Private Battles

The story of war is not just about combat on the battlefield. It's also about the families who remain behind to fight their own private battles.

It's the story of Aimee Ybarra, a mother of two grade-school children, whose husband came home after his fifth combat tour and told her he wanted to leave their 15-year marriage because he had gotten used to being gone. It's the story of Lisa Bernreuther, who's steeling herself for her husband's sixth deployment; he's only been home from his last tour since April. She keeps his Army boots by the door, she says, "because sometimes I forget I even have a husband."

And it's the story of Gwendolyn Roberts, a bright, outgoing sixth-grader and "Daddy's girl." When her father left for war for the third time in five years, the spark went out of her and she tumbled into severe depression.

After nearly nine years of war, military families like these at Fort Hood in Central Texas find themselves in a relentless cycle of crisis and stress.

Over the next several months, The Dallas Morning News will examine how:

• Repeated combat tours to Iraq and Afghanistan have split up marriages and forced kids to grow up without one or both parents for chunks of their childhood.
• Troops return home from combat tours with severe injuries and psychological disorders, thrusting spouses and other family members into new roles as long-term caregivers.
• Suicides in the military have risen to record levels, and the divorce rate has climbed steadily since the U.S. went to war in 2001.

These burdens of war have fallen heavily on the troops - who represent less than 1 percent of the U.S. population - and their families.

"Injuries that result in long-term changes in behavior or abilities can seriously challenge marriages, thrusting the spouse into a caregiving role, increasing the risk of depression and other psychological problems and increasing the likelihood of divorce," said a March report published by the Institute of Medicine.

Yet "there are not enough mental health providers to meet the demand, case managers and providers are overwhelmed, wait times are too long for appointments and between appointments for those in need of mental health and other services," the report stated. The institute's two-year study was mandated by Congress to help veterans readjust to civilian life.

The extended military operations and multiple combat tours are not just a short-term problem for military families. They will have a lasting impact on the well-being of the next generation - the nearly 2 million children who are growing up in military households.

"This isn't going away," said Ybarra, 33, the mother of a 10-year-old girl and a 6­year-old boy, who lives near Fort Hood. She has been separated from her husband, a first sergeant, for a year and is in the process of divorce. He is leaving soon on his sixth deployment.

"I can guarantee you that in the next 10 years," she said, "we'll still be seeing the effects on my children."

Uncharted territory

The Iraq and Afghanistan wars have developed into the longest sustained combat operations since the Vietnam War. The all-volunteer military, which replaced the draft in the mid-1970s, finds itself in uncharted territory: a seemingly endless era of military operations and deployments.

"We've never been here before in history," said Maxine Trent, a licensed professional counselor who has seen hundreds of military family members from Fort Hood. "We've never asked our military families to do what we're asking them to do."

Family Readiness Groups are the traditional approach to supporting military spouses during deployments.

Made up of soldiers, family members and volunteers with each unit, the groups offer a network of communication and support. While many of these groups have been effective, others have split into cliques or deteriorated into gossip-mongering, according to military spouses interviewed by The News.

That lack of social bonds can further isolate military families already suffering from stress or depression.

One of the first studies to look at the psychological impact of deployments found that spouses of troops sent to Iraq or Afghanistan were "more likely" to have depression, anxiety, sleep disorder and other mental illnesses compared with spouses of those not deployed.

Researchers from the University of North Carolina at Chapel Hill looked at recent medical records of more than 250,000 female spouses of soldiers who had five or more years of military service. (Men married to female soldiers made up only 5 percent of the sample, a size too small from which to draw conclusions.)

The report, published in January, also found that the longer the deployment, the more likely the spouse was to be diagnosed with a mental disorder, said Alyssa Mansfield, the study's lead author and a research epidemiologist.

Since October 2001,more than 2 million troops have been deployed to fight the two wars. No military installation has been busier than Fort Hood, the country's largest active-duty base, with more than 50,000 active-duty soldiers. More than 85 percent of its units have deployed to Iraq or Afghanistan for at least one yearlong tour. Most units have served at least two tours. Several are on their third or fourth combat tours.

Fort Hood is also home to more than 100,000 Army family members. About 85 percent live off post.

Trent, the lead counselor at Military Homefront Services, a private, nonprofit clinic, said her center has been "really, really swamped," since it opened two years ago to meet the psychological needs of military families at Fort Hood.

From its start in January 2008 through this May, the clinic, part of Scott & White Healthcare system in Central Texas, has served nearly 5,000 patients - more than five times the number anticipated.

"A lot of times, moms will initially come in with concerns about their kids" before acknowledging their own difficulties, Trent said. "What they're telling us is, 'We're exhausted. Our kids are exhausted.' "

Breaking point

Even in normal times, military life demands much from families. Service members move from one installation to another every two to three years and often spend months away from home in training.

These are not normal times for military families.

"Because of the need, we have recycled the same folks back to the front lines," Trent said. "This was never intended to be - back-to-back deployments - never intended to be part of the military lifestyle."

At times, combat tours have been extended from a year to 15 months. "That's another birthday. That's another Christmas," Trent said. "In terms of milestones, particularly in a child's life, you've just missed another."

The majority of military personnel are married - more than 50 percent in the enlisted ranks and more than 70 percent of officers. Of those married, more than two-thirds have children.

Few studies have looked at children of parents who have deployed to Iraq or Afghanistan. The Rand Corp., a Washington, D.C., research center, published a report in March that found that children from military families with a deployed parent reported higher rates of anxiety, depression and behavioral difficulties than children in the general population.

The study, commissioned by the National Military Family Association, also showed that the longer the parent was deployed, the greater the number of difficulties the children reported.

Martha Roberts' experience reflects the report's findings. The 40-year-old Army wife from Killeen has made it through each of her husband's three deployments with help from her church, Unity Baptist. But when her daughter Gwendolyn became depressed, Roberts sought the help of counselors at Military Homefront Services.

Gwendolyn, 12, went to therapy for a year and feels better- especially now that her father has returned home. Sgt. Glenn Roberts, with 22 years of military service, has decided to retire this summer.

"I made a promise to her when she was 7 years old that I would be out of the military by the time she turned 11," Roberts said. "I'll be a little late, but close."

The divorce rate in the armed forces has risen steadily in the past decade. It stands at 3.6 per 1,000 couples, compared with a rate of 2.6 per 1,000 in 2001 when the war in Afghanistan started. (The U.S. Census has estimated the civilian divorce rate also at 3.6 per 1,000 couples in 2007, the latest figures available.)

However, those statistics offer only a snapshot of military marriages and do not count veterans who get divorced after leaving the military.

Other surveys indicate more military marriages are in trouble - especially for deployed soldiers. The Army's latest annual survey of troops in Iraq found that the percentage of married soldiers who said they expected to get a separation or divorce grew from 12 percent in 2003 to 22 percent in 2009.

Pam Posten, an Army wife at Fort Hood, said deployments are particularly hard on young spouses: "I think the majority struggle with being away from their families and home for the first time. And if you add to that a first-time mom whose husband's deployed - that's a lot to take on."

Aimee Ybarra was a young military wife with a preschool daughter when she and her husband moved to Fort Hood in August 2003. Just afterward, she learned she was pregnant with her second child. Three months later, her husband left for Iraq on his third combat tour. And two weeks after that, a burglar broke into Ybarra's off-post house.

With no friends yet in their new community, and their closest relatives in California, Ybarra and her daughter, who was 4 at the time, had only each other for support. For weeks after the break-in, they would huddle together in bed at night, sometimes crying themselves to sleep.

"It was a scary time," Ybarra said.

Spouses who get divorced can face economic devastation, including the loss of health benefits.

Carissa Picard moved five times during her eight-year marriage to an Army helicopter pilot. In March, after the couple agreed to divorce, Picard and her two sons, ages 6 and 9, had to leave her house at Fort Hood. She moved into a temporary residence in San Antonio while looking for work.

More should be done to help divorced military spouses get back into the job market, said Picard, who also believes divorced military spouses should be eligible for unemployment compensation.

"It's such a drastic change in your life status," she said. "It's just like transitioning out of the military for a soldier."

Coming home

Like clockwork, counselors typically hear from military spouses about two to three months after a deployed unit returns. The initial euphoria has worn off and reality has set in.

"What I usually get from the spouse is that, 'My husband's been back from Iraq or Afghanistan. ... He's a different person. I don't understand it,' " said Ashley Koonce, a therapist in Killeen.

Sometimes the soldier seems more angry and temperamental than before, or he or she has withdrawn from family life.

"You will get a lot of spouses saying, 'I've had to be so strong for so long, and I expected relief when he got back,' " Koonce said. "But now there's more stress."

These changes are often resolved after a short adjustment period. But other times, they point to a deeper medical or psychological issue.

Defense Department figures show that 163 active-duty Army personnel committed suicide in 2009, up from 140 in 2008 and more than double the 77 suicides reported in 2003. The Army suicide rate is higher than that of civilians. There is no single explanation, Pentagon officials say, but the wear and tear of repeated deployments appears to be a major factor.

Roadside bombs - the most common cause of U.S. casualties - have produced many cases of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Rand Corp. estimates that more than 300,000 troops who have returned from Iraq and Afghanistan report symptoms of PTSD or major depression.

