A serial tragedy — like Friday's mass shooting at Sandy Hook Elementary School in Newtown, Conn., that left 20 children dead — is like “a big rock thrown in a pond,” grief experts say, casting emotional ringlets that drench those closest to the bloodshed in life-changing despair and bathe entire communities and even distant observers in sorrow.

"What happens after that rock lands in the pond? The waves circulate out from ground zero. There are the victims. And these (at Sandy Hook Elementary School) are babies, so unbelievably sad,” said Dr. Jeff Dolgan, chief psychologist at Children's Hospital in Denver. “Some people are not even directly touched by the trauma but are in fact traumatized — think about the other kids at the school, the administrators at the school, the first responders, the caregivers. Then the waves radiate out from the school into the community."

Those ripples may initially unite a town in candlelight and song then splinter it into a torrent of blame and lawsuits, as happened after the Columbine High School shootings in 1999 that killed 12 students and one teacher and injured 24 others.

"At Columbine, the impact was very widely felt. I talked to the people who were dealing with the fatalities at the hospitals. They had caregiver trauma. They did everything they could with the influx of severely injured but felt inadequate to the task,” he added.

After the Columbine massacre, Dolgan and his colleagues aligned with mental health experts in Jefferson County, Colo., launching a hotline where local parents could call for advice on soothing their own kids' anxieties. On Friday, Dolgan urged the parents in Newtown to similarly band together.

“This is a neighborhood elementary school and the parents there hopefully are tight-knit. Once you have the care done, I hope the parents are supportive of one another and work with one another,” Dolgan said. “I hope parents team up and, in time, do get-togethers.”

Dolgan witnessed firsthand how some Columbine families looked initially to condemn and penalize neighboring families and local law enforcement officers for the deaths in their school. The families of more than 30 Columbine victims sued the parents of the two killers, also Columbine students, eventually settling for $2.53 million. The families of 17 Columbine victims also sued the Jefferson County sheriff’s department; one of those victims settled in 2004 for $117,500.

Many of the Columbine families, Dolgan agreed, were likely seeking outlets to vent their anger at the tragic event, and at the murders.

“But who are you going to blame? The first responders? No. (Columbine principal Frank) DeAngelis? No. The school security? No,” Dolgan said. “In time, there was more healing and the parents came together. But initially, no, there were some fractious qualities.”

While heartache and fury may engulf a town after a mass killing, such serial traumas psychologically damage those closest to the suffering on a far deeper level than they do people who were merely in the vicinity, who were, perhaps, close enough to hear the gunfire but not see the deaths, science has found. 

Among 1,000 students who were on campus at Dawson College in Montreal in 2006 when a man shot and wounded 19 people, killing one, about one-third were found to be dealing with some form of mental illness within 18 months of that tragedy, according to a paper published in 2009. 

“The most common form was clinical depression – which affected 12 percent or 1 in 8. That is about three times higher than would be expected in a normal population,” said Dr. Warren Steiner, head of the department of psychiatry at McGill University Health Centre in Montreal, and one of the paper's authors.

“The next highest was substance abuse — drug or alcohol — which affected about 10 percent, people who were self-treating their own anxieties. That’s about three times higher than you would see in the normal population,” Steiner said.

The precise proximity of the survivors to the violence that day directly affected their mental health later, the research team learned. They divided the 1,000 students into four groups based on their “level of exposure.” Those who had witnessed the shootings received the “highest” exposure score, followed by those who only heard gunfire, followed by those who locked themselves into classrooms without knowing if they were next, followed by those who were on campus but unaware of the attacks.

Slideshow: Connecticut school massacre

Michelle Mcloughlin / Reuters

The second deadliest school shooting in U.S. history sent crying children spilling into the school parking lot as frightened parents waited for word on their loved ones.

Launch slideshow

“There was a direct correlation between the level of exposure to the shootings and the development of mental illness. It’s common sense, but it had never been proven before,” Steiner said.

For those who viewed the killings, or who had held a wounded classmate in their arms, post-traumatic stress disorder was the most commonly diagnosed illness, followed by depression and then alcohol dependency. 

But while the mass traumas at Columbine and Dawson College soaked each community in immediate anguish -- and, eventually, imbued those closest to the gunfire with psychological turmoil -- they continue to resonate in the Denver area and in Montreal, the psychologists said.

Memories of each are rekindled after the news of other serial shootings, including the 32 people who were shot and killed at Virginia Tech in 2007, the 13 people who were shot and killed at Fort Hood in 2009, and the 70 moviegoers who were shot — 12 fatally — in Aurora, Colo. on July 20.

“You hear about another one, and there’s the reflex of anxiety,” Steiner said. “I guarantee everyone who was at Dawson will hear the news this evening and they will have flashbacks and disturbing memories, PTSD-like symptoms from what happened to them.

“It goes on for a generation, no doubt about that,” Steiner said.

Dolgan agreed that the shelf-life of a local mass tragedy sticks with a community for several decades, and isn't simply shaken by the passing of time.

“No, no,” Dolgan said. “This is very long-lived.”

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Officials within the U.S. military are actively targeting over-boozing troops at home and abroad, but addiction specialists and service members say binge drinking remains as rampant as ever inside the armed services.

Among the new initiatives to stem the problem: The Marines, starting next year, will give random breathalyzer tests to Corps members; the Air Force and Army curbed some overnight liquor sales for U.S. military personnel in Germany; and American service members in Japan were barred from leaving their residences after consuming more than one adult beverage.

The restrictions seem to have been independently created by brass within each branch — for example, the new rules for service members in Japan follow the October sexual assault of an Okinawa woman allegedly carried out by two U.S. sailors. Still, the fresh regulations arise three months after a study commissioned by the Department of Defense found that binge drinking by active-duty troops now constitutes "a public health crisis," noting as well that drunken soldiers were cited as a problem as far back as the Revolutionary War.

"But we can do better," said Dr. Charles P. O’Brien, chairman of the panel that authored the report and director of the Center for Studies of Addiction at the University of Pennsylvania. "We have a lot of research, a lot of medication, and a lot of techniques that have been developed over the years. We don’t have to be stuck in the old ways of handling things.

"We found, though, that in the whole Army, there’s only one doctor who's trained in addiction medicine. This is a specialty where we need more people and they're not there. So, most people are not getting treated with evidence-based medicine," O'Brien told NBC News. The study was issued by the Washington, D.C.-based Institute for Medicine.

Worse, O'Brien said he has learned — from emails he received in recent days from active-duty personnel — that one of the study's most simple suggestions has not been implemented: that the military's health system, TRICARE, alter its rules and allow substance-abusing service members to be treated with anti-addiction medications like Suboxone.  

"We met a general who is on Suboxone but they (military doctors) are not letting other people have it," O'Brien said. "It's ridiculous ... When we briefed (military leaders in September), they expressed interest in following our recommendations. But, so far, I don't have any concrete evidence that anything has happened." 

NBC News asked the Department of Defense to list which, if any, of the panel's recommendations have been installed to date. 

"The Department of Defense appreciates the hard work of the Institute of Medicine in assessing substance abuse programs and policies in the Military Health System," Cynthia O. Smith, a DoD spokeswoman, responded in an email. "We are in the process of analyzing their findings and recommendations, but most importantly, we want to do the right thing for the Service member. If there are areas in need of improvement, then we will work to improve those areas. The health and well-being of our Service members is paramount."

