Eliza Browning
AC360° Associate Producer

The suspect in the Fort Hood shootings, Maj. Nidal Malik Hasan, is a mental-health professional who worked to help others in high-stress situations. A soldier who served two tours in Iraq and is awaiting medical retirement for chronic PTSD referred to Hasan as "a soldier's soldier who cared about our mental health."

The impact on therapists who work with traumatized individuals is known as vicarious traumatization – or compassion fatigue. The motive behind Hasan’s attack is uncertain, but some believe that in addition to working with people suffering from mental health problems, he too may have been troubled.

This has left many of us at AC360° wondering about Post-Traumatic Stress Disorder (PTSD) and whether or not it played a role in the shooting. What we know for sure, however, is that the shooting at Fort Hood could give rise to PTSD among many of the people impacted.

Here are some details on PTSD compiled by the Mayo Clinic:

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder that's triggered by a traumatic event. You can develop post-traumatic stress disorder when you experience or witness an event that causes intense fear, helplessness or horror.

Many people who are involved in traumatic events have a brief period of difficulty adjusting and coping. But with time and healthy coping methods, such traumatic reactions usually get better. In some cases, though, the symptoms can get worse or last for months or even years. Sometimes they may completely disrupt your life. In these cases, you may have post-traumatic stress disorder.

Take a look at some of the symptoms, causes and treatments to deal with PTSD.

Alexandra Poolos and Ismael Estrada
AC360°

Jerri Hyde first sent Anderson an email in July. In it, she wrote that her sons Donald and Daniel had both served in Iraq. Dan, 23, worked as an explosives expert in the Marines, and Don, 25, had been in the Army. Both, Jerri wrote, now suffered from Post-Traumatic Stress Disorder (PTSD) and weren't getting the help they needed.

"I am writing because I feel Mr. Cooper just might be the one to listen," Jerri wrote. "My sons are suffering PTSD after serving our country. And getting no help. I don't understand this."

Jerri's email arrived after visiting her younger son Dan in Texas.

When we first called her, Jerri told us that Dan's problems seemed minor when compared to his older brother Don’s, who had deserted the military almost six months ago after reenlisting for another tour of duty. Don didn't know what to do now that he deserted the army. Jerri didn't know where he was hiding, just that he was somewhere in their home state of Illinois. For three months, the family kept in touch, and then finally in late September, Don reached out and said he wanted to talk.

Don was on the run and was getting tired of looking over his shoulder. He was ready to turn himself in and face the reality of his decision to abandon his duties.

According to the army, the penalties for desertion can be quite steep. He could receive up to 5 years of confinement, forfeiture of all pay, and a dishonorable discharge.

Still, Don showed up at the Illinois State Police station with his mother, father-in-law and girlfriend. He was emotional, but ready to turn himself in. He says leaving was a good decision because he was worried that he would hurt himself or a fellow soldier while he was in the army. His only regret was re-enlisting.

Dr. Gupta reflects on post traumatic stress disorder. He shares personal stories and asks viewers to submit questions.

U.S. soldiers join hands in prayer before a patrol in Iraq last year.

CNN

The killing of five comrades by a U.S. soldier on Monday in Iraq is no surprise and illustrates the mental toll that the current wars take on troops, the leader of a veterans group said.

"It's tragic. I mean, It's deeply disturbing, but I don't think folks who have been in the [war] theater are surprised," said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America.

Rieckhoff talked with CNN's Anderson Cooper on Monday night about the killings.

The "unprecedented" number of times that soldiers are redeployed to Iraq and Afghanistan adds to the stress soldiers are feeling, Rieckhoff said.

"There's a study of one in four folks coming back [from war] with some kind of stress-related mental health injury. But these folks are going back over and over again," he said. "Each time you're deployed, you're more likely to have a mental health disability. There's not enough psychologists, psychiatrists in theater."

Keep Reading...

Program Note: Tune in tonight to hear more on the charges on AC360° at 10 p.m. ET.

U.S. troops based at Camp Liberty near Baghdad, Iraq, wait while a robot disarms a roadside bomb in 2005.

