working the same roads. ``It seemed like once every other or three days somebody was getting hit," she recalled recently.

Unexpectedly, in January 2004, she was shipped home three months early, sidelined with severe kidney stones. Later, at Walter Reed, the dreams started: violent dreams, with exploding mortars and hordes of barking dogs. She mentioned them to a doctor.

In more than three years of war, 137,000 service women have served in Iraq and Afghanistan, some exposed to the most profound stresses of combat: ambushes, mortars, bombs, fallen comrades. They have killed people and been shot at.

As these women have returned home, Army researchers studying the psychological fallout of Iraq have noted a surprising trend in early studies: Women appear to be showing symptoms of post-traumatic stress disorder and other mental health troubles at roughly the same rates as men.

A recent study showed that, overall, more than one in three US troops sought mental-health care in the year after returning from Iraq. An earlier study found that about one in six soldiers and Marines showed signs of PTSD, major depression or anxiety after Iraq.

For Johnson, treatment at Walter Reed made things better, with group sessions, art therapy, and combat-stress counseling. ``You're in there with other people who are going through the same things," she said, ``and you kind of feel like, `OK, now I don't feel crazy.' "

The most wrenching day, as she remembers it, was when she was sent home: Oct. 3, 2004. No longer did she have the supportive environment of the hospital. She was on her own -- medically discharged from the military because of the stress disorder.

For several months, while her fiance supported them, she could not bring herself to go to work. Finally, last year, she returned to her job as a receptionist in the National Guard building in Northwest Washington, which houses a museum lined with exhibits that depict combat.

This year, Johnson and her fiance bought a house, a brick ranch with a big back yard in Clinton, Md. Her children, who had been staying with relatives, now seem rooted and happy.

But Johnson rarely goes out anymore, and she recently passed up a higher paying job because she was concerned that it would bring additional stress.

Some days, she feels perilously close to the edge.

If she is home, she may retreat to her bedroom. There, she can collect herself. Or she may, for a moment, lose her connection to everything, as the ceiling fan turns, as her mind goes blank.