The report, issued in 2008, noted that only slightly more than half of service members with PTSD or TBI had sought treatment within the past year.

More than 36,000 service members have been wounded in the wars in Iraq and Afghanistan. In many cases, their injuries would have resulted in death in previous wars - advances in protective armor and medical technology have helped more survive. And that means more spouses, parents and other family members are taking on new roles as full-time caregivers.

Kelly Russell, 28, an Army spouse who lives near Fort Hood, needed help adjusting to her husband's behavior after he returned from his second combat tour in 2007. He was eventually diagnosed with PTSD and TBI.

"His patience level was almost to zero," said Russell, the mother of two young boys. "I needed an outlet as far as dealing with his mood changes. It wasn't just the normal mood swings. With PTSD and TBI, it's drastic from one minute to the next."

One day, her husband, who declined to be interviewed, brought home a leaflet promoting the Military Homefront program. "I called immediately," she said.

"I was getting overwhelmed most of the time," she said, recalling that she told her therapist: "I feel like a single mother. Even though he's home with me, I feel like I'm raising these kids by myself, and it's frustrating."

With her husband's five deployments in eight years, Lisa Bernreuther might be one of the most seasoned leaders of a Family Readiness Group - one with an answer to just about every problem. She became friends with Amparo Bracero-Sierra, whose husband was deployed to Iraq for the first time in their marriage. When Bracero-Sierra was hospitalized with a brief illness, Bernreuther came to her aid. And Bernreuther stood next to the nervous Bracero-Sierra for the homecoming ceremony in April when both of their husbands returned from Iraq.

But Bernreuther, 48, said that every family deals with deployments differently, depending on variables such as the ages of their children and whether the spouse works.

Her advice boils down this: Try not to follow the news about the war too closely, and keep your personal business off Facebook and other social media websites, where husbands and boyfriends can read it. "It could be misconstrued," she said.

Her final suggestion sounds like the 11th Commandment: Trust your spouse.

"If we didn't have trust, there's no way I'd be able to survive," Bernreuther said. "I don't know how some women, if they don't trust their husbands, how they get through a deployment. I really don't - because it's very hard."

She still has trouble adjusting each time her husband returns home. With her only child grown and living on her own, she works full time and gets into her own routine.

"It's like I'm a single person," she said, "because I'm here by myself for so long."

ABOUT THE SERIES

In the midst of the longest U.S. combat operations since the Vietnam War, military families are struggling through a relentless cycle of crisis and stress. Many suffer their own wounds of war: Depression. Anxiety. Divorce. Suicide. Staff writer David Tarrant and photojournalist Sonya N. Hebert have spent four months meeting dozens of military families and chronicling their journey through these perilous times. This is the first of a series of reports that will appear over the next several months.

SUPPORT AND RESOURCES FOR MILITARY FAMILIES

The National Association of Military Families, www.nmfa.org, has resources and support for military spouses and children. It also runs Operation Purple camps for military kids.

Blue Star Families, bluestarfam.org, is a network of military families with 70 chapters around the U.S.

Strong Bonds, www.strongbonds.org , offers relationship enrichment classes for military couples.

The National Guard Family Program, www.jointservicessupport.org, provides outreach and information to Guard families.

Force Health Protection & Readiness, fhpr.osd.mil/deploymentTips.jsp, is a family support program for reservists.

VA North Texas Health Care System, www.northtexas.va.gov, offers more information on local Veterans Administration programs.

TRIAD fund, www.triadfund.org , has state and local resources for veterans and military families.

Scott & White's Military Homefront Services, [email protected], 254-680-1139, offers counseling and other services.

Fort Hood's new Resiliency Campus focuses on helping troops before they go to war

Standing 6-4, with a head shaved smooth as a mortar shell, Monty Mitchell looks the part of a battle-hardened soldier with three combat tours and a Bronze Star to his credit.

The 44-year-old staff sergeant loves working on his vehicle - a Chevy Tahoe equipped with a four-wheel-drive lift. He relaxes by watching NASCAR on the Speed Channel.

He's not the kind of guy you'd expect to see taking a cooking class with his wife.

But that's where he was in late March, gamely by Deana's side, as the couple spent the day at a family resiliency program at Fort Hood. Mitchell, who supervises a dozen soldiers in a field artillery unit, believes in leading by example.

"If I'm asking my soldiers to do it, then I should be able to do it," said Mitchell, who has 16 years of military service.

The military has ramped up the number of programs for military families in recent years, with a major focus on resiliency training. It's part of an effort to help soldiers learn how to better handle combat stress and the strain of military life in general.

Fort Hood, the largest base in the nation and a three-hour drive south of Dallas, offers a broad assortment of services. At the center is the new Resiliency Campus, a complex of buildings with a wellness center and classrooms that became fully operational in September.

The campus is the first of its kind and showcases physical, psychological, financial and spiritual programs, said Col. Bill Rabena, the facility's commandant.

A gym includes weights and exercise equipment, as well as tai chi, yoga and massage therapy. Instructors teach personal finance, weight-control and marital classes, plus state-of-the-art breathing, focusing and calming techniques. Chaplains can be reached there 24 hours a day, seven days a week. Counselors with the Military and Family Life Consultant program are also based at the campus and provide short-term, problem-solving counseling and services.

"We deal more with the preventive side, trying to build that resiliency and inner strength before the [deployment]" to the war zone, rather than wait to fix soldiers and families after they have suffered a mental health crisis, Rabena said.

Last fall, the Army rolled out the servicewide resiliency training program, which will include all soldiers from young recruits on up the ranks.

Beginning Oct. 1, all active-duty and reserve soldiers will take a confidential, online evaluation of their resiliency. A similar assessment for military family members is in the works. The evaluation will offer advice to soldiers and family members based on their resiliency scores.

After attending the resiliency day program in March, the Mitchells, who have two teenage children, started working out every week at the wellness center. Deana, 42, also leads their unit's Family Readiness Group. "I know what [being in the Army] means to him," Deana said. "That's why I stand behind him."

But Deana and the kids are already bracing themselves for Mitchell's next deployment. "We try not to get too attached to him when he's here," Deana said, "so it's easier to deal with it when he's gone."
 

A War Rages Within

On the road ahead, a turkey vulture lurches into the air. Mike Nashif, driving at a 60-mph clip with an 18-wheeler bearing down in the oncoming lane, realizes that a collision with the bird is unavoidable. His girlfriend, Anndra Mulholland, shuts her eyes and covers her face with her arms.

As if in slow motion, Mike sees the vulture hurtle toward him. He sees it hit the windshield and explode. He sees the web of cracked glass smeared with blood and feathers.

He slams the brake and swerves to the side of the road. He stumbles to the shoulder, swallows deep gulps of air and sinks to his knees with a groan. As he crouches by the side of the road, Anndra rubs his neck and back, saying: "It's OK, we'll be all right."

Mike, a two-tour Iraq war Army veteran, checks the car. It looks like it's been hit by a rocket-propelled grenade. A direct hit, too.

The collateral damage to his psyche will prove far more difficult to measure.

In April, after eight years in the Army based at Fort Hood, Texas, Mike took early retirement for medical reasons. He spent 27 months in Iraq dodging roadside bombs, rocket-propelled grenades, mortars and snipers. He saw friends die.

Army doctors noted his searing migraines, frequent nightmares, memory lapses, hyper-vigilance and anxiety. They diagnosed severe post-traumatic stress disorder and traumatic brain injury and recommended him for medical retirement.

He lost much more than a military career. His marriage of 12 years fell apart, and he saw his four kids only every other weekend.

Experts say that there are hundreds of thousands of veterans like Mike. That PTSD is a dangerous enemy that destroys relationships. That families of veterans with PTSD often suffer deep psychological trauma, too.

After learning how to survive in the world's most hostile environment, Mike's mission these days is to relearn how to survive as a civilian.

Fishing is one of the few activities that helps Mike relax. That's why he and Anndra, the woman he's been seeing for about a year, spent a few quiet days at a lakeside retreat before heading back home to Belton, near Fort Hood. Driving through southeast Texas, Mike had felt calm in his Honda Passport, rolling past wide-open ranches dotted with broad-limbed live oaks.

But now, as he kneels by the side of the road, inspecting the damage caused by the turkey vulture, it occurs to him that life has just fired another lesson at him.

And it's knocked him to his knees.

Married with kids

In 2001, Mike was 24 and married with two children and one on the way. He'd met his wife, Dena, in Oregon, where they'd grown up. They'd moved to Texas to be close to Dena's mother in Waxahachie. Before enlisting, Mike had worked as an assistant manager at a grocery store, making $12.50 an hour. He was ready for a change.

In boot camp, Mike's drill instructor repeatedly harped on how soldiers needed to train hard because the world could change in a split second. Sure enough, Mike's graduation took place on Sept. 12, 2001, as the nation reeled from the terrorist attacks the day before in New York, Washington, D.C., and Pennsylvania.

Just over two years later, in March 2004, Mike deployed from Fort Hood for a year in Iraq. He was one of the forward observers, who scouted enemy targets. Their base was in the volatile southern Baghdad sector. His 12-month tour of duty coincided with the heaviest fighting in Iraq since the initial invasion. Insurgents attacked troops with hit-and-run tactics. They ambushed convoys of Humvees and Bradley Fighting Vehicles with roadside bombs, or what the Army calls improvised explosive devices (IEDs).