CNN

The U.S. soldier who killed five fellow troops at a stress clinic in Iraq apparently used a weapon he wrested away from another soldier to carry out the act, a defense official said Tuesday.

The shooter was identified as Army Sgt. John M. Russell, according to Maj. Gen. David Perkins, the military spokesman who briefed reporters in Baghdad.

Russell has been charged with five counts of murder and one count of aggravated assault after Monday's shooting at Camp Liberty, near Baghdad International Airport, Perkins added.

A 44-year-old communications specialist from Sherman, Texas, Russell is serving his third tour in Iraq and has previously deployed to Bosnia and Kosovo, Perkins' office said.

Russell recently had been referred to counseling by his commander due to unspecified words and actions, Perkins said. The commander also ordered that the sergeant's weapon be taken away.

Keep Reading...

Watch this video for more on the symptoms and treatment of post-traumatic stress disorder.

The aftermath of a roadside bombing in Afghanistan.

Gregg Zoroya
USA TODAY

Josh Barber, former combat soldier, parked outside the Army hospital here one morning last August armed for war.

A cook at the dining facility, Barber sat in his truck wearing battle fatigues, earplugs and a camouflage hood on his head. He had an arsenal: seven loaded guns, nearly 1,000 rounds of ammunition, knives in his pockets. On the front seat, an AK-47 had a bullet in the chamber.

The "smell of death" he experienced in Iraq continued to haunt him, his wife says. He was embittered about the post-traumatic stress disorder (PTSD) that crippled him, the Army's failure to treat it, and the strains the disorder put on his marriage.

Read More...

Soldiers suffering from post-traumatic stress disorder will not receive the Purple Heart, the Pentagon says.

Mike Mount
CNN Senior Pentagon Producer

The Purple Heart medal, awarded to service members who have been physically wounded in combat, will not be given to troops diagnosed with Post Traumatic Stress Disorder, a Pentagon statement said.

The decision, which was made in early November but just made public this week, came about after months of deliberations sparked by a question on the topic posed to Defense Secretary Robert Gates during a Pentagon briefing in May.

"(It's) clearly something that needs to be looked at," Gates said, responding to the query. His answer prompted a review by the Defense Department's Awards Advisory Group, made up of "award experts" in the Pentagon.

After the review, Undersecretary of Defense for Personnel and Readiness David Chu examined the advisory group's findings and determined service members suffering from PTSD would not be eligible for the award, according to Pentagon spokeswoman Eileen Lainez. Gates agreed with the decision, Lainez added.

Thousands of service members are at risk of suffering from or have already been diagnosed with PTSD after serving in Iraq and Afghanistan, according to Pentagon statistics. The Department of Veterans Affairs estimates up to 11 percent of Iraq veterans and 20 percent of Afghanistan veterans have PTSD.

"The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member," according to a statement released by the Pentagon.

"PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event; it is not a wound intentionally caused by the enemy from an 'outside force or agent,' but is a secondary effect caused by witnessing or experiencing a traumatic event," the statement continued.

The Defense Department statement noted that historically, Purple Heart designations are awarded for bodily injuries from "an outside force or agent," which is considered an objective standard. It also cited other Purple Heart award criteria and 76 years of precedent as other factors in deciding when to bestow the honor. The medal has never been awarded for psychological conditions, it said.

Currently, the department explained, PTSD is not diagnosed "as objectively or routinely" as would be required for the award. The Pentagon did leave the door open to possibly awarding the medal to those suffering from combat-related PTSD in the future, saying, "advancements in medical science may support future re-evaluation."

Watch Randi Kaye's interview with Veteran Keri Christensen.

We received an enormous number of comments on Randi Kaye’s Blog: Women vets suffering from Post Traumatic Stress Disorder (PTSD). Many of you shared stories, provided insight, and offered your support... but one of those comments came from the very person Randi reported on, Keri Christensen.