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The agency has a stated policy to "prevent and eliminate drug and alcohol abuse and dependence from the Department of Defense." The U.S. military, therefore, screens for problem drinking, provides treatment for those identified with alcohol or drug problems, and is working to "change attitudes toward binge drinking," Smith said, adding that "such abuse and dependence are incompatible with readiness, the maintenance of high standards of performance, and military discipline."

Indeed, in its analysis of boozing on military bases, the Institute of Medicine found that 47 percent of active-duty personnel engaged in binge drinking during 2008 (the most recent year for which data was available), and the authors concluded the use of alcohol and other drugs are "currently at unacceptably high levels," making it "detrimental to readiness and total force fitness." 

Military members like Marine Sgt. Thomas Brennan, who joined in 2004 and who later served in Iraq and Afghanistan, describe drinking as a staple of life in uniform. He knows of several recent drunken-driving arrests involving his Marine buddies or his former unit members, he said.  

"With the amount of recreational drinking that goes on, it’s like peer pressure times 10," said Brennan, 27. "Everybody’s drinking. The Marine Corps is a brotherhood. You want to be part of that brotherhood, and your brothers are doing it. Nobody forces you to do it but the inclination to do it is pretty strong.”

In a New York Times blog published in October, Brennan wrote that the "golden rule" among Marine officers and non-commissioned officers seems to be: "If you’re going to partake, do so behind closed doors and keep your mouth shut about it. I have heard many leaders tell under-age Marines that if they were going to drink that they should keep their doors locked and be smart about it. Only when they were caught were they told not to do it."

“I couldn’t tell you how many times I’ve heard that over the years," Brennan told NBC News on Monday. "I wasn’t perfect either. I let it go on.”

The September study on alcohol abuse within the military also chastised the armed services for allowing "ready access to relatively inexpensive alcohol on military bases." 

At Camp Lejeune, where Brennan was stationed, convenience stores contain large refrigerators stocked with domestic and imported beers, sold tax free. A six-pack of Stroh's, for example, costs about $4, he said.

On base, Marines also can purchase "Military Special" liquors, a cut-rate brand of liquor, including vodka and whiskey, that goes for about $6.50 per liter. At AR15.com, a firearms website popular with military members, one commenter described Military Special booze as: "No good for sipping, but for shots it works;" another said: "I am not sure I would clean battery terminals with that crap." 

One combat-related factor exacerbating the overindulgence of alcohol is Post-Traumatic Stress Disorder. In September, the Institute of Medicine reported that Iraq and Afghanistan veterans diagnosed with PTSD have alcohol-abuse rates that are twice as high as those found among civilian young adult males.

Brennan was diagnosed with PTSD and said that self-medicating with alcohol caused him to suffer a "short-lived drinking problem" after he returned from Iraq.  

"You’re already depressed because of the PTSD. Alcohol’s a depressant. A lot of guys with PTSD just got angry (when they drank) and did dumb stuff, like fighting," Brennan said in a phone interview. "We had one guy throw his refrigerator off the third deck one night when he was drinking. But I don’t know if that was PTSD, or just him being a crazy drunk."

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Why do some people reject the existence of PTSD?

The topic is touchy. Even asking the question is slammed as irresponsible.

“Why on Earth would you try to put out something that states combat PTSD isn't a true affliction? Or even try to debunk it? Or to put questions into the minds of society? In the first 155 days of 2012, we lost 154 men,” Amy Cotta, an author and the mother of a Marine wrote in an email to NBC News. Her message arrived minutes after she learned NBC News was seeking to interview a PTSD denier.

Despite exhaustive scientific studies that have explored the symptoms, causes, diagnoses, and prevalence of post-traumatic stress disorder, hardcore skeptics remain.

They exist within the military, where some leaders openly call PTSD a mental weakness, according to mental health advocates. David Weidman, who did two tours in Afghanistan and was diagnosed with PTSD, said all of his senior non-commissioned officers advised him not to seek treatment, instead suggesting he “just put your head down and keep going” in order to maintain any chance at a promotion.

They exist within the veteran community. Kevin R.C. “Hognose” O’Brien, who operates a blog called “WeaponsMan” and identifies himself as “a former Special Forces weapons man,” wrote in July that PTSD was a “quack” diagnosis, “invented” to clump “any odd and many normal behaviors.” He added: “If a vet is wound up tight? PTSD! If he or she is calm? Hypercontrolling due to PTSD! Lose weight, gain weight, maintain weight, those are all PTSD markers. Get in fights? PTSD, natch. And avoid fights? Well, clearly it's .... are you starting to get the idea?” O’Brien declined to be interviewed for this story.

And they exist within medicine. In late September, Washington, D.C. psychiatrist Dr. Joseph Tarantolo authored an op-ed piece titled: “PTSD, The Grand Scapegoat.” In it, Tarantolo described PTSD as a “pseudo-diagnosis” and held that “the PTSDer gets an enormous amount of pseudo-sympathy.” On Friday, Tarantolo’s voicemail message said he was out of the country on vacation.

To Afghanistan veteran Weidman, most people who so stridently dismiss PTSD have simply failed to read the available scientific literature on the subject and are, he said, “uneducated.”

But Weidman acknowledged that different people possess varying degrees of mental “resiliency,” underscoring the slippery nature of diagnosing anxiety disorders. That means, he added, that if an entire platoon collectively endures the same moment of extreme combat violence, not every platoon member will ultimately feel the symptoms of post-traumatic stress. According to the Mayo Clinic, those signs can include “flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.”

“There are people who can experience something who have no side effects. It could be that person (who ends up being a denier),” said Weidman, a student at Penn State-Lehigh Valley. “Or it could be the person who is extremely uneducated and chauvinistic, who says a guy who gets diagnosed with PTSD ‘is not being a man.’ You’re going to have a perfect storm within the individual who’s going to be that outlier, who says: ‘It doesn’t exist.’

“Or, it could be the person who actually has post-traumatic stress, who is not seeking help, who is more living up to society’s ideal male image of being strong and being resilient,” he added. “Those people going to make even more noise.”

Mental health experts say the occasional repudiation of PTSD is merely an extension of the larger societal taint associated with anxiety or mood disorders.

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“It comes back down to the stigma of mental illness,” said Jean Teichroew, spokeswoman for the Anxiety and Depression Association of America. “Military members also are afraid to speak out because it’s seen as a weakness. The VA has programs to try to combat that, too. But when you have a sergeant who doesn’t think you should be afraid of a bomb going off near you or seeing a dead body, that’s another issue.”

Still, the rate of diagnosed PTSD cases among Iraq and Afghanistan veterans is higher than the rate of cases associated with men and women who served in past conflicts. That abrupt spike has sparked an ongoing debate within American and British academia as to how common PTSD truly is among military personnel and veterans.

“The suffering of people with PTSD is very real whether we label it an ‘anxiety disorder’ or not. As for the skeptics, some of them may believe that a proportion of veterans without the disorder may report symptoms to secure service-connected disability compensation payments for PTSD,” said Harvard University psychology professor Richard J. McNally. He has penned more then 320 publications on anxiety disorders, including PTSD.

“According to (Department of Veterans Affairs) data reported late last spring, 45 percent of all veterans from Iraq and Afghanistan have applied for service-connected disability compensation, and 31 percent have secured it already. This figure includes all forms of medical problems, however, not just PTSD," McNally said. "The percentage of veterans of World War II and Vietnam who obtained disability compensation is 11 percent and 16 percent, respectively.”