On nightly missions, Mike would be either in the Bradley or a Humvee in a squad of three vehicles. The missions included patrolling hostile neighborhoods, checking houses for weapons or enemy combatants, and rebuilding roads and schools.

They were repeatedly exposed to roadside bombs. "I think my traumatic brain injury came from the repeated explosions. At least once a week, we were being hit by something," Mike says. "I think I had about 30 IEDs go off next to my vehicle, or within 25 yards of my vehicle."

One of them was a 250-pound bomb rigged to blow up in a parked car as he rolled by in his Bradley. Mike says he never heard the blast.

"You feel it, you smell it and you taste it," he says. "It's one big beat on your body. It's like somebody slapping you very hard on both sides of your body. You feel it on your toes, chest, head, fingers - all over your body."

Luckily, no one was seriously injured. Mike received a Purple Heart for shrapnel wounds on his hands and wrists, but it could have been worse. He found a piece of shrapnel embedded in the Bradley's hatch.

"A few inches closer," Mike says, "and it would have taken off my head."

During his tour, three close friends in his unit died. One was a medic who was sent home with a gunshot wound in his foot. He asked to rejoin his buddies in Iraq and was back less than a month when he was killed by an IED.

When another friend was killed by an IED, it was Mike's job to clean the shattered Humvee, removing blood and tissue from the electronics and radio gear that needed to be salvaged. "It took four hours to clean the blood out of the Humvee," he says.

Halfway through his tour, he faced perhaps his most traumatic moment: He was riding in the back of a three-vehicle convoy when the patrol was hit by a roadside bomb, mortars and gunfire. One of his closest friends, Spc. Raymond White, was killed in the attack.

Mike learned to become hard and leave his feelings behind whenever he went "outside the wire," military jargon for leaving the relative safety of the base.

"Everywhere you go, people are trying to kill you. You learn not trust anyone," he says.

War at home

When Mike returned home in March 2005, his wife noticed right away how much he had changed.

"He pretty much distanced himself to the point that whatever I did while he was gone, I continued to do," Dena says. "The bills, the children, the schooling, the doctors' appointments ... anything that needed to be taken care of here, I did."

At the time, Mike and Dena had three children, ages 4 to 10, and Dena was pregnant with their fourth child. Mike was scheduled to return to Iraq within 12 to 18 months. That didn't give him enough time to re-engage in the lives of his children, only to pull away again.

"It was like I was standing outside my house, watching my family through a window," he says.

When he did become emotional, he went off like a rocket. Mike admits he struggled with his short temper. "It was hard to control when I came back [from Iraq]," he says. "I went from zero to 90 in a half-second."

In a house with kids and dogs, the chaos and noise could be overwhelming. Once, when Mike's oldest son wouldn't stop poking his brother with a toy, Mike exploded in a flash. "I grabbed him by his throat and held him up against the wall," he says.

When one of the boys broke a wooden airplane model that belonged to his sister, Mike ordered his son to bring his favorite monster truck into the living room. Then Mike picked up a baseball bat and smashed the toy to bits.

In a war zone, instant obedience can save lives; disobedience is tantamount to mutiny. However, Mike could not distinguish between the battlefield and his living room. "My own anger scared me," he says.

He was having other problems, too. During a family road trip to Oregon to see Mike's father, Dena noticed that whenever Mike drove under a highway overpass, he would clench the steering wheel and open his mouth. In Iraq, insurgents would use overpasses to ambush convoys.

"I had to rub his arm and tell him he was OK. There were no insurgents, no bombs," Dena says.

He also struggled with searing migraines and bouts of dizziness and nausea - signs of possible traumatic brain injury.

Seeking professional help, Mike says, "was out of the question. He didn't want the Army to know he had psychological problems, "especially when your livelihood depends on your being promoted," he says.

He sought out his own forms of therapy. He began to spend a lot of time at fishing holes. "I had a hard time doing just about anything in public except for fishing," Mike says.

In many ways, he was still living as though he were deployed - putting up emotional walls and doing things that recreated the adrenaline rush he'd felt in a war zone.

While in Iraq, Mike had spent some spare time in Internet chat rooms, talking to women. For a soldier deployed thousands of miles from home, even virtual relationships could provide an outlet from the grinding tedium of life in Iraq. But one of those connections eventually led to an affair. Dena found out a few months after Mike deployed on his second tour in 2006. She was devastated. They quarreled during phone calls for the first three months of his deployment. Then Mike stopped calling.

"He pretty much told me he wasn't coming home," Dena says. "He didn't want to be a dad or a husband anymore."

Mike said he quit calling home because he felt helpless to fix his marital problems and he needed to stay focused on his mission in the war zone. When his second deployment ended in 2007, he and Dena had decided to make one last effort to save their marriage. They talked to a chaplain. They went on a marriage retreat. "It was kind of touch and go," Dena says, but at least they were living under the same roof.

About this time, Mike was put in charge of the recreation program for Fort Hood's Warrior Transition Brigade, a unit of soldiers trained to provide medical and other forms of support to wounded service members. Mike arranged fishing events in what would grow to become Take a Soldier Fishing, the nonprofit organization he runs today.

As he got to know wounded soldiers, Mike began to pay closer attention to his own medical problems. He suffered chronic headaches. He slept fitfully and suffered from nightmares. He hated crowded places - he wouldn't shop at Walmart and avoided busy restaurants. He met soldiers with similar symptoms, who were receiving treatment for post-traumatic stress disorder and traumatic brain injury. Eventually, he asked for help, too.

Meanwhile, he and Dena were working together to organize fishing events. But then came one final blow to the marriage. About mid-summer in 2009, Mike told his therapist about a dream he couldn't put out of his mind. In the vision, he saw his wife lying dead in the shower. He found the image disturbing enough to bring up in therapy.

Mike wasn't prepared for what happened next. He was immediately admitted to Fort Hood's psychiatric ward for five days of observation. He says he was put there because his dream was considered a "homicidal ideation." Mike vehemently disagreed and called his confinement a huge overreaction. Eventually, he and his therapist talked again and Mike concluded that his dream probably represented the death of his marriage.

Dena says Mike's dream extinguished any hope she had for their relationship. They agreed to divorce.

Mike said they tried for almost two years to fix their marriage. "I was living with my wife and kids, trying to do the right thing," he says. "But what I thought was right and what I felt was right were two different things.

"I know it's right to stay with your wife and kids and to provide for the family. At the same time, I needed to stop worrying about everybody else and worry about me."

At a crossroads

He met Anndra when he was at a crossroads, shortly after he was discharged from his short stint on the psychiatric ward. Weary and dejected about his future, a shadow of his former vibrant self, he was living out of a duffel bag in the Army barracks. He felt frozen in place, unable to go back to the way he had lived and afraid to leap forward into the unknown.

He responded to a long and quirky personal ad from Anndra; she said she liked guys with a mischievous sense of humor. That's how Mike used to think of himself: playful and impish. They arranged to meet - and immediately connected.

Anndra empathized with Mike's PTSD. Her first husband, a Navy veteran, had suffered a massive seizure and died suddenly in her arms, when she was 21. She lost her dad when she was 25 and her mother at 28. A mother of three young boys, she felt emotionally blocked and empty.

"Within the first week of seeing her, she knew everything there was to know about me," Mike says.

Over the last year, Mike and Anndra have been living together in Belton with her sons. But they plan to move soon to Lake Sam Rayburn in East Texas. The owner of a campground in Broaddus has donated a mobile home to use as the headquarters for Take A Soldier Fishing. Mike and Anndra are cleaning it up and planning to move in with her children this fall.

Anndra is learning to deal with Mike's PTSD. Whenever the artillery range at Fort Hood is in use, the sound of cannon booming makes Mike jumpy, she says. At such times, she scratches his head and rubs his neck and shoulders.

Safe and relaxing forms of recreation, like fishing, can provide an antidote to soldiers returning from war. That's one reason Mike decided to continue running his organization after leaving the Army. It's also good for his own therapy. "Take a Soldier Fishing gives a purpose to my life," he says.

He hopes the fishing events will create stronger family bonds. During previous fishing events, wives have seen their husbands open up with other vets about the war in ways they couldn't around their own families.

"I've had spouses come up to us and say, 'I learned more in 30 minutes of listening to them war-storying than I did in two years of asking questions,' " Mike says.

He thinks a program like this might have helped him. "If I had a program like this when I came back from deployment, I might still be married," he says.

But Mike's life has always been about change. Relearning to live as a civilian won't be easy. He knows there will be setbacks - like when a turkey vulture comes out of nowhere and ruins a perfectly good trip.

That day, Mike and Anndra climbed back in their car and continued driving home. Mike spent the next 50 miles feeling tense, white-knuckling the steering wheel and straining to see through the cracked windshield. He prayed it wouldn't rain and honked the horn to scare away any critters lurking by the side of the road.

But Iraq taught Mike that there's only so much you can control. That life can change in a split second. At times, that knowledge fills him with dread, and at other times, a kind of serenity.

"For me," he says, "the grass is a little greener, the trees are a little taller and the water's a lot prettier, just knowing it can be gone in a flash."