Keri was nearly the victim of a roadside bombing in Iraq when the convoy in front of hers was hit. She suffers nightmares from the incident and has brought that anxiety of war home... Keri also suffers from MTS (Military Sexual Trauma); a situation so prevalent in the military that it has its own acronym...Keri shared her situation, the unease she still endures, and you responded...

We wanted to post a follow-up response, from Keri herself:

"Thank you to everyone for the kind words. I told my story because I am a strong woman and feel that it’s important for other Vets out there to get help and let the American people know that it’s ok to speak out on such topics. I joined the Military back in 1991, because I was raised in a family where women were taught that we can do and be anything we want. As far as my superior sexually harassing me, he stepped out of line. He is a married man with children himself and just because we were overseas does not constitute his actions. As far as the military denying my claim, I expected that, and I have to live with that. It’s like being locked up in prison for a crime you didn’t commit and you spend a lot of time trying to prove yourself. I was told by the State of Wisconsin “what happens in Kuwait, stays in Kuwait” Isn’t that what they say about Vegas, I don’t recall my duty overseas was anything like Vegas."

- Keri

To read more about Keri’s story and see the interview, check out Randi's blog: ‘Back from Iraq, but still fighting the battle’

For more on bloggers' reaction check out: ‘Bloggers react to women vets story’

As always, please share your thoughts with us here.

Veteran Keri Christensen was nearly a victim of a roadside bombing in Iraq when the convoy in front of hers was hit. Here's part of her interview with Randi Kaye.

More than 180,000 women have served in Iraq and Afghanistan, and they’d be happy to know so many of you care about them.

In my blog yesterday, I shared with you the story of Keri Christensen, a former member of the National Guard who served in Iraq and is now suffering from Post Traumatic Stress Disorder (PTSD). She’s married and the mother of two adorable little girls, Madison and Oliva.

Keri has nightmares about body parts falling on her, she has thoughts of suicide and panic attacks, and sometime she’s so anxious she can’t even remember her home phone number...

Her story got such a tremendous response. Nicholas wrote, “My heart breaks for you. Your struggles are my own. And though I may never really know you, Keri, I want you to know, you have my love, and my heart.”

A male veteran, Richard, wrote, “I am also an Iraq vet and have PTSD, it took me 2 1/2 years to finally get my VA claim…. someone in Congress needs to help us.”

That’s the problem! For women especially, this is an historic time. Keri and so many others are making history as the first women “combat veterans” and the U.S. government doesn’t really have an official program in place to treat their unique needs. In the past, like in Vietnam, women served as nurses, and back then there were only about 7500 of them serving. In the brief Persian Gulf war, about 41,000 women were deployed.

Today, even though women are assigned to “combat support missions” they are in the thick of the violence and it is affecting them both physically and mentally. In 2006, the Veterans Administration diagnosed nearly 3,800 women with PTSD.

And as I mentioned on the last blog, which really disturbed so many of you, women serving today find themselves in many cases to be victims of sexual offenses, both harassment and assault. It’s so prevalent experts have given it a name: Military Sexual Trauma, or MTS.  Keri told me she was harassed by a fellow soldier who made comments about her breasts and propositioned her for sex. The military told CNN the complaint she filed had “no merit.”

In response to that, Kevin wrote, “The military would deny the existence of the moon if it served their objectives.” And Mechelle had this thought, “I don’t believe women should be in combative roles. If they are unable to defend themselves from fellow soldiers, in friendly situation, how will they be able to defend themselves from an enemy during combat?”

And then there was this response from Kathryn: “It’s common knowledge about women being sexually assaulted in the armed forces. Did she believe war was going to be a picnic? I’m as sympathetic to her as I would be to any soldier having PTSD, but surely she knew the risks before she ever decided to join the Guard. She didn’t have to join, & she should not have.”

So many interesting ways to look at this topic of women in combat.  The V.A. reports between 2002 and 2007, nearly 22 percent of women veterans had experienced some type of military sexual trauma. 22 percent!!! Who is going to help these people? There are some programs around the country but just as the hospitals weren’t prepared for all the male veterans who needed counseling or who were considering suicide, they are still trying to figure out how and what to do with these women. 