In 2011, the VA listed the three most common service-connected disabilities among veterans receiving federal compensation that year: tinnitus (ringing in the ears) at 10.9 percent, hearing loss at 7.5 percent, and PTSD at 5.3 percent.

Is PTSD being over-diagnosed in post-9/11 veterans?

“Yes. I think it is,” said Simon Wessely, vice dean of academic psychiatry at King’s College in London. “I think that despite the formal criteria, there is a confusion sometimes (about) the normal emotional responses to war — my father still has nightmares about his World War II service in Royal Navy and he is 87, but he doesn't have PTSD.

“I also think that, for example, depression often gets under diagnosed, and substance misuse also,” Wessely said. “Our evidence also shows, for example, that quite often the triggers for what becomes labeled as PTSD is not combat exposure but actually a reflection of problems back home. It is important that we remember that not every mental health problem in theater is PTSD."

Despite the loose diagnoses or cases of outright PTSD fraud, to those in medicine and the military (post and present) who deny PTSD altogether, Wessely offers three final words: “They are wrong.”

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Brennan Linsley, AP

World War II combat veteran Ben Kauffman, 86, carries an American flag as he listens to a speaker during a Veterans Day ceremony in Loveland, Colo., on Nov. 11. Cultural fault lines clearly run between the generations that saw action in different conflicts or that wore the uniform in different eras, including peacetime.

The war stories from his grandfather, though sparse in detail, blended one moment of explosive drama with a vague reference of death — all wrapped around a description of how old-school military men used to handle both experiences.

David Weidman, who spent two tours in Afghanistan with the Air Force, recalls his late grandfather, a veteran of World War II and Korea, telling him that he survived having his body and his Jeep blown through a wall. He did not reveal to Weidman where that attack happened. He also gave his grandson some advice: “You don’t want to be in a foxhole talking to a guy one minute and then you turn around and he’s dead. You just don’t want to experience that.”

“He said he just dealt with it all. It’s that same mentality: ‘I did what I had to do. I got myself better then I went back to work.’ Other than that, he never spoke about the wars at all. That tells me he never did deal with it,” added Weidman, 32.

Cultural fault lines clearly run between generations of veterans who saw action in different conflicts or who wore the uniform in different eras, including peacetime. The refrain echoed by some older veterans to some younger ex-service members: “We had it so much harder than today’s military.”

It is, quite likely, a tradition that hearkens back to the Civil War or possibly the Revolutionary War, according to some ex-service members. But many post-9/11 veterans who have chatted with older veterans revealed the sentiment they've often heard carry the same note: “We just came home, put our heads down and got to work — without any whining."

Buried, not so subtly, in that message is that the current crop is a tad less tough and lot more needy. Some of that cultural gap may have to do with how aging veterans were taught not to talk about combat stress whereas today's military members are constantly urged to open up about any symptoms of anxiety they're feeling. It's a battle of Macho circa 1945 or 1970 versus Macho 2012. 

This age-old cultural chasm between military generations has been further fueled in recent years as the modern American armed services welcomed far more women into its ranks (about 15 percent are female), and as the federal government repealed the "Don't Ask, Don't Tell" policy, which barred openly gay people from serving their country, modern veterans say. 

“Human nature is that we all resist change, especially as we get older. The cultural changes, especially within the military, are hard to swallow by some people my age,” said Craig Roberts, who served as a carrier-based Naval pilot, flying missions over Vietnam from 1969 to 1971.

“I’m in my 60s now. And (some veterans my age) just take a blanket view of the military as softer now, that it is a less-difficult experience to live through. I don’t think that’s true at all,” Roberts said. “In combat, it doesn’t matter what gender is next to you, the experience is the same.

But the generational disconnect among veterans also impacted Roberts and tens of thousands of his fellow service members after they returned from an unpopular war in the early 1970s.

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“We of the Vietnam era experienced some of that when we joined veterans services organizations — or attempted to join — and many felt rejected by the older fellas there from Korea and World War II,” Roberts said. “Because there was a resentment — they perceived that they had seen more severe combat than we were in. There may be some truth to that.

“So I think it may be a generational thing. As one gets older, one views one’s past life — the hardships and, sometimes, the triumphs — as being greater.”

While heading an organization that represents more than 200,000 veterans of from Iraq and Afghanistan, Paul Rieckhoff said he’s become well aware of what he calls “a little bit of a sibling rivalry” between generations of veterans.

“We all generally stick together (as veterans) but some of it is just more deeply ingrained,” said Rieckhoff, founder and chief executive officer of Iraq and Afghanistan Veterans of America. In Iraq, he served as an infantry platoon leader, leading 38 men on more than 1,000 mounted and dismounted combat patrols. 

“This is also just the military: Everybody thinks everybody else had it harder than every generation that came after them. You go to Fort Bragg and they'll tell you how much harder basic training was (years ago). That’s always there,” Rieckhoff said. “I think there’s also some some level of fear and apprehension just around the evolution of our culture. It’s happening in the military, too."

That this version of the American military is the first to include so many women “is hard for some people to accept,” Rieckhoff added. “And now that ‘Don’t Ask, Don’t Tell’ has been repealed, that too is hard for some people to accept.”

While some young-old divides certainly exist within pockets of the veteran community, Rieckoff said “a tremendous sense of unity also descends generations." As evidence, he cited the fact that that the chairman of IAVA’s board (Edward Vick) is a Vietnam veteran and that, before Thanksgiving, Rieckhoff received a letter of support from former Sen. Bob Dole, a World War II veteran.

“I think most veterans, no matter what era, including my era — Vietnam — are not resentful, whatsoever, of the treatment given to today’s veterans,” Roberts added. “In fact, we celebrate this. We applaud it. This is what is due to them. Their combat experience and ours, while it is apples and oranges in some ways, was still — all — combat experience. The stresses of combat are the same, no matter what the venue is, no matter what the era is.”

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After a decade of war, America is well schooled on post-traumatic stress, lost limbs and traumatic brain injury, but the most common injury sustained by U.S. troops is literally a silent wound: hearing loss.

Mark Brogan, a retired Army captain, can speak quite personally about almost all of those examples of combat carnage – he suffered a brain injury, a spinal injury and a nearly severed right arm when a suicide bomber on foot detonated his weapon near Brogan six year ago in Iraq.

Courtesy of Mark Brogan

Mark Brogan sustained a spinal injury, a brain injury, a nearly severed arm - and severe hearing loss - when a suicide bomber blew himself up not far from Brogan in Iraq six years ago.

What does Brogan, 32, consider the worst of the physical trauma? “Hearing loss and the brain injury,” he said from his home in Knoxville, Tenn. He has “profound unusable hearing” in his right ear and severe hearing loss in his left, he said, along with constant ringing, or tinnitus, in his ears.

After the insurgent's bomb killed a soldier just behind Brogan – along with the person who was wearing the device – other U.S. troops quickly rushed Brogan's side and saw blood streaming from both ears, he said.

“You’ve been to a concert – you know how your ears are ringing afterward? It’s just like that my entire life,” Brogan said. “A lot of guys get home and they probably don’t even think about getting their hearing checked.

According the Department of Veterans Affairs, the most prevalent service-connected disabilities for veterans receiving federal compensation in 2011 were tinnitus and hearing loss, respectively, followed by PTSD.

"I suspect today’s generation of veterans – those who have been in a combat environment – probably have a higher severity of hearing loss (than past generations), especially with the explosions and the IEDs and the ruptured ear drums they’ve sustained,” said Brett Buchanan, a VA-accredited claims agent with Allsup, a national provider of services with disabilities.