Some veterans get mental health help, but needs are far from being met

Two summers ago, Alexander Onzures was an Army medic assigned to a bomb removal squad in Afghanistan. The mission was to clear roads of improvised explosive devices.

"We had a saying," says Onzures, 24. "Sometimes we find them, and sometimes they find us."

Onzures was in Afghanistan only a month when an IED found his team. The explosion killed one soldier and wounded four others, including Onzures. Temporarily blinded, his back severely injured, he spent months recovering from his injuries.

In the meantime, four friends he'd lived with in Afghanistan were killed by another roadside bomb. By the time Onzures returned to Fort Hood, Texas, he was dealing with full-blown, untreated post-traumatic stress disorder.

"I was very withdrawn," he says. "If I was at work, then I was in a corner by myself. If I was at home, I was in my room, doors locked, lights off."

He tried to numb his physical and emotional pain, taking a daily dose of painkillers prescribed for his back and drinking half a bottle of Jack Daniels every night. Finally, a friend and fellow soldier suggested he enroll in a special program for soldiers with PTSD called Warrior Combat Stress Reset Center.

"He knew I was hurting," Onzures says. "He was a very good friend."

Opened in August 2008, the three-week program focuses on one of the core problems of PTSD - hyper-arousal, a state of mind that feels like a "stuck fire alarm," in which every situation seems to pose a threat, says Jerry Wesch, a clinical psychologist with the Fort Hood program. Hyper-arousal leads to avoidance behavior and social isolation, he says. Treatment combines traditional and alternative therapies, including counseling, biofeedback, breathing exercises, yoga and acupuncture.

Onzures' case had a positive outcome. But the military still says it falls short of meeting the mental health needs of all active-duty soldiers and veterans who need help.

Even Fort Hood, the country's largest base with 50,000 soldiers, is scrambling to meet the demand for services. Though Fort Hood offers a broad range of mental health services, it still must rely on local hospitals in Central Texas, such as Scott & White Healthcare, as well as independent therapists, to meet the needs of its military community, which includes more than 100,000 family members.

"We are not able to serve the entire population. So we are relying on our partners in the community to help provide some of that care," says Dr. Adam Borah, chief of Fort Hood's Resiliency and Restoration Center, which provides on-base outpatient mental health services. "We're lucky we have a relatively speaking robust network of community providers we can rely upon."

Nearly 20 percent of all combat veterans from the Iraq and Afghanistan wars - about 360,000 in all - report symptoms of PTSD and depression. Yet only a little over half of those have sought treatment, according to a study by Rand Corp. Many cite the stigma attached to mental illness for not seeking treatment, saying that doing so might harm their careers.

At Fort Hood, the number of soldiers diagnosed with PTSD has more than doubled - from 1,006 in 2007 to 2,390 through May of this year, according to the Carl R. Darnall Army Medical Center. In recent years, Fort Hood has hired more therapists to try to meet the demands for mental health services and make it easier for soldiers to find help. In January 2007, the Resiliency and Restoration Center had about 80 mental health specialists. As of July 2010, that number had doubled to 161 A year ago, Fort Hood opened a new resiliency center, a one-stop wellness hub. The sprawling campus houses a gym and meeting rooms with a choice of services, including licensed mental health therapists, chaplains, massage and acupuncture.

Increasing numbers of war veterans are leaving active-duty service and returning to their communities. There are 12,038 Iraq and Afghanistan war veterans enrolled in the VA North Texas Health Care System. Various programs, both public and private, are reaching out to them and others who are not yet in the system.

The local VA recently expanded services for recent combat veterans. New community-based clinics have opened in Mesquite , Arlington, Fort Worth and Far North Dallas to supplement services offered by the Dallas VA Medical Center in southeast Dallas.

The VA also has begun offering special classes for spouses and other family members. "When you're dealing with readjustment issues, the role of the family has unfortunately been downplayed in the past," says Michael Heninger, a licensed clinical social worker at the Vet Center in Arlington.

"We are here for families of war-zone veterans," offering classes and services at no cost, Heninger says. "They've already paid the price."

Soldiers' survival rates on rise, but so are challenges presented by brain injuries

Thanks to advances in combat gear and battlefield medicine, more troops survive injuries that would have killed them in previous wars.

This is good news, but it also presents some long-term challenges. The soldiers are "surviving, but with things like post-traumatic stress disorder and traumatic brain injury ," said Dr. Carol Tamminga, professor of psychiatry at UT Southwestern Medical Center.

Traumatic brain injury, or TBI, is caused by a blow or jolt to the head, or a penetrating head wound, that disrupts the function of the brain. Because of its prevalence, TBI has been called one of the "signature injuries" of today's wars, along with PTSD.

An estimated 19 percent of the 1.8 million troops who have served in Iraq or Afghanistan - about 342,000 - may have experienced a traumatic brain injury during deployment, according to Rand Corp., a California-based nonprofit research organization.

More than half of those cases, however, go undiagnosed and untreated, the Rand study said. The reasons: There is no simple check, such as a blood test, to diagnose TBI, and many soldiers do not seek treatment for concussions.

About 75 percent of all injuries to troops in Iraq and Afghanistan have been caused by blasts, including roadside bombs. Only the most severe head injuries are visible. Most head injuries remain hidden inside the skull. Symptoms of the more common mild TBI can include headaches; dizziness; temporary loss of balance and memory; insomnia; and depression.

Researchers don't completely understand TBI's long-term health effects. One of the problems is that TBI's symptoms are so general, they "can be associated with something serious or not so serious," said Tamminga, who served on an Institute of Medicine panel examining TBI.

The TBI panel looked at previous studies that didn't include soldiers in the current wars. The panel found that those who suffered moderate or severe brain injury were more likely to have dementia, Parkinson's disease, diabetes and PTSD.

But the panelists cautioned that there has been no comprehensive review of head injuries from the Iraq and Afghanistan wars. They recommended that the Defense Department and the Department of Veterans Affairs conduct such research as soon as possible.

In Texas, Fort Hood's TBI clinic has seen 3,081 patients since opening in November 2008. "What we don't know is how many of those are simple screenings, and how many needed follow-up [care]," said Heath Steele, spokesman for the Carl R. Darnall Army Medical Center.

PTSD and TBI are separate conditions but can go hand in hand. While PTSD can be caused by a brain injury, it "can be associated with any kind of stressful, life-threatening experience, not necessarily TBI," Tamminga said.

TBI and PTSD are "associated with traumatic memories and traumatic situations. These memories are seared into the mind ... almost permanently implanted. So the treatment is really long term," Tamminga said. "You can give pills to help people sleep, and pills that decrease anxiety. But you can't give pills that cure troubling memories. You have to really work through with the person those troubling memories."

Doctors can work through disturbing memories in a professional way, Tamminga said, but families also can play a role.

"Patience and understanding will do an awful lot to support people as they go through this process," she said.

An Unexpected Enemy

Just home from work, Charles McKinney sat in his Bedford home watching TV with his 13-year-old granddaughter. He glanced out the window of his front door and saw two soldiers in dress uniforms striding up his front walk.

He bolted into the kitchen, where his wife, Rhonda, was cooking supper. "Don't let them in!" he yelled. "Don't let them in!"

Charles knew there would be only one reason why the soldiers would be coming to his house: to inform him that his only son, 40-year-old Master Sgt. Jeffrey McKinney, had died during his second combat tour of duty in Iraq. The only question was how.

When they learned that their son had fatally shot himself, the McKinneys sat in stunned disbelief.

Suicides among service members have occurred with disturbing frequency during the nine years of the wars in Iraq and Afghanistan, leaving family members and military leaders struggling for answers.

Jeff's death, during a routine morning mission on July 11, 2007, was one of 115 suicides in the Army that year - a record total at the time, but one that would be broken continually over the next three years. In 2008, the number increased to 140, and last year, 163 soldiers took their own lives. Altogether, the Army's suicide total has doubled since 2004.

In Texas, Fort Hood has seen a similar spike. Military police are investigating four suspected suicides in the last 10 days. With 14 confirmed suicides already this year, Fort Hood is on pace to shatter its previous record of 14 suicides set in 2008.

The Army's vice chief of staff, Gen. Peter W. Chiarelli, says the suicide issue is the most frustrating problem he has faced in his 38-year military career. The reasons for the rash of suicides are unclear. Combat deployment is not necessarily the prime reason for the increase, according to experts. The Army is one year into a groundbreaking study with the National Institutes of Mental Health that could help explain the root causes.

The Army, along with the other military branches, is adding mental health counselors and behavioral health programs to combat a problem still not fully understood. "It's about the mental well-being of the force, both soldiers and families," Chiarelli said.

For the McKinneys, the fact that Jeff could take his own life was the furthest thing from their minds. This wasn't the son they knew, the man with a wife and newborn son in Germany, where he was stationed before deploying to Iraq. This wasn't the beloved first sergeant who liked to sing Sesame Street songs to his men - some as young as 18 - to cut the tension during dangerous patrols. This wasn't the caring leader who always made sure his soldiers had their needs met before he ate or rested.

"No, he didn't do that," Charles heard himself saying to the soldiers who'd come to his door. "There's no way."

Top enlisted soldier

Whatever troubled Jeff McKinney is still not clear, even three years later. He did not leave a note. He wasn't having any financial problems. He was looking forward to retiring from the Army in about a year and a half.

