EUGENE (AP) - Oregon Army National Guard Master Sgt. Jeff McDowell of Eugene thought he was fine in 2005, after he returned from a year of combat in Iraq, but his wife knew better.
McDowell, then 41, couldn't sleep, was quick to anger and often found himself feeling anxious, especially when out in public, worried that other people were a threat to his wife and their two children.
His wife, Shelly, said, "'You need to go and talk to somebody,'" McDowell recalls.
He saw a mental health counselor at the Eugene Vet Center. Other visits followed and, the next year, the U.S. Department of Veterans Affairs diagnosed McDowell with post-traumatic stress disorder, an anxiety disorder that can affect people who have been through traumatic events, including combat.
McDowell, who now lives outside Veneta with his family, said the counseling helps him manage his anxieties, but he knows other veterans who aren't doing so well.
"They are holed up in their homes," he said.
Precise numbers of former soldiers who have PTSD aren't available, but of the veterans who served in Afghanistan or Iraq, an estimated 20 percent - one in five - have the disorder, said Tom Mann, public information manager of the Oregon Department of Veterans Affairs.
The federal VA estimates the number is higher - 25 percent.
And, with 3,000 to 6,000 Oregonians who serve in all branches of the military, including those who saw combat, returning to civilian life, the number of people afflicted by PTSD is expected to grow.
PTSD symptoms, including insomnia, feelings of rage, suicidal thoughts and reclusiveness, can make it difficult for veterans to readjust to civilian life, leading to divorce, unemployment, family estrangement, alcoholism and drug abuse, Mann said.
Sometimes, the disorder can lead to incidents with tragic results.
In December, Michael Mason, an Iraq and Afghanistan veteran from Springfield who had been diagnosed with PTSD, was shot and paralyzed by Eugene police after he had inexplicably fired shots with a 9 mm handgun in the Valley River Center parking lot. No one was injured by Mason's shots.
The VA classifies PTSD as an anxiety disorder that can occur when a person experiences a traumatic, life-threatening event. Strong emotions, such as fear, anger and confusion, caused by the event create changes in the brain that may result in PTSD, the VA says.
PTSD has been around a long time, mental health professionals say, although it was called different names following earlier wars, including "soldier's heart" after the Civil War, "combat fatigue" for WWI veterans and "post-Vietnam syndrome" for Vietnam veterans.
But anyone who undergoes life-threatening or terrifying experiences, such as a car accident or rape, can develop symptoms, according to the VA.
People with PTSD can continue to relive the traumatic event in their minds, through flashbacks and nightmares.
Certain sights or sounds, such as fireworks or a car backfiring, can bring back memories of gunfire for combat veterans.
"During flashbacks, people aren't thinking real well," said David Baldwin, a Eugene psychologist who specializes in stress and trauma counseling. "They are responding to danger, or a life threat, or fighting for their lives, and feel as if they're back in their traumatizing experience."
People with PTSD can have "heightened levels of physiological arousal," such as elevated heart rates even though they are not in real danger, Baldwin said.
"Because they feel unsafe, they're more likely to be triggered into a defense state that might get them out of a traumatic experience that isn't really happening," he said.
"During this type of event, you think that your life or others' lives are in danger," Baldwin said. "You may feel afraid or feel that you have no control over what is happening."
McDowell, a member of the of the Oregon Army National Guard 2nd Battalion/162nd Infantry Regiment, arrived in Iraq in 2004, about a year after the U.S. entered the country. Fighting was heavy as the insurgency and sectarian violence grew.
McDowell belonged to a battalion scout unit, which operated in downtown Baghdad.
"We were the eyes and ears of the battalion commander," he said. "We did intelligence gathering. We went on raids. We worked very closely with the explosive ordnance teams. We did explosive ordnance removals. If a soldier or Iraqi policeman was injured by an improvised explosive device, we did the investigation."
"Sixty-five to 70 percent of the time, you are moving along and not much is happening, but 25 percent to 30 percent of the time, all hell is breaking loose. And there were a handful of significant events that I don't know how we survived."
After returning to Eugene, McDowell remained in the National Guard and resumed work as a contractor. He said he often felt keyed up, or "hypervigilant" when he was in public with his family.
At restaurants, for example, he would constantly look at other people and listen to what they said.
"You are constantly assessing people," McDowell said. "You are constantly looking for threats.
"It was getting obsessive."
But after he underwent counseling , McDowell said, his symptoms improved.
After 22 years in the National Guard, McDowell retired from the service in 2007.
He's now attending Northwest Christian University, working on a master's degree in community counseling.
His goal: to become a VA counselor to help Vets with PTSD and other problems.
"Maybe I have something to offer other veterans," he said.
In the last year, 3,414 veterans affected by PTSD made a total of 21,564 visits to VA clinics overseen by the VA's Roseburg office, which administers health care for veterans in Lane, Douglas, Coos and Curry counties and northern California's Del Norte County.
The relatively high rate of PTSD among returning veterans can be attributed to the military's reliance on repeated combat deployments, officials say, which increases the chances of soldiers being exposed to traumatic events, as well as the possibility of suffering brain injuries, both of which contribute to PTSD.
About 80 percent of the patients seen in the Veterans Affairs mental health clinics in Eugene have been diagnosed with PTSD, said Dr. Les Garwood, the VA's lead psychiatrist in Eugene.
Last year, the VA relaxed its standards to make it easier for veterans to get help for PTSD.
Previously, veterans had to identify a particular traumatic event that could have caused the disorder and the VA would have to verify that event through military records. Now, benefits for combat-related PTSD can be given without the VA having to document a specific event, only that combat experiences contributed to the disorder.
The VA benefit adjudicators "will rely on a VA mental health provider's diagnosis that the person has PTSD and it's related to their combat experiences," said Joseph Reiley, supervisor of the Lane County Veterans Services Office.
"So folks who have concerns about having this condition, I would encourage them to contact this office and we will assist them with their claim for benefits."
Garwood, the VA psychiatrist, said PTSD can be treated with medication and individual and group therapy, but it's rare for the disorder to completely disappear.
"PTSD tends to be a maintenance disorder; it improves over time with treatment in most instances," he said. "But I don't like to misrepresent the concept of PTSD, that you cure it like a sore throat or cancer. It's more like treatment of diabetes or arthritis. They are chronic conditions, and the goal is reducing (PTSD) symptoms to the point where the quality of life is improved and the ability to function is optimized."
The trauma of war - killing other people and seeing friends die - can challenge veterans' beliefs about themselves and the meaning of life, Garwood said.
"PTSD is a chronic condition," he said. "It's not something (veterans) can snap out of or get over right away. Veterans deserve empathy, compassion and grace from the public."
Nearly one in five veterans who served in Afghanistan or Iraq are believed to be suffering from post-traumatic stress disorder, and with thousands of Oregonians coming back from war, military officials expect growing numbers.
Post-traumatic stress disorder is an anxiety disorder that can affect people who have experienced traumatic events, including combat. Symptoms include insomnia, rage and suicidal thoughts.
The Eugene Register-Guard reports that the Oregon Department of Veterans Affairs says about 20 percent of veterans suffer from it.
Officials say the relatively high rate of PTSD among returning veterans can be attributed to the military's reliance on repeated combat deployments. Last year, the VA relaxed its standards to make it easier for veterans to get help for the disorder.
Information from: The Register-Guard, http://www.registerguard.com