Allsup recently organized a one-day Web expo where younger veterans had a chance to log in and seek advice on how and where to get treatment — including a primer on how to successfully access and steer through the monolithic VA system.

While chatting online with dozens of veterans, Buchanan repeatedly was told about their hearing loss, he said.

To Buchanan, a former Army artillery officer who was among the first wave of U.S. troops to invade Iraq in 2003, the massive scope of the disability is simple to grasp.

“The military, in general, is just a high noise-producing environment,” Buchanan said. In the Navy, where most sailors work only below deck, there is " the constant drumming of the engines and metal-on-metal noise.”

And in the Army and Marines, many personnel, he added, spend hours inside “military vehicles that are not quiet,” including tanks and personnel carriers.

In addition, service members typically devote time to practicing at firing ranges.

“In those cases, hearing protection negates the loud noise to a large degree. But when you’re in these environments for years upon years, that negation you do with hearing protection may not be enough to prevent injury long term,” Buchanan said.

“Then you get into the combat environment where weapons are going off, explosions are going off. In combat, you can’t call time out and say, ‘Hey, I need to put in my earplugs.’ ”

Service-related injuries in veterans are assessed and rated by VA doctors to determine how much monthly compensation those veterans will be paid for their physical sacrifices. Those ratings span scores of 0 to 100 depending on the severity of the wounds. (Brogan, who due to the partial spinal injury has weakness on his right side and a lack of sensation on his left side – but no paralysis – is classified as 100 percent disabled by the VA, he said).

Through earphone-tone exams and other diagnostic means, the VA also rates hearing loss and tinnitus in veterans who come in for checkups.

“For hearing loss, the ratings I usually deal with for my clients are 0 percent, meaning they’ve had some hearing loss but it doesn’t quite meet the criteria to get the minimum VA disability rating, which is 10 percent,” Buchanan said. “Tinnitus is a simple 10 percent rating. There’s nothing above that. My tinnitus might be worse than yours but there’s no test for that.

For Brogan, post-military life has included mastering subtle tricks and new technology to adapt to his muffled hearing. For example, his phone transcribes conversations as they take place. “And in a loud restaurant with background noise, I pretty much can’t understand anybody’s voice,” Brogan said. “I have to tell somebody, ‘Hey, can you repeat that? Can you speak slower so that I can understand you?’ There are techniques, over time, that you learn.”

But his world is not devoid of pretty sounds. At age 5, he learned the piano. Six years after a bomb bloodied the insides of his ears, someone donated a new piano to the veteran. Brogan tickles those black-and-white keys as physical therapy for his brain and for the weakness in his right hand. He's mastering covers of popular tunes. And he's even composed his own melody, captured on video.

Finally, he's making music again. 

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The word “veteran” was uttered seven times during Monday night’s debate – each time by President Barack Obama.

Republican nominee Mitt Romney did not use the word although he did say: “We're blessed with terrific soldiers.”

Three times, including his closing remarks, Obama veered momentarily into economic and health concerns facing the tens of thousands of men and women returning from war and those ex-service members trying to crack into the civilian work force. He mentioned recently having lunch with a veteran in Minnesota who, due to medical-certification procedures, can’t simply transfer the skills he learned as a combat medic to become a licensed civilian nurse. And he cited work done by First Lady Michelle Obama on the “Joining Forces” initiative, through which 2,000 companies have hired or trained 125,000 veterans or military spouses.

“After a decade of war, it's time to do some nation-building here at home. And what we can now do is free up some resources to, for example, put Americans back to work, especially our veterans ...” Obama said. “Making sure that, you know, our veterans are getting the care that they need when it comes to post-traumatic stress disorder and traumatic brain injury, making sure that the certifications that they need for good jobs of the future are in place.”

Related: Truth squad: The third and final presidential debate
Related: Risks and rewards of Romney's final debate approach

Those shout outs marked the first substantive attention either candidate has paid to former service members during their three debates – and they came 19 days after a leading veterans group urged the contenders to start discussing some of the home-front costs of two American wars, including a higher unemployment rate among ex-troops and battle-related anxiety symptoms linked to an alarming military suicide rate.

On the day after the final direct, verbal showdown between Romney and Obama, four veterans offered their reactions.

Paul Rieckhoff, chief executive officer and founder of Iraq and Afghanistan Veterans of America, a nonpartisan nonprofit with more than 200,000 members:

Q: What is the most critical issue facing military members?

A: Unemployment, but we've yet to hear either candidate address the scope of the problem – let alone smart solutions. In September, the unemployment rate for post-9/11 veterans was two percentage points above the general public at 9.7 percent, and even worse for female veterans at 19.9 percent. We must do better.

Q: Did you hear what you needed to hear about that issue?

A: In last night's debate, veteran unemployment briefly became a subject of discussion – finally.

Q: What is your takeaway from last night's debate?

A: The new veteran community needs real leadership and commitment from our next president to reverse negative trends in unemployment, suicide and (Department of Veterans Affairs) services. We haven't seen either candidate step up to the plate, so we'll keep asking the tough questions until November 6th.

Jason Thigpen, founder and president of the Student Veterans Advocacy Group and a student at the University of North Carolina Wilmington. As a U.S. Army sergeant, he earned a Purple Heart medal for combat wounds he sustained in Iraq in 2009:

Q: What is the most critical issue facing military members?

A: The budgetary cutbacks on defense spending leading to nearly a million service members losing their jobs, which will send them to the unemployment line. Additional cutbacks in veteran-appropriated budgets by way of education and medical benefits will invariably leave many with unfulfilled promises made to them for their service to our nation, while our government creates more lenient guidelines for illegal immigrants.

Q: Did you hear what you needed to hear about that issue?

A: No, but I do feel as though our efforts to raise awareness of the detrimental impacts facing our veterans, and how that affects our national economy, both now and in the future, are being heard.

Q: What is your takeaway from last night's debate?

A: While I'm not enthusiastic about the lack of bipartisan efforts from our federal legislators, (and) neither party looks appealing to me, I personally think the president has wiped the floor with Governor Romney in every debate. Although I've always considered myself a Republican, I don't feel it's in the best interest to elect Governor Romney as president. Electing Governor Romney will give Republicans control of the House, Senate, and presidency, which doesn't seem like much of a democracy to me, especially with a group of federal legislators whom can't seem to agree on much of anything except the end of a work-day or session.

Genevieve Chase, founder of American Women Veterans, a foundation that works to improve the lives of women veterans and their families. She served in Afghanistan in 2006 and remains in the U.S. Army Reserves. She earned a Purple Heart for injuries sustained in a bomb blast in Helmand Province:

Q: What is the most critical issue facing military members?

A: What's going to happen (when) we draw down our presence in Afghanistan? How will the military, responsibly and with the best interests of its members and families in mind, decide which troops will be kicked out in order to bring down its numbers? The witch hunts have already started and I'm learning of incidents that are disconcerting.

Q: Did you hear what you needed to hear about that issue?

A: The money our country thinks we'll save in the defense budget will need to be put toward our veterans – there’s no getting around the fact that America will be paying for these wars in one way or another, long after they're over. I'd like to know how either candidate proposes they'll do that.

Q: What is your takeaway from last night's debate?