Just two months earlier, he had been appointed first sergeant of his unit. "He was so proud," Charles said. "He e-mailed me and said, 'I'm the top enlisted man in the company.' "

At their modest one-story home in Bedford, Charles and Rhonda spend each day trying to balance the pain of losing Jeff with their fond memories of him. Charles remained close to his son after divorcing Jeff's mother when his son was in grade school. Jeff was an adult when Rhonda married Charles, but she loved Jeff like her own family.

Their living room is filled with mementos and photographs of their son. One photo placed prominently on the TV set shows their son at a castle in central Germany where he and his German bride were married in 2005. Jeff is smiling broadly and looking tanned and fit.

Another shows Jeff at about age 10, holding a .22 rifle and striking a soldier's pose. Jeff had always wanted to follow his father, a former Marine and Vietnam veteran, into the military. Jeff joined the Army while still finishing up at DeSoto High School, under a program that allowed him to complete boot camp the summer before his senior year. When he graduated in 1985, he was already ahead of most of his peers.

Jeff's best Army buddy was Kevin Floyd, a fellow first sergeant. He got to know Jeff at Fort Polk, La., and later joined him in Iraq. Jeff never showed any signs of depression, Floyd said. He loved fishing and mountain biking, and he spent many weekends at Floyd's house for crawfish barbecues. "He was always very outgoing and active," Floyd said.

As a soldier, Jeff was an "excessive perfectionist," Floyd said, always going above and beyond. He recalls an officer asking Jeff to put together a work space for a tactical operations center in Iraq. Most people would have shoved a few card tables together, Floyd said. But Jeff persuaded some civilian contractors to build a U-shaped desk space, complete with built-in shelving for TV monitors and other communications equipment. "It looked really awesome," Floyd said.

Jeff's first assignment took him to Germany. He fell in love with the country and managed to get stationed there three times, teaching himself to speak German fluently. He was assigned to Berlin during the Persian Gulf War in 1991 and thought he had missed his only chance at combat.

But in 2004, his turn came when he deployed to Iraq with the 1st Battalion, 26th Infantry Regiment out of Schweinfurt, Germany. His unit fought in the Battle of Samarra in central Iraq, which had fallen under the control of insurgents. He was repeatedly exposed to improvised explosive devices, known as IEDs. He was haunted by one battle in which his patrol fought insurgents holed up in a school and some children were killed in the crossfire.

"He lived with that every day afterward," Charles said. "He said he could still hear the mothers screaming and crying and wailing."

After that deployment, Jeff lost interest in hunting and the rifle his father had given him the Christmas before he left for Iraq. "I just don't think I like guns anymore," he told Charles.

He married his longtime girlfriend, Christina Maurer, in a church wedding in her hometown of Muehltal, a small community southeast of Frankfurt. By the time Jeff left for Iraq again in the summer of 2006, Chrissi was pregnant. That November, she gave birth to a son, Jeremy.

Jeff was doing a 15-month tour of duty in east Baghdad, a stronghold of the Sunni insurgency. Midway through, he was appointed the top sergeant of Alpha Company. In an e-mail on June 16, 2007, to wish his dad a happy Father's Day, he grumbled about the extended deployment and "brutally hot" temperatures. He said he was looking forward to retirement and to being "able to come home each day at a normal hour."

That was the last time that Charles heard from his son.

Enduring casualties

Five days later, on June 21, 2007, one of the 1st Battalion's Bradley armored vehicles drove over a roadside bomb, exploding into flames and trapping its five soldiers inside. Jeff and other soldiers arrived quickly but were too late to save the men.

Jeff stayed to help pick up body parts.

"This seemed to be the first of a few incidents that affected" Jeff, a medic told investigators, according to records that were released to the McKinneys. On June 24, another roadside bomb exploded two feet in front of Jeff's vehicle. His driver told investigators: "There is no doubt that if this IED had struck the vehicle, we all would have been killed."

After that, Jeff's behavior began to change. He openly worried that he wasn't doing a good job. His company commander said Jeff repeatedly expressed concerns that he was "failing the company" as the senior noncommissioned officer. "His complaints were unfounded, and I explained this to him each time," the commander told investigators.

On the Sunday before his death, Jeff called his wife in Germany. He told her he was having trouble sleeping. "We were talking, and he said he felt pretty weird and not right and very tired," Chrissi said. "He fell asleep on the phone, and I told him it's better for him to go to bed. He promised me to see a doctor in the morning."

The company commander also observed that Jeff wasn't sleeping and appeared gaunt. On July 10, the day before his death, Jeff met with the company commander, who later told investigators that he gave Jeff "a handful of Benadryl" - a decongestant and sleep aid - and ordered him "to get at least 10 hours of sleep" or else he could not go out on the next morning's mission.

The next day, as the platoon gathered for the pre-dawn patrol, Jeff was supposed to give the casualty evacuation briefing. But Jeff responded with only "a blank stare," the commander reported. "I took over the rehearsal and conducted the briefing."

Even so, the commander decided not to remove Jeff from the patrol. "If I would have sent First Sergeant McKinney back to his rack, I'm afraid his soldiers would have lost confidence in his leadership. ... I believe this would have broken him and his self-confidence," the commander told investigators.

According to statements from soldiers in Jeff's Humvee, he sat silent in the front passenger seat and played with a round from his M-4. When he got a call on the radio, he stared mutely at the receiver. "But we did not think anything of it," one soldier said, "just figured he was tired."

When the mission ended about 2 p.m., an Iraqi interpreter asked for a ride back to base. After some grumbling from the other soldiers, Jeff ordered them to make room for the interpreter.

Then, according to statements from soldiers at the scene, Jeff threw down the round he'd been holding, opened his door and yelled "[Expletive] this!" He took a couple of steps and fired two rounds into a vacant building. Then he placed the muzzle of his M-4 under his chin and pulled the trigger.

"As he pulled the trigger, I saw in his face that he realized what he was doing and did not want to do it," the Humvee's driver said. "He tried to move his head, but still the round caught him."

'He just cracked'

Jeff was buried near his wife's home in Germany. Charles and Rhonda traveled from Texas to the memorial service and were joined by more than 200 soldiers from their son's base in nearby Schweinfurt. But the ceremony provided no emotional closure.

"We expected that he possibly could get shot by somebody or by a roadside bomb ... but not this," Charles said. "This wasn't planned suicide. It wasn't a premeditated suicide. I think Jeff was in a daze. He just cracked at that time."

The autopsy report indicated there were no drugs in Jeff's system. But photographs of his barracks that came with the investigative report showed several bottles of sleeping pills, including Ambien. The McKinneys have requested but have been unable to get any records from the Army that would shed light on their son's medical history.

Still, the photographs offer clues to Jeff's mental state during his final days. He was a stickler for neatness from the time he was a child, but his sleeping area was in complete disarray. "That wasn't like him," Charles said.

Charles believes his son was probably taking sleeping pills and that might have affected his thinking. He also believes Jeff was probably suffering from post-traumatic stress disorder or a traumatic brain injury aggravated when the bomb exploded in front of his vehicle three weeks before his death.

Rhonda and Charles fault the commanding officer for allowing their son to go out on the patrol - even when he was acting strangely during the pre-mission briefing. "I'm not a military person, but wouldn't that be a red flag?" Rhonda asked.

For a long time, Charles had trouble sleeping. "I would wake up at night sobbing having had a dream that I'd been with him," he said.

Because he couldn't easily visit his son's grave, he started attending other military funerals. "I didn't have him nearby to go visit. I needed to pay my respects somewhere, so I'd go do that," Charles said. "I felt like I could relate to those people, and I needed to be there and share their grief. I would stand off to the side and just observe the funeral."

Charles and Rhonda eventually found support among other military families who, like themselves, had suffered the loss of a service member. That led them to the Tragedy Assistance Program for Survivors, a national, nonprofit organization. They met and bonded with other families grieving over the loss of loved ones.

Two years after Jeff's death, Charles decided to fly back to Germany and visit Jeff's grave. He stayed for 10 days. "I spent hours at the cemetery by myself with Jeff," he said. "I cried a lot. I just kind of poured it all out. I just had to get it out, because we never really let go.

"And when I left there, I felt like a weight had been lifted off of me. It was like Jeff had said, 'OK, Dad. I'm fine. I'm not hurting anymore. You need to get on and live your life.' I was able to come back home."

Focus back on Fort Hood after recent rash of suicides

KILLEEN - A wave of apparent suicides, including a suspected murder-suicide of a soldier and his wife, has once again thrown the spotlight on Fort Hood and mental health issues at the country's largest base.

This year, officials have confirmed 14 suicides of soldiers and six more suspected suicides, according to figures released by Fort Hood and the Army Suicide Prevention Task Force. That's an increase from the 11 suicides of Fort Hood soldiers confirmed in 2009. It equals the record high of 14 recorded in 2008.

Maj. Gen. William Grimsley, the post's senior commander, called the most recent cases "very frustrating. ... Soldiers, for whatever reason, make a conscious decision to choose a terminal solution to what most often are temporary problems."

The suspected suicides include four deaths reported in the last 10 days. All four soldiers had overseas combat deployments, including one who had served four tours in Iraq and was found dead of a gunshot wound in his home near Fort Hood.