Melissa’s comments really spoke to that. She wrote, “After all the sacrifices we make for everyone else’s services surely we should be able to receive whatever help we need to readjust to life as a civilian. After all we rehabilitate criminals and work to reintroduce them to society why is this so hard to do for such selfless individuals as our soldiers.”

And Katherine added, “It will take eons, unfortunately, for the military and the VA to find a solution to sexual harassment or trauma to our woman vets. It took me 36 years to admit to anyone that I was raped while serving as a non-combat Vietnam era marine.”

Let’s hope it doesn’t take eons. Women like Keri Christensen may not have that kind of time..

- Randi Kaye, 360° Correspondent

Editor's note: Find out how you can help at Impact Your World

The story of Keri Christensen (featured here on CNN.com) should upset all Americans. She is a patriot. She is also one of an estimated 180,000 women who have courageously served in combat in Iraq and Afghanistan since 9/11.

Women make up 11 percent of Iraq and Afghanistan veterans, and 15 percent of the military as a whole. Despite DoD and Army policies that prohibit women in combat, there are more female service members serving in Iraq and Afghanistan than in previous conflicts, and a greater portion are situated
in combat roles.

But, like so many others, Keri is now facing another fight. Today, she is back at home in Denver struggling to overcome mental health injuries . And five years after the start of the Iraq war, Keri is not alone...

By now, many Americans know that mental health problems can be crippling for veterans, increasing the risk of divorce, unemployment, even homelessness and suicide. A recent news report offers a dire warning:

"Veterans aged 20 through 24, those who have served during the war on terror... [have] the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age."

This shocking data only highlights the tremendous need for quick action to treat troops' mental health problems. PTSD is treatable, especially if it's caught early. We can (and must) help hundreds of thousands of veterans just like Keri.

Unfortunately, the Department of Defense's system for screening troops - a bunch of paperwork followed by a phone call - doesn't catch most of the people who will need treatment. We vets have known this for years. A recent study in the Journal of the American Medical Association agreed.

The study looks at the paperwork forms on 88,000 soldiers to see who needed treatment and who actually got care, and came to some disturbing conclusions.

1) Asking a troop just back from Iraq to fill out another form is not the same as screening them for PTSD. The report concludes:
"Surveys taken immediately on return from deployment substantially underestimate the mental health burden." That's why it's crucial that troops get mandatory, in-person interviews with a mental health professional. And not just when they come home, but months later, when the long-term effects of combat have had time to become visible.

2) Mental health issues are family issues. In the six months after getting home, there was a four-fold increase in troops' concerns about "interpersonal conflicts" with family and friends. The military needs to do a better job of reaching out to troops' families, so they can help get their loved ones into treatment.

3) National Guardsmen and Reservists are facing a special set of issues, and their concerns need to get heard. 42.4 percent of National Guardsmen and Reservists were identified as needing mental health treatment, compared to 20.3 percent of the active duty. These troops are more likely to have family and financial problems result from their deployment, and when they get home, they go straight back to work in a civilian job. No wonder they have higher rates of stress. We need to get them the care they need, starting with stronger job protections and better family support for deploying reserve troops.

4) Troops need more time to access care. Far more troops admitted a mental health problem when interviewed after six months than when they just got home. Of those who received a referral for mental health treatment, 39 percent still had not seen a mental health professional 90 days after their second interview. That's nine months after their return. The military and the VA need to prepare for the time-lag between troops coming home and their entry into the mental health care system.

As the authors of the JAMA study conclude, there is an "enormous opportunity" for the military to "intervene early before soldiers leave active duty." That includes thousands of women who have bravely fought and suffered wounds right alongside their male counterparts–and sometimes also face the incredibly stress of a sexual assault and/or trauma.