A: That war has become so lucrative for some and the defense industry employs thousands of veterans who have families and no degrees – they will need jobs in the post-war economy. Before we espouse ideologies, what are the practical measures being considered for the short-term issues – or are we still being so reactive that we're not looking five years ahead? Additionally, in terms of veterans, if the VA backlog isn't being handled now, why is that and what's being done or promised to address it?

John E. Pickens III, executive director of VeteransPlus, a nonprofit that has offered financial counseling to more than 150,000 current and former service members.  He served as a combat medic with the U.S. Army Special Forces and the 82nd Airborne Division in the early 1970s. 

Q: What is the most critical issue facing military members?

A: The unexpected obstacles they face while transitioning into civilian life: jobs and employment. In this economy, it’s a difficult transition. For those who are lucky enough to be engaged by the VA understand their benefits, but they may not realize there are delays getting those benefits. They’re going to wait. That’s improving. But from our experience, those who are transitioning are so excited about the prospect of civilian life, they sometimes fail to see some of the obstacles.

Q: Did you hear what you needed to hear about that issue?

A: No, I honestly didn’t. I was glad that, especially the president, talked about how the nation owes veterans a debt of gratitude and good care. But it’s a much deeper subject than that. The military is an honorable profession. And even though they’re drawing down, we’re wondering: Are people going to continue to look at the military as a good profession, as something I want to go into after high school? It’s that old adage that people will join the military if they truly believe it’s a respected career and that (society) will treat you well when you finish your career.

Q: What is your takeaway from last night's debate?

A: It’s always good to hear people mentioning how we need to appreciate our veterans in a public forum. But somebody I admire a lot, Col. David Sutherland, who co-wrote that outstanding white paper, “Sea of Goodwill”, had a statement that has always stuck with me: ‘Well done is better than well said.’ ”

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Franz De Leon

Veteran Julie Weckerlein and her family are shown last weekend in the Washington, D.C. area. She served in Iraq and Afghanistan in 2007 with the Air Force. While in Iraq, she was a few yards away from another female service member who was killed by incoming mortar round.

Julie Weckerlein vividly recalls the horrid sounds that filled her base - and her head - after the incoming shell exploded: the radio call summoning the chaplain, the whirling blades of the chopper evacuating the burned remains of the Army sergeant killed in Iraq

Five years later, she still remembers the name of that dead soldier: Trista Morietti. 

“Females died over there, too,” said Weckerlein, who served in Afghanistan as well. She works today as a full-time federal employee in Washington, D.C. “But there is a cultural disconnect in our society. People don’t know: What is a female veteran? What does she look like? What does she bring to the table? What did we do over there?”  

Women compose 15 percent of homecoming U.S. troops and 15 percent of the U.S. armed forces, yet many Americans are unsure how to accept or view them, female veterans say. That applies to the job market, fueling a 19.9 percent unemployment rate among post-9/11 female veterans, while some VA hospitals seem unprepared to handle the heavy influx of women returning from war, contends a leading veterans group.

"I’m the first female veteran that a lot of people know personally, and I’m becoming more aware of this lack of understanding of who we are," said Weckerlein, who spent nine years in the Air Force. Now, 31, she is married with three children and, as an Air Force reservist, she also works part-time at the Pentagon. "There is no real example in society of a female veteran. In Hollywood, there's just the 'GI Jane' version – you know, like Demi Moore shaving her head. But that’s about it.

Jim Varhegyi

Julie Weckerlein waits for the all-clear in a shelter during a 2007 mortar attack at a U.S. post south of Baghdad. A moment after this photo was snapped, Weckerlein and others heard the radio call go out for a chaplain. A female sergeant was killed in the explosion.

"We are a normal family. My husband is addicted to (the TV series) 'Pawn Stars.' My 9-year-old and I, we struggle with homework. I struggle with DC life and the commute. This is a female veteran." 

Last week, Iraq and Afghanistan Veterans of America, a nonpartisan and nonprofit group with more than 200,000 members, called on President Barack Obama and Republican nominee Mitt Romney to cast at least some of their attention on the mounting and - as IAVA sees it - unaddressed needs afflicting female veterans. That heightened focus, IAVA said, should begin with how the Department of Veterans Affairs provides health care to female ex-service members. 

"There aren’t enough female health professionals in the VA system. There aren’t enough folks specialized in female health, especially around reproductive health. We’ve got to push the system to work harder for them," said Paul Rieckhoff, chief executive officer and founder of IAVA

"The bottom line is you need someone who recognizes that female veterans are a critical part of this population and that they have unique needs," added Rieckhoff, who served as a first lieutenant and infantry rifle platoon leader in Iraq during 2003 and 2004. "We’ve got women on our staff who say that a lot of times, when they walk into the VA, they get treated like a candy striper instead of like a returning warrior. As a country, we've got to go through a huge cultural shift." 

VA officials maintain, however, that their agency has launched multiple initiatives to cater to the rising number of female veterans using its hospitals. Last Friday, NBC News asked a VA spokesman to lay out some of those programs. On Wednesday, that spokesman emailed NBC News a series of Internet links describing the strategies, adding: "Nearly all of these programs are new in the past few years (2-4 years), and some have simply been enhanced. Of course, women vets are eligible for VA programs just as males would be too."

For example, the VA's Women Health Services "addresses the health care needs of women Veterans and works to ensure that timely, equitable, high-quality, comprehensive health care services are provided in a sensitive and safe environment at VA health facilities nationwide," says the VA website. "We strive to be a national leader in the provision of health care for women, thereby raising the standard of care for all women."

In 2007, the VA broadened the scope of Women Health Services to include the use of mammography machines, ultrasound and biopsy equipment, the VA reports.

'Didn't know what to do with me'
But Air Force veteran Terri Kaas, 29, said that after being seen at two VA hospitals near her home in Pasco, Wash., for knee problems she said were sustained during overseas service, she felt the staff at those VA facilities "didn't know what do with me." Kaas, who received a 20 percent disability rating after leaving the Air Force, said the VA also recently admitted to her that it had lost her medical records, leaving her pension and disability package pending, and allowing her to use VA facilities to receive only "some care that's service related."

courtesy of Terri Kaas

Terri Kass, an Air Force Veteran who lives in Washington State, has been job hunting for a year since leaving the military. She has more than 100 rejection letters to show for her effort.

When she did go in for treatment, Kaas described the VA visits this way: "Here you have a young woman – who is not old – who mostly likely will have another child or two. But I think they’re always amazed to see me. They’re like, 'Oh, is your husband here?' I’m like, 'No, it’s me. You're seeing me.' I’m used to being the only female in the lobby."

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Kaas, who served for 10 years, spending time in Bahrain and Germany, also has been snared by the second critical pitfall facing one in five post-9/11-female veterans: unemployment. She said she has more than 100 rejection letters to show for her job hunt during the past year. More troubling, she said, numerous hiring managers have asked if she is "service disabled." 

"Every job I've applied for that required both my resume and their corporate application asked that question. Are we discriminating against our wounded warriors? Starbucks, Walmart, Macy's, Amazon, Target, and Lockheed Martin are just a few who asked," Kaas posted on Facebook. Amid looking for work, she is attending college with hopes of becoming a math or science teacher. 

"That question astounds me - and it's always the follow-up question to: Are you a veteran?" Kaas said in a phone interview. "If Walmart won’t hire me at Christmas, when they're advertising, I kind of wonder what the reason is. I’m not trying to dime out Walmart. I’ve applied for work at many major department stores. But when I can’t get work at Walmart, I wonder: Why not? There’s other people getting hired there during the holidays."