With 46,500 troops, the sprawling Central Texas base is the largest in the United States. Most Fort Hood soldiers are assigned to high-tempo units that have deployed more than once. But Grimsley said he doesn't believe deployments are a primary factor for the suicides. "Some have a deployment history and others don't," he said.

The Fort Hood suicides reflect those across the Army, Grimsley said. The soldiers tend to be under 25 years old - junior-grade enlisted personnel who are struggling with financial problems and multiple deployments. Some of the cases involve substance abuse. The majority of cases, he said, involve "a significant relationship or emotional issue."

Grimsley said that Fort Hood soldiers from the rank of sergeant and below - more than 32,000 soldiers - were scheduled to receive visits in their barracks or off-post homes this past week to get "a better sense" of how they are doing. Their superiors also will make sure weapons privately owned by soldiers are properly registered, he said.

In the aftermath of the Nov. 5 shootings at Fort Hood, in which Army Maj. Nidal Malik Hasan is accused of killing 13 colleagues and wounding 32, base officials began a concerted campaign focusing on the psychological needs of soldiers, civilians and military family members at the base.

One phase of the plan involves quarterly comprehensive surveys of health care providers, soldiers and their families to learn the mental health needs of the military community.

Fort Hood has begun putting emphasis on proactive programs that help soldiers maintain good mental health and resiliency. Last fall, Fort Hood opened its Resiliency Campus, the Army's first multifaceted facility intended to help soldiers and families prepare for the stress and uncertainty of combat deployments.

The Army is trying out some new programs to better engage soldiers. At Fort Hood, more than 15,000 soldiers have participated in role-playing exercises aimed to spark conversations and raise awareness about suicide, said Tim Block, who runs Fort Hood's employee assistance program.

"We're trying to turn the tide on suicide and reduce the stigma of folks asking for help," he said.

ROTC cadet's suicide spurs parents to speak out about depression

Nobody wants to help distressed soldiers get help more than Maj. Gen. Mark Graham and his wife, Carol. In June 2003, their 21-year-old son, Kevin, a promising ROTC cadet at the University of Kentucky, killed himself. He had been diagnosed with depression.

"I think we've come a long way. It will never be fast enough for any of us," said Mark Graham, deputy chief of staff of Forces Command in Georgia. "And it's not an easy issue. If there's a physical wound you can see, it's a lot easier to tackle it."

Kevin was the middle child of three children and was more sensitive than the others, Carol Graham said. His older brother Jeffrey, nicknamed "G.I. Jeff," looked forward to a military career. Kevin wanted a similar career, but on the medical side. "From the time he was a child, he'd always wanted to be a doctor," Carol Graham said.

The moves that military families make every two to three years helped the Graham kids draw close together. "They were each other's best friends," said Carol Graham. Later, when Kevin followed Jeff to the University of Kentucky, they shared an apartment.

The Grahams were aware that Kevin suffered from clinical depression and was taking Prozac, an anti-depressant medication. At the time, Carol thought that Prozac was like taking an antibiotic and that, after a while, he wouldn't need the pills.

In fact, Kevin stopped taking his medication at some point in the spring of 2003. He was scheduled to attend an advanced ROTC training camp that summer and didn't want to report that he was taking medication for depression.

"He was the top ROTC cadet," Carol said. "He had been selected to be battalion commander his senior year. He didn't want anyone to know."

But in June 2003, he hanged himself in his apartment at the University of Kentucky. "We blame ourselves, and we always will," Mark Graham said. "We missed it and didn't see it coming with Kevin."

That tragedy was compounded eight months later when Jeff died in Iraq after a bomb exploded while he led a foot patrol.

The Grahams mourned privately for several years. But as the military struggled with an increase in suicides, they decided to tell their story to raise awareness about depression.

"Kevin wanted to be a doctor, and he wanted to help other people," Mark Graham said. "We decided that if people wanted us to talk, we would do that, especially if it could help other people become aware so this wouldn't happen to someone else."

Mark Graham was a featured speaker at a spring conference in Dallas sponsored by Contact Crisis Line, the nonprofit 24-hour suicide prevention hotline.

The Grahams plan to continue telling their story as long as needed.

"People need to know that you can die from depression. You can die from untreated depression," Mark Graham said.

Love, Loss and a Fight to Live

When Jessica Hansen awoke that Thursday morning, she found a text message on her cellphone.

"Happy Nov. 5th. I love you."

It was from Staff Sgt. Patrick Zeigler of Fort Hood. He and Jessica, a senior at Boston University, met 11 months earlier on Dec. 5, 2008, and they liked to celebrate each new month of their relationship. They kept in constant communication, so when Patrick followed up his text with a noontime call, it wasn't unusual - except for the way it ended:

"I love you, Jessica," he said.

"I love you, too," she replied.

"No, really, I love you," he insisted.

He sounded serious, unlike his usual wisecracking self. She wondered if he was having a hard day.

Hours later, after the news broke of a mass shooting at Fort Hood, after her frantic calls to Patrick's cellphone went unanswered, after the late-night call from Patrick's father telling her Patrick had suffered a gunshot wound to the head, Jessica replayed that last conversation over and over.

"I love you, Jessica. No, really, I love you."

Jessica needed to see Patrick right away, even if it was to say goodbye. When she boarded the Delta Air Lines flight from Boston through Atlanta to Killeen, she had no idea what lay ahead. She steeled herself with this prayer: Please stay alive until I get there. I just want to hold your hand one more time while it's warm.

In her take-on bag, she carried only pictures of Patrick, his letters and a black dress - for a funeral.

Critical condition

One out of every 12 people shot in the head survives. Two-thirds die on the way to the hospital. Recovery varies widely; many are severely disabled or linger in a persistent vegetative state.

Patrick's father told Jessica that Patrick was "currently alive," but in critical condition. He had been shot four times, with wounds in his arm, shoulder and hip. But the bullet that struck the right front side of his skull - that was the worst.

In fact, Patrick, now 29, was one of the most seriously wounded in the slaughter at Fort Hood where 12 soldiers and one civilian died and 32 others were wounded. The shooting took place one year ago this week at the Soldier Readiness Processing Center, where soldiers prepare to deploy for war in Afghanistan and Iraq. Police wounded the alleged shooter, Army Maj. Nidal Hasan, and took him into custody.

They took Patrick 30 miles to Temple's Scott & White Memorial Hospital, the closest Level 1 trauma center in Central Texas. But Patrick's father, whose name is the same as his son, warned Jessica to expect the worst.

"He's gone," she recalled Patrick's dad telling her. "You need to get down here right away."

Tears held in check all night began to flow. "I just kept saying we were going to get married," said Jessica, now 22. "It was supposed to be fate."

What else could explain how a soldier from Fort Hood, about to deploy to Iraq, and a college student from Boston would meet and fall suddenly in love in Hawaii?

The son of a career Navy man, Patrick had moved around. But he spent his formative years in Honolulu. In late November 2008, with a couple of weeks off before going to war, he decided to get together with some old buddies in Hawaii.

Back in Boston, two of Jessica's best friends wanted to celebrate their 21st birthdays in Hawaii. She couldn't really afford to go, but they persuaded her to join them over Thanksgiving break.

On the flight over, she asked everyone she met what to see in Hawaii, and where to go. One spot was the Mai Tai Bar in Waikiki. When the three friends got there, the manager of the band playing there suggested that Jessica meet his friend Patrick. "He's been to Iraq before and he had a really rough time," the manager explained. "He's going back. Don't bring it up."

When Patrick walked up, Jessica introduced herself and said, "I hear you're going back to Iraq."

Nevertheless, the two hit it off. As they were leaving the bar, Jessica slid down a handrail in her dress and high heels and hopped to a stop, her arms outstretched like an ice skater nailing the landing.

"That was awesome," Patrick gushed. "I think I love you."

They sat in the lobby of Jessica's hotel, talking until sunrise. By the end of her trip, Jessica found herself fending off marriage proposals from Patrick. He had sung in a ska band and graduated from Florida State University. After serving in combat in Iraq a year earlier, he now wanted to become an officer. She told him that she was studying neuropsychology and wanted to help combat veterans with post-traumatic stress disorder and traumatic brain injury, the two signature wounds of the wars in Iraq and Afghanistan.

As she was about to return to Boston, he made another pitch for her hand. "I can't just get married," she said. "My parents don't even know I'm here."

Making plans

But two weeks later, when Patrick deployed to Iraq, Jessica vowed to be his girlfriend for the year he was away. Patrick's deployment in 2009 wasn't as intense as his first combat tour two years earlier. He kept in daily touch with Jessica by Skype and e-mail. He also was accepted into officer candidate school. But his entry was delayed until Nov. 23, 2009, the earliest a slot would open up at Fort Benning, Ga.

He arrived back at Fort Hood on Oct. 23. Jessica visited for a week. They made plans to live together the following spring, after her graduation from college and his completion of officer candidate school.

After Jessica left, Patrick concentrated on the paperwork to transfer to Fort Benning. That's why he was at the soldier processing center the afternoon of Nov. 5.