60,000 veterans were diagnosed by the VA with Post-Traumatic Stress Disorder. ³Of those, 22 percent of women suffered from military sexual trauma,¹ which includes sexual harassment or assault, compared with just 1 percent of men.² 

In 2007, there were 2,688 sexual assaults reported. This followed a 24 percent jump in 2006, and a 40 percent increase in 2005. The overwhelming majority of service members who report sexual trauma are women.
The VA has clearly seen a connection between mental health injuries and sexual assault.

But more research is necessary to understand the connection. Although the number of female veterans is rising, there is still a knowledge gap when it comes to the unique needs of female veterans. In IAVA's 2008 Legislative Agenda, we call for a more comprehensive approach to treating female service members¹ psychological injuries, including funding for an independent research study of the scope of sexual harassment and assault in the military, and an analysis of the effectiveness of the military¹s response to the problem.

We know the consequences if we fail to act. The only question is whether we have the political will to help these heroes like Keri before it's too late.

Founder and Executive Director of Iraq and Afghanistan Veterans of America.
- Paul Rieckhoff, Iraq Veteran, Founder and Executive Director of Iraq and Afghanistan Veterans of America. (www.IAVA.org), author of Chasing Ghosts (www.PaulRieckhoff.com)

She doesn’t drive more than two miles from home. She’s afraid her minivan is going to hit a roadside bomb.  She has thoughts of suicide, nightmares about body parts falling on top of her, and sometimes can’t even remember her home phone number.

Veteran Keri Christensen was nearly a victim of a roadside bombing in Iraq when the convoy in front of hers was hit. Here's a preview of her interview with Randi Kaye.

This is what life is like for Keri Christensen. She served in Iraq for the National Guard. Her job was to haul tanks up and down the country’s most dangerous roads. She was shot at by snipers and witnessed the convoy in front of hers blow up. That terrified her. She told me, “you have this fear, oh my god, I still have to go through there… and am I gonna make it?”

I first interviewed Keri in November 2006. She was part of history then, among the first group of women in the history of the United States classified as combat veterans.

Female troops technically are only allowed to do “combat support” but women are seeing violence like never before, and it’s leaving them with battle scars, both inside and out.

Keri was diagnosed with Post Traumatic Stress Disorder, or PTSD, before she left the war zone. She’s been home now two and half years and is still struggling. Last fall, she hit rock bottom. Again, she thought about killing herself after another panic attack.

I asked her what “rock bottom” feels like, and she said “a very dark, lonely place.”

Keri is married with two little girls, Madison and Olivia.  She says her kids know she’s not the same “mommy” she was when she left for war. They know she’s going to counseling once a week and also group therapy. She’s taking all kinds of pills for her nightmares, PTSD, anxiety and depression.

She says she never needed any of that before the war. There have been some improvements. Keri no longer has imaginary conversations with her husband, which she was having when she first got back, and she’s sleeping about six hours a night, a step up from the four hours she’d been able to manage.

Still, she never goes far from home because her sense of direction gets foggy, and is terrified when her husband drives. She told me, “when my husband drives, if something is on the road like cardboard, I'm like don't run over it, don't run over it, when he does, I'm like (gasps)”

In 2006, the Veterans Administration diagnosed nearly 3,800 women with PTSD. But some women’s stress is compounded by sexual trauma in the military.  Keri says she was sexually harassed while serving, though the military tells CNN her complaint had no merit. Still, the VA reports between 2002 and 2007, nearly 22 percent of women veterans had experienced Military Sexual Trauma, or MST, which includes sexual harassment and assault.  

One expert, who councils women veterans, says the numbers are even worse. She says many women are afraid to report their attacks and their attackers. 

Darrah Westrup with the National Women’s Trauma Recovery Program in San Francisco says, “ the same indivduals who attacked you are those who will be protecting you or you'll be fighting along side you the next day.” 

Can you imagine?

Like many in this new class of women soldiers, Keri is learning to live with the scars she brought home. I asked her, though, if she has any hope that one day she’ll return to the woman she was before she went to war. She told me, simply, “I don't think we'll ever be the same.”

Read the full story

- Randi Kaye, 360° Correspondent
Program Note: Watch Randi's report, tonight on 360° at 10 p.m. ET