The disability question, Kaas suspects, is asked because some hiring managers "assume that most veterans have PTSD."

"I don't know if it's legal to ask that but it certainly doesn't seem appropriate," said John E. Pickens III, executive director of VeteransPlus, a nonprofit that has offered financial counseling to more than 150,000 current and former service members. He agrees that such a query by hiring managers "is being driven by mental health concerns."

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Said Walmart spokeswoman Tara Raddohl: "That question is not standard practice or a part of our company interview process. We’re looking into this specifically" (at the Walmart store where Kaas applied for a job).

A number of Pickens' female-veteran clients have told him that although they served in war zones, they don't seem to earn the same level of prestige - or employability - as do U.S. male combat veterans, "and they don't carry home that same mantel as a warrior."

'Hey, I'm a female veteran'
Yet many carry home combat tales equally as harrowing as those being told by male veterans of Iraq and Afghanistan.

Just ask Julie Weckerlein. 

Courtesy of Julie Weckerlein

Veteran Julie Weckerlein and her husband, Martin. After nine years of active duty in the Air Force, she now works at the Pentagon.

After the insurgent shell detonated at the coalition base in Nasir Lafitah, Iraq, Weckerlein didn't know the name of the casualty - Trista Morietti, 27 - until she returned to her own post in Baghdad and read the incident report. Several U.S. service members were wounded as well when that mortar round landed on a sleeping quarters just a few yards from Weckerlein's position. 

"I also spent a lot of time reading up all the hometown articles and blogs her friends wrote about her. Hers was the first death I experienced on my deployment, and that she was also a 20-something female NCO really affected me," Weckerlein said. "I felt so sick for the family members back in the states who had no idea what was going on at that moment. Later, actually seeing those family members and their pain ... it tore out my heart.

"I think of all the awesome women who served alongside me, who are struggling to find work, and it just baffles me because they are so qualified," she added. "It just motivates me to want to go out there and say, 'Hey, I’m a female veteran.' "

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The Department of Defense is hoping that two new weapons – big money and little oil – can curb the rising military suicide rate.

A three-year, $10 million study, to be funded by the Department of Defense and conducted at the Medical University of South Carolina, will test whether omega-3 fatty acids found in fish oils can relieve the anxieties and quiet the suicidal thoughts plaguing many combat veterans, one of the lead researchers said Monday.

Scientists at the National Institutes of Health have long maintained that a diet heavy in omega-3 – common in salmon, anchovies and other oily fish – can elevate happiness.

“The problem is coming to a head with the recognition that in the military, you’re more likely to die by suicide than by enemy combatant – and that’s not acceptable,” said Dr. Ron Acierno, a co-investigator on the project and a professor in the department of psychiatry at the Medical University of South Carolina in Charleston, S.C.

“Omega-3s are among the primary fatty acids in the brain. They cannot be synthesized by the body – which means they have to be eaten (via food, drink or pill form). They’re responsible for neural generation and neural repair – for new neurons to be made and for broken ones to be fixed,” added Acierno, who also serves as the director of the PTSD clinical team at the Ralph H. Johnson VA Medical Center in Charleston.

The participants are veterans or service members who have been referred to a VA mental health treatment program because they are having suicidal thoughts. If the patients agree to join the study, they will be secretly placed in one of two groups. One segment will drink juice-box-sized smoothies high in omega-3. The second will drink placebos.

“Anybody who is showing suicidal ideation is going to be referred for the standard mental health treatment at the VA here in Charleston, which is a best practices site, so the standard treatment here is pretty good,” Acierno said. That means, he added, that military folks in the placebo group will not receive inadequate care. 

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For those former and current service members who receive the omega-3-laced smoothies, they’ll be asked to gulp one in the morning and another at night. All of the study participants then will be tracked over time as researchers interview them and measure, via a scoring system, their suicidal thoughts and intentions – whether they have formed a plan to take their own lives – along with their anxiety levels and cognitive-processing abilities, Acierno said. Any actual attempts by the participants to harm themselves will be immediately treated but that bahavior will become part of the study’s data.

In addition to medical literature accounts that show omega-3 can buoy mental health, the study team is “excited” about the prospects of fish oil serving as something of a solution, Acierno said, because the product carries an “extremely low risk” for side effects. It's also relatively cheap – costing between $12 and $35 retail.

At Target, for example, a bottle of Nature Made Ultra Omega-3 Fish Oil, priced at $11.89, holds 45 softgel pills each containing 1,400 milligrams. Target also sells $44.99 boxes of Coromega orange-flavored squeeze packets that each contain 650 milligrams of omega-3, derived from pharmaceutical-grade fish oil. 

“The potential good versus the potential extraordinarily low risk and low cost make this a type of intervention that can be – if findings are warranted – rolled out extremely fast and on a large scale,” Acierno said.

Bonnie Carroll, a leading expert in military suicides and founder and president of the Tragedy Assistance Program for Survivors (TAPS),  said she has not read or heard about omega-3 as a possible medicinal tool in treating depression or post-traumatic stress. 

"We are very open-minded on any techniques that might be useful," said Carroll, whose organization provides peer-based emotional support for families affected by the death of a loved one serving in the U.S. military. She also was co-chair of the DOD Task Force on the Prevention of Suicide in the Armed Forces. 

Omega-3 has been on under the microscope for more than a year as experts have tried to dissect the high number of military suicides. In August 2011, a study published in the Journal of Clinical Psychiatry suggested that certain fish oil components had potent psychiatric benefits and suggested that taking an omega-3 supplement might help service members. That research, performed in part by the Uniformed Services University of Health Sciences, scanned through the medical records of 800 U.S. service members who took their own lives between 2002 and 2008, comparing those against the health files of 800 active-duty personnel who had not attempted suicide. The scientists found that service members with higher blood amounts of docosahexaenoic acid - an omega-3 fatty acid - were less likely to take their own lives.

Should veterans who have considered suicide begin swallowing omega-3 pills on their own now?

“Buying the omega-3s and taking them is not going to be a problem,” Acierno said. “However, if they do have these types of thoughts or feelings, remember that even the people in this study – even those who are on the placebo – are getting mental health care.

“So we never want to say this is a replacement for evidence-based mental health care," he added. “This is a supplement and one that is easily added. It’s also important that you get the care you need.” 

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Everything you see in the music video happened to Marine-turned-country-singer Stephen Cochran: Pushing the girl away, boozing into oblivion, the gun on the blanket. It all went down last year. 

Courtesy of Stephen Cochran

Stephen Cochran, a former Marine recon scout and now a country-music singer, has penned a new song about PTSD - combat-related symptoms that almost claimed his life in 2011.

Even the actor who portrays Cochran is, himself, a former Marine and Iraq veteran who knows of post-traumatic stress, who has wrangled with identical demons. The actor was not acting.

The only on-screen tweak from reality was the type firearm shown. In his dimmest hour, behind a locked door in his Nashville home, exhausted, alone, and telling himself: “I’m done,” Cochran rested a loaded shotgun against his bed.

“I was just trying to get the nerve. I had it planned out,” Cochran told NBC News. “I didn’t know what was wrong with me. I was tired of taking all these pills. I was going through a breakup. Couldn’t write anymore. Watching everything fall apart. I was ready to check out.”

Then: salvation, and a surreal rescue scene worthy of an epic ballad. His dog, Semper Fi, began scratching relentlessly at his door, bloodying her paws. Next, Cochran’s ex-fiancé unexpectedly entered the house, simply to retrieve a forgotten item, he said. She saw the anxious dog. She expected the worst. She barged into the bedroom, spotted the gun and physically restrained Cochran. 