About 1 p.m., just after a meal of pork and rice from his favorite takeout spot, the C&H Hawaiian Grill, Patrick signed in at the medical section - the 13th and last station - to make sure all his blood tests and immunizations were up to date. About 40 soldiers were ahead of him, sitting in four rows of chairs. He took a seat near the back and waited. Bored, he looked around the room. He saw a man in a soldier's uniform stand up. The man yelled, "Allahu Akbar!"

Patrick froze. He recognized the Arabic for "God is great!" He thought that this might be a training drill. Even as the soldier lifted a handgun, Patrick felt strangely disengaged, an observer watching the scene. He saw a laser sight, a moving beam of red light that crossed his vision. Then, he felt something hit the side of his head, like a metal baseball bat.

He fell to the floor, people all around him screaming, shouting and moaning. He tried to drag himself with his right arm, the only one that worked, toward the back exit. Blood poured from his head, pooling on the floor. He grabbed for a chair but it fell over. Everything faded to black.

It was the next morning when Patrick regained consciousness. He was in a bed at Scott & White Hospital, surrounded by family members and Jessica.

'Jessica, is that you?'

The slug entered the right side of his skull and left fragments of bone and bullet embedded in his brain. Surgeons operated immediately and removed a fist-sized portion of the damaged brain matter. When Jessica walked into Patrick's room the next morning, she could only see the right side of his face. His eye, she said, was "the blackest black I've ever seen."

A cast covered his whole left arm except his fingertips. She grasped his fingers. "Patrick, it's me, I'm here." He opened his uncovered eye. "Jessica, is that you? How'd you get here so fast?"

Patrick's recovery astonished his family and friends. Despite the brain damage, his memory and intellect seemed unimpaired. He was talking and in good spirits. Although he had lost use of his left arm and leg, he was determined to walk again. The medical staff was more cautious. "After each bit of progress," Jessica recalled, they'd say, "Don't get excited. That might be how he is forever."

Six weeks after the shooting, Patrick was admitted to the Texas NeuroRehab Center in Austin. He wondered if Jessica would follow him.

Jessica's parents wondered the same thing. They didn't like the idea of her dropping out of school. Jessica's mother, Lori Hansen, thought her daughter couldn't possibly be so in love "that she would need to drop everything in her life to be with him." After talking to Jessica, "we realized she was where she needed to be, and she needed to be there to take care of him," Lori Hansen said.

On Dec. 18, Patrick took Jessica out on their first date since the shooting six weeks earlier. A volunteer drove them to the Oasis, a restaurant with a beautiful view of Lake Travis. Patrick wore his best suit; Jessica helped to dress him, somehow without noticing the small box he had hidden in his coat pocket. He wore a helmet to protect his skull and leaned on a walker for balance. He hadn't anticipated the cobblestone path that led up to the restaurant.

"Oh, God, what do I do? This is not what I practiced for," he said to Jessica. But she had a firm grasp on the gait belt tied around his waist, and he made it to their table. When the waiter brought a dessert of chocolate cake and coffee, Patrick took the small case from his jacket. It contained a diamond ring.

"Thank you for staying and taking care of me," Patrick told her. "And will you take care of me the rest of my life?" Jessica doesn't remember her exact words, but her answer was never in doubt. He had her at "thank you."

Turn for the worse

In mid-January, Patrick returned to Scott & White for what was described as routine surgery: A custom-fitted plate would be placed over the opening in his head. But after the procedure, Patrick fell into a coma, and doctors removed the plate. "We weren't sure if he had come down with an infection or if he had a reaction" to the plate, Jessica said.

Patrick drifted in and out of consciousness for the next six weeks. By March, he was back at the Austin rehabilitation center - still without a plate. "He had to wear a helmet all the time. He had to relearn how to walk again," Jessica said. "We were back to square one."

In late April, surgeons tried again to insert a plate. Once more, Patrick's health rapidly declined. All through May, Patrick was virtually comatose. He'd awaken for a few minutes and fall back into a troubled sleep. He was having nightmares. His condition was precarious.

It was a crushing time for Jessica. Patrick's recovery, which looked almost assured at first, now seemed like a cruel trick. Some medical staff reminded her that Patrick's brain had been severely injured, and he might never be his old self again.

Before the first surgery to put a plate in his skull, Patrick gave Jessica power of attorney to make medical decisions on his behalf. He told her that he didn't want to spend the rest of his life in a coma. His life was in her hands, and now she agonized over the prospect of making a life-or-death decision.

She wondered if she should push to have the plate removed. She didn't want to subject him to more surgeries. But she felt it was too dangerous for him to spend the rest of his life forced to wear a helmet to protect his exposed brain.

She spent all her time tracking down and talking to neurologists elsewhere in the Army and private practice, scanning the Internet, reading medical texts for hours. At the end of May, doctors found that the shunt in Patrick's head - which was supposed to drain built-up fluid - had become clogged. They put in a new shunt, but Patrick's condition barely improved. By this time, Jessica was considering moving Patrick to another medical facility, hoping a change of venue might bring new results.

By coincidence, Jessica's father had just sold a house to a doctor from Temple who was moving to Jessica's hometown of Rochester, Minn. The doctor, a neurologist, planned to study neurosurgery at the renowned Mayo Clinic. He talked to Jessica and suggested that Patrick transfer to the Mayo Clinic, which had a well-regarded rehabilitation program for head injury patients. The Army agreed to the transfer, and Patrick was admitted the first week of June.

At the Mayo Clinic, doctors adjusted Patrick's shunt to permit a higher level of fluid to drain. The change was dramatic. "Within 24 to 48 hours, Patrick was cognitively back to where he was," Jessica said.

But he had lost one-third of his body weight. Before the shooting, Patrick was a sturdy 6-foot-1 and weighed 210 pounds. "He was pure muscle when he came back from Iraq," Jessica said. Now, he was a shade of his former self. "Bony with a beard," she said. "I have a picture of him in his hospital gown, and you can see his left shoulder sticking out."

Once again, he had to relearn the basics: Sitting up in bed. Walking to the bathroom. Willing the dormant muscles in his legs, arms and shoulders to move, even if only a fraction of an inch.

"For me, it wasn't really a choice," Patrick said. "I wasn't going to be in a hospital or in that situation for the rest of my life."

He drew on his combat experience, especially that first tour in Iraq in 2007 when his unit suffered many casualties. "You just have to push forward and put things out of your mind and put your head down and attack it," he said.

Face-to-face

On Oct. 14, Patrick came face-to-face again with the man accused of shooting him. He walked slowly into a military courtroom at Fort Hood, the rhythmic click of his metal cane accompanying him, willing himself forward step-by-step.

After relating his experience during the shooting, Patrick rose to leave the stand. He paused and looked straight at Hasan, the man accused in the Fort Hood massacre, who sat motionless in a wheelchair. Then Patrick and Jessica walked from the courtroom. Two days later, he received a hero's welcome during a football game at his alma mater, Florida State.

He's now back at Fort Hood, living on base with Jessica. He goes every morning to the Warrior Transition Brigade for his daily rehabilitation. He has started riding a modified bicycle. His goal is to do the Ride 2 Recovery race from San Antonio to Arlington in April. He plans to ride his bike in this week's events at Fort Hood, commemorating the anniversary of the Fort Hood shooting.

They are looking forward to next summer and their wedding - a slender hope just five months ago. At one of Jessica's lowest points, when Patrick was in a coma and fighting for his life, she recalled thinking not how weak he seemed, but how strong. She watched him and took heart from his courage.

"He's 140 pounds, he can't talk, I'm changing his diapers, and I'm thinking, 'That's the strongest person I've ever seen,' " she said. "He won't give up. He kept me strong."

Staff writer Lee Hancock contributed to this report.

HOW WE REPORTED THE STORY

Interviews with Staff Sgt. Patrick Zeigler and his fiancée, Jessica Hansen, took place in Killeen in September, shortly after they returned from the Mayo Clinic in Rochester, Minn. Information about Patrick's wounding during the Nov. 5 shooting came from his testimony at Fort Hood during an Article 32 hearing, a military proceeding to determine whether Maj. Nidal Hasan, an Army psychiatrist, will stand trial on charges of murder and attempted murder.

Stress of Separation Takes its Toll

Russell and Erin Miller met while deployed in Iraq in 2005 and discovered a shared passion for Dungeons and Dragons. Their interest in the popular role-playing game led to their marriage and settling down in Rice, 45 miles southeast of Dallas.

The husband and wife, both in the Texas Army National Guard , now have new roles: Erin, 28, as a soldier deployed to Afghanistan; Russell, 30, as a stay-at-home dad with 2-year-old daughter Abby.

How their marriage fares during Erin's 12-month deployment is a question of keen personal interest to the Millers - as well as a matter of urgent national security.

Two wars and multiple deployments have caused enormous strains within the ranks, contributing to a rising military divorce rate that is outpacing the civilian divorce rate, as well as a sharp increase in mental health problems.

While e-mail and video chats have made it easier for couples to stay in touch, the dangers of war can wear down the feelings of intimacy and togetherness that keep marital bonds strong. "It's all on you," said Russell. "You have to make so many decisions, and you don't get to bounce ideas off each other. And even when you do talk, you lose a lot of personal connection in the conversation."

In response to the strain on families, the Pentagon has increased spending to a record $9 billion on family support programs, including more for child-care services and family counseling.

"Military families are stressed - really, really, really stressed," said Dr. Benjamin Karney, a professor of social psychology at UCLA who has studied military marriages for the Rand Corp., a California think tank that often does studies for the military.