But from anguish came inspiration. Amid an existence long blurred by PTSD — the residue of Afghanistan firefights, Marine buddies lost in combat, and his own nearly fatal injury — one question blazed in Cochran's head. He jotted it down: “How do you paint a picture back in focus?”

“It was the only way I could describe trying to put your life back together, literally trying to do the impossible,” he said.

Around that single thought, Cochran penned an entire song, “Pieces,”an ode to the blackness from which he was aching to escape, a tale of reconnecting the scattered fragments of his shattered world, and a message of solidarity for his military brothers and sisters. The single — part of a CD with the same title — will be released in this country on Nov. 11. The song already has charted in Europe.

“It’s not just my story. So many of us think about (suicide) because you just get so tired, so tired of being the crazy guy. Or of hearing: ‘He’s weird.’ Or of hearing: ‘We can’t hire you because we really don’t know what post-traumatic stress is and you might come back and kill us all.’

“I really wrote it as my own healing, for what I was going through,” added Cochran, 33, who teamed with fellow musician Trevor Rosen to complete the song. It took them only 15 minutes.

But after playing it at several veterans’ benefits, Cochran heard from service members up and down the chain of command how they, too, connected with the lyrics. That feedback has turned “Pieces” into the soundtrack of the singer’s ongoing crusade.

“We have an epidemic of suicides in the military right now. At this point, we are physically losing both of these wars in the United States of America, not overseas.

Related: First opera about Iraq War reaches out to veteran suffering from PTSD

“If we want to stop our suicides, we need a complete overhaul in our ‘warrior’ terminology in this country, in the way we train our families (how to relate with homecoming veterans). That’s what I want to start with ‘Pieces,’ and the video. I want to get a bridge between our civilian population and the veterans. And I want to reach into the rooms of some of these guys and girls — who are just sitting in the dark and watching TV all day like I did — and let them know: You’re not alone.”

Perhaps the most ironic thread of Cochran’s story coils back to the days of his first, true musical success. In 2007, one year after retiring from the Marines, he scored a country hit with “Friday Night Fireside,” the culmination of a childhood dream for a guy raised in Nashville. The accompanying video was voted No. 1 by Great American Country fans for five straight weeks.

courtesy of Stephen Cochran

After his the light-armoured vehicle crashed in Afghanistan, Stephen Cochran fractured vertebrae and suffered a traumatic brain injury in 2004. Told he would never walk again, an experimental procedure by VA surgeons restored his steps.

Two years later, Cochran became the national spokesman for research and development at the U.S. Department of Veterans Affairs — his thank you for a successful, experimental surgery performed by VA surgeons who repaired his broken back. In 2004, Cochran had splintered several lumbar vertebrae when the vehicle in which he was riding through southern Afghanistan slammed into gaping hole that once held an anti-tank mine. He couldn’t feel or move his legs for months, and was told by doctors that he’d never take steps again. He walked.

The former Marine reconnaissance scout, part of the U.S. force that first knocked the Taliban out of Afghanistan’s Helmand Province, next teamed up with the VA to become its national co-chair for voluntary service. In that role, Cochran toured America, urging veterans to seek help for combat stress, “to let them know you don’t have to suffer in silence,” recalled Rosetta Fisher-Oliver, the VA’s chief of voluntary service for Tennessee and for parts of Kentucky and Georgia.

In 2011, Cochran recorded the music video “Hope” for the VA to try and cement his get-help pleas to fellow troops. What few knew: Cochran was losing his own hope.

“We worked on that video together, and the week he was supposed to make the video, I tried to get in touch with him, just to check to see that he was going to be on time,” said Fisher-Oliver.

She was unable to reach him, however, because Cochran was by then seeking treatment — after reaching the brink of suicide in his bedroom.

“Here’s a person who’s trying to get the message out and he’s still struggling with issues too,” she said. “He later told me: ‘I almost wasn’t here.’ ”

Cochran now acknowledges that he carried “almost dual personalities” during that time. In front of fellow veterans and fans, he sang, smiled, shook hands and signed autographs. “But I also had to deal with this monster I have inside my head and inside my gut, all day.” At home, his family and his then-fiancé, he admitted, took the brunt of his mood swings and emotional detachment.

courtesy of Stephen Cochran

After breaking his back in Afghanistan, Cochran was greeted by a fellow Marine. He later regained the ability to walk.

“You’re screaming out: Please help me understand what I’m going through, because I have no clue! That’s why you see the high number of divorces in the military,” Cochran said. “I told my fiancé: ‘I don’t know what I’m dealing with so the best thing for you to do is just leave and you’ll thank me later.' ”

She left.

But in what could have been Cochran’s final minutes, she came back, and burst into his bedroom.

After Cochran artfully turned that horrid moment into a song, he met the man picked to portray his downward spiral in the “Pieces” video: Daniel Dean, a Nashville songwriter and actor. He also looks a bit like Cochran. He seemed like a logical choice.

In talking with Dean, though, Cochran learned that the man was a Marine sniper who did three tours in Iraq. And they both had lived for years with the lingering anxieties that often remain for veterans who log months of combat exposure.

“He told me: 'This is my story, too,'” Cochran remembers. “That dude lived that.”

They also agreed with the concept that “Pieces” would be not just the first music video to delve so deeply into PTSD. It would break ranks with dozens of other standard, country-music videos about the U.S. military — mini movies that often include battle scenes that, some critics say, glorify war.

“Stephen does country music and so do I, and there’s a lot of military songs and a lot of them are pretty much B.S.” Dean said. “You’ve got the Toby Keith type stuff and that’s all right for what it is. But very rarely does a song hit a military person the way this one does.

“Just because it’s real. It’s one of the things I doubt you’ll hear any of the other country stars singing about. It’s (usually) more of the patriotic angle. Most military members aren’t songwriters like Stephen and I. So, I guess that lets us be able to sing things that you can’t say or can't deal with.” 

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A packed convention center — even a place staffed with PTSD experts — is precisely the type of environment most service members and veterans are likely to avoid. 

For many military folks dealing with the symptoms of post-traumatic stress, crowds make them jumpy. And due to the attached social stigma of the disorder, the thought of being spotted at such an gathering would make lots of veterans cringe. 

But a virtual get-together where disabled veterans can anonymously ask questions about the anxieties weighing them down?

That's part of the thinking behind the first True Help Disability Web Expo taking place Thursday from 9 a.m. to 4 p.m. Central Standard Time. The free event, organized by Allsup — a nationwide provider of services for people with disabilities — loops together more than a dozen leading health, disability, advocacy and social service organizations, several of them adept at working specifically with current and former service members.

Attendees simply need to register to chat all day from the comfort of their homes, local coffee shops, or their places of work. The expo will provide a "veterans booth" where military personnel past and present can seek and find suggestions, tips and advice on how and where to get treatment — including a primer on how to successfully access and steer through the monolithic U.S. Department of Veterans Affairs, said Brett Buchanan, an Allsup’s VA-accredited claims agent. 

"In my experience dealing with veterans with PTSD and with depression, I find that the veterans do much better over the phone, when they’re in their house," Buchanan said. "I can have better conversations with them then when I meet them face to face.

"I think, absolutely, when you’re going to compare a Web expo to a live expo at an actual convention center, I don’t think you would get those individuals anywhere near that environment with those crowds," he added.