For citizen soldiers like the Millers, the needs are greater than ever. Since the 9/11 terrorist attacks, 787,000 Guard members and reservists have been called to active duty, the most since World War II. A half-million have deployed to Iraq and Afghanistan - and 200,000 have served multiple tours. Nearly 100,000 Guard members and reservists are currently serving on active duty.

Members of the nation's reserve component leave behind careers and families. Their spouses and children do not have a built-in support structure, as full-time active duty service members who live on military installations do. But outside the military community, few Americans realize the sacrifices made by these families.

More than 50 percent of military personnel are married, and 70 percent have children. The divorce rate for active-duty military personnel has risen from 2.6 percent in 2001 to 3.6 percent in 2009, when there were an estimated 50,000 military divorces, the Pentagon reported. That's slightly higher than the civilian divorce rate of 3.4 percent.

The Pentagon's divorce records don't tell the whole story because they leave out the National Guard and reservists. The overall percentage of Guard members and reservists who are married has decreased from 53 percent in 2001 to 48 percent in 2008, according to other military records.

The Pentagon also doesn't account for soldiers who get divorced a year or two after leaving the military, Karney said. And divorce rates aren't the only indicator that marriages are in trouble. It's not unusual for estranged couples in the military to remain married to continue receiving higher housing payments. In addition, a civilian spouse who divorces a service member loses his or her military health coverage.

Meanwhile, combat veterans are at an increased risk of marital problems, according to studies. The rate of post-traumatic stress disorder (PTSD) has increased almost sixfold from 2003 to 2008, according to the Defense Department's Medical Surveillance report issued in November.

Couples dealing with post-combat stress go through a period of trying to make their relationships work. "And this will serve to depress divorce in the short term. The problem is that families might not be able to sustain this [work on their relationship] over the long term," Karney said.

His research found that military women have the harder time staying married. Divorce rates are two to three times higher for female service members than for men. The highest divorce rate occurs with military women married to civilian men.

One possible reason is that there are fewer role models for stay-at-home dads. "There are very few movies about the loyal, stay-at-home husband of a female soldier," Karney said. "The support available in the military to the stay-at-home spouse is geared toward women."

Sergeant Dad

Russell Miller, a sergeant with 10 years in the Guard, is used to playing the role of the loyal, stay-at-home husband. After Abby was born, Erin went back to work full time as a paralegal for the Guard. Russell quit his telecom job installing fiber optic cables to stay home with Abby. He also took online courses to complete a bachelor's degree in history. "It's been the greatest time of my life ... watching Abby grow up and bonding with her," Russell said.

At times, he's felt like the odd man out. During one of the Guard's Yellow Ribbon events for spouses of deploying soldiers this summer, Russell met only one other stay-at-home dad. That man's wife also was headed to Afghanistan, but not with Erin's group.

Erin, a staff sergeant and an eight-year veteran of the Guard, is assigned to the headquarters company of the 176th Engineer Brigade. The brigade held its farewell ceremony at TCU before deploying in July.

Before the ceremony, Erin and Russell watched as their petite, sandy-haired Abby scampered around the tiled walkway encircling the arena. Erin wore her camouflage combat uniform. Russell leaned against a wall in his brown cowboy boots, faded jeans and a red T-shirt inscribed with the words "Proud Army Family," issued by the 176th's family readiness group.

Erin tried not to think about her impending departure. "Otherwise, you have a meltdown," she said. She did not want to cry in front of Abby. "She's not going to understand if I cry."

Abby bounced up and down in her new cherry-red cowboy boots, staring at them with delight. "We went to three or four stores looking for just the right boots," Erin said.

Abby took off down the hallway, and Russell chased after. When they returned, Abby held a book she'd been given at a table staffed by the family readiness group. It was a new version of Over There for preschool children of deployed parents. "Oh, they finally have the Mommy version!" Erin said. "We have the Daddy version."

The next morning, several buses waited at a hotel to take Erin and her fellow soldiers to the airport. Erin's unit was scheduled to fly to Wisconsin for eight weeks of training before heading to Afghanistan.

Standing near the entrance, her eyes welling up, Erin held Abby tightly and buried her face in her daughter's hair. At last, she gave Abby back to her husband, turned and quickly walked toward the buses, wiping away tears.

"Mama, mama," said Abby, reaching out toward Erin. In her other hand, she clutched a baby bottle.

"Mama going bye-bye," said Russell, his voice thick with emotion as he softly bounced her in his arms.

Left behind

Russell and Abby made the five-hour drive back to Santa Fe, Texas, a small town near Galveston where he grew up and his parents still live. He and Abby have lived with his parents since then. Russell visited Erin briefly in Wisconsin before she left for Afghanistan. He also attends training one weekend a month with his Army National Guard unit in Waxahachie. When he's away, his parents take care of Abby.

Even with good support at home, the first four months of Erin's deployment weren't easy for Russell. He became moody and depressed. The problem started after he tried to quit smoking. He took a prescription for Wellbutrin, an antidepressant also used to quit smoking. He began to feel intense anxiety and paranoia.

"I thought I was having a hard time with Erin's deployment," he said.

He became preoccupied with negative thoughts, worrying about Erin getting hurt or if she was going to divorce him. "We all have thoughts about worst-case scenarios, but I couldn't use logic to counter those daydreams," he said. "I couldn't emotionally detach." He tried ignoring the feelings but felt "needy and emotionally unstable," he said.

Russell and Erin talked every day, mostly via military phone lines or Skype. "This wasn't the person I left for deployment. [He was] a little emotionally insecure," she said.

In November, Erin returned to Texas for two weeks of R&R. Russell had stopped taking the medication because of the side effects. His mood improved, but he slipped back to smoking. Erin put a stop to that.

In Afghanistan, she quit smoking with the help of a "quitters' club" she joined. She gave Russell fair warning. "I told him, 'I'm not a smoker anymore, and I don't want you to be a smoker, either.' "

The couple attended several pre-deployment Yellow Ribbon events. Topics included managing stress and anger, and learning how to talk about personal problems that can drive a wedge between couples.

When Erin visited in November, Russell felt they weren't in sync. He brought it up with her. "It was awkward at first, and we were just getting used to being around each other again," he said. "So we talked about it."

He and Erin are on the same page about one thing - that it's easier to be the one who deploys than the one who stays home. Her schedule revolves around work, exercise (she lost 10 pounds her first three months overseas) and socializing. She helped organize a knitting club for other female soldiers. She's already knitted scarves and hats for Russell, Abby and several friends.

Her routine also helps with homesickness. When the Internet is working, she can see and talk to Abby using a Web camera. But such moments have proved bittersweet, Erin said. "You get used to not seeing her, and then it's harder when you do, because you realize how much she's changed."

Something special

Russell and Abby are not scheduled to see Erin until her deployment ends sometime in June. By then, Russell will be nearly finished with his studies. He also plans to work on their house in Rice, in preparation for moving back when Erin returns.

Most days find him parked in a recliner in his parents' spacious living room. He studies on his laptop while keeping an eye on Abby as she plays on her rocking horse or watches Ponyo and Sesame Street, her favorite programs.

Russell tries not to look too far ahead. "If you look at it as one big chunk of time, it's self-defeating," he said.

Still, he's a little worried. "It's been a hard four months, and I've seen [Erin] twice. We'll make it to Christmas and then to New Year's and then the next milestone," he said.

Erin will probably be working on Christmas Day, so she has planned ahead to do something special for Abby. She got her daughter a special copy of 'Twas the Night Before Christmas, one with a built-in tape recorder that allowed Erin to record herself reading the classic.

She said, "I don't want her to forget my voice."

Military spouses at Fort Hood work out sorrows with Zumba

Zumba has invaded Fort Hood.

The trendy dance exercise has become popular at the nation's largest military base, particularly among spouses whose husbands are deployed to wars in Iraq and Afghanistan. Zumba combines a high-energy, aerobic workout with the contagious beat of Latin dance - the perfect antidote to the deployment blues, according to several military spouses.

"This is how I deal with deployment," said Carolynn Torres, a Killeen resident whose husband is a soldier in Afghanistan. "It helps me to get out of the house and to keep myself going and not think about how is he doing and if he's OK."

Susan Araujo, whose husband also is in Afghanistan, discovered Zumba at Fort Carson, Colo., a year ago and instantly made it her primary workout. "I noticed a lot of improvement in myself physically and mentally," said Araujo.

When her husband transferred to Fort Hood this spring, Araujo started teaching Zumba at a gym on base and at a Curves studio in Killeen. "I just love it. It's not just a workout. You're having fun."

Torres, who is also a Zumba instructor, said that the workout originated in Colombia, and incorporates the sounds and movements of merengue, salsa and other Latin dances. It's spreading around the country and showing up at other military bases, too.

Torres' husband has seen a big difference in her life since she took up Zumba. "He noticed I wasn't crying anymore and missing him, so he doesn't have to worry about me," she said.

Zumba has helped Torres and Araujo meet other spouses of deployed soldiers, and they've started getting together outside of the gym, too. "There are five of us who like to go to Starbucks. Or we'll get together at someone's house for a potluck and karaoke," Torres said.

"And somehow we end up doing Zumba."