Allsup will bring together representatives from 15 national nonprofit groups that specialize in disabilities, including the National Alliance on Mental Illness, the Brain Injury Association of America, the Invisible Disabilities Association and the National Family Caregivers Association. 

"Our hope is that veterans will find valuable information and resources that they just didn’t know existed," said Rebecca Ray, director of corporate public relations for Allsup. "We know veterans have a lot of options through the Department of Veterans Affairs and the Department of Defense. But there are a lot of groups that help veterans that may be new to them." 

While attendees can live chat with experts throughout the day, the expo will offer two moderated sessions for service members and their families: "What You Need to Know About Veterans Disability," from 1:30 to 2:30 p.m. CST, and "Wounded Warriors — A Discussion on Veteran Disability Resources," from 2:35 to 3:00 p.m. CST.

"We dive into little nuances of the VA disability system," Buchanan said. "There are special considerations for different veterans — specifically if the veteran has more than one disability that’s related to service, or if they’re a combat veteran they are given special consideration.

"We’ll be talking about the VA process," he added. "We’ll be taking people through, step by step, on filing a claim, what happens if the claim is denied, or what happens if you get a decision and you’re not satisfied with it: are you able to appeal it?"

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It began with an Army veteran’s exasperated affirmation and a purposely casual question, just 22 keystrokes.

Then, a gush of feelings, dammed up for years by the attached stigma, cascaded from Rob Ulrey’s mind through his fingers to his computer screen; 770 words, a personal purge, a plea for understanding: “I am tormented in my dreams ... I am functional in society ... I am medicated ... I am always on the lookout for danger ... I have no regrets ... I am just as normal as you."

His opening line: “I have PTSD ... So what?”

Last February, that post on Ulrey’s military website — penned partly to set “the media” straight, partly as an online life buoy for men and women like him — resonated with hundreds of current and former service members who posted comments to echo and empathize with the former Army gunner’s frustrations and fears. The reactions haven’t stopped coming: “I am living this with you,” wrote Mike R. on Aug. 27, and “Thanks for these words,” typed Greg H., also on Aug. 27. Talk of the column has spread far and wide among American military ranks. 

"The comments it got, and that it's getting, are really kind of inspiring. It seemed like it touched a lot of people. A lot of it was guys and girls who just seemed real lonely out there, real isolated," Ulrey told NBC News. "And they just seemed real relieved there was somebody out there like them."

Ulrey now looks at his essay as — if not the first embers of a true movement — maybe the early moments of a fundamental shift in the public discourse on Post Traumatic Stress Disorder, a series of anxiety-based symptoms afflicting up to an estimated 500,000 U.S. troops who have served in Iraq and Afghanistan. He wrote the article, he said, at roughly the same time he finally sought treatment, 15 years after an IED in Bosnia shattered his wrist, blew out his eardrums and began chronically haunting his slumber.

“It just came out of me, just kind of flowed from the heart,” Ulrey told NBC News. “I guess my higher calling is to make sure other veterans get this message, get the help they need. But If I can make people understand we’re not the big, evil demons that some people make us out to be, so much the better.”

Indeed, the piece was meant to be aimed largely at "mainstream" media outlets, Ulrey said. Amid a litany of news reports in recent years about young veterans committing violence or suicide, he winced at how often journalists swiftly linked the acts to PTSD. 

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"I, along with my cohorts, have been classified as a potential powder keg just waiting on that spark to set us off into a murderous explosion of ire. This is not the case," Ulrey wrote in his post. 

That sort of breathless PTSD coverage has painted the diagnosis, and perhaps all combat veterans, with a social stain, Ulrey said. PTSD evokes concerned whispers from family members, worried glances from co-workers, and dead-ends at job interviews. 

"The stigma is so negative. I’ve heard time and time again from veterans: 'I’m not getting the looks (from companies) that I should be getting. I’m not getting that second interview.' I know some guys who are leaving stuff off their resumes or downplaying what they did during their time in the service so that it doesn’t trigger those kinds of questions (about mental health). 

"You’re automatically tainted just because of your service, even if you don’t have PTSD at all," Ulrey said. 

But it's not just corporate America that, in Ulrey's view, misunderstands PTSD. Even inside the military, the disorder, and certainlythe act of service members seeking help for it, is often viewed as a personal flaw, or as a lack of mental muscle, he added. 

"They’ve been suffering with it and they’ve been afraid to say anything about it, because they were afraid of the ramifications," Ulrey said. "In the military, if you need to go to mental health, then you’re weak. And we don’t have weak in the military. We’re warriors, we’re not supposed to feel this way. But it will take out the baddest dude or the littlest, wimpiest dude. It doesn’t discriminate."

At the top of the U.S. military pyramid, however, leaders say they are toiling to change that old thinking. 

"Seeking help is a sign of strength not weakness," said Cynthia O. Smith, a spokeswoman for the Defense Department. "No, military careers aren't at risk for seeking help." 

As proof, Smith e-mailed NBC News a memo, signed May 10 by Secretary of Defense Leon Panetta, that read: "Leaders throughout the chain of command must actively promote a constructive command climate that ... encourages individuals to reach out for help when needed."

And on the topic of Ulrey's matter-of-fact pitch for America to stop demonizing PTSD and those diagnosed with it, Smith said: "Mental health disorders, like most medical conditions, are treatable. Many service members with symptoms of PTSD recover with appropriate medication and/or psychotherapy within a few months."

Ulrey's medication includes prescribed blood-pressure drugs that prevent the flashback nightmares he once suffered. Those dreams used to wake him with a jolt four to five times a night and caused him to sweat so profusely that his sheets often were drenched by dawn. 

"I have never physically assaulted anyone out of anger or rage," he typed last February. "I have never committed violence in the workplace, just like the vast majority of those who suffer with me. My co-workers know I spent time in the military but they do not know of my daily struggles, and they won’t."

But like any good writer, Ulrey has picked up on the irony in his larger quest to convince the world to simply see soldiers and veterans as regular folks who are dealing with battlefield stress on their own terms. In his current job as a law enforcement officer — he asked to keep his city of residence out of this article to protect his family — Ulrey earlier this month faced a pointed question from his boss. 

"He saw the article and asked me: 'Do I need to know anything about this? Do I need to be worried?’ I said, ‘No not at all.' 

"It had been bugging him and, I guess, bugging the other supervisors I work with for a couple of months. That was the whole purpose of the article. So that people don’t get that question from co-workers or supervisors," Ulrey said. "Even if we have PTSD, we’re OK. I am not going to freak out on you."

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Michelle Rossitch

Army veteran Luis Zaragoza, 28, with his service dog Cheyenne. Zaragoza did two tours of duty in Iraq, and suffers PTSD.

The Department of Veterans Affairs will cover the costs of service dogs to help veterans with impaired vision, hearing or mobility, but will not cover canines assigned for mental disabilities, according to regulations published on Wednesday in the Federal Register.

The VA said that despite many individual veterans’ testimonials that mental health service dogs provide relief from the symptoms of combat-related disabilities such as Post Traumatic Stress Disorder (PTSD), it lacked research substantiating the efficacy of mental health service dogs.

"VA has not yet been able to determine that these dogs provide a medical benefit to veterans with mental illness," the department said. "Until such a determination can be made, VA cannot justify providing benefits for mental health service dogs."

To be defined as a "service dog" the animal has to be trained to do specific tasks for a person — such as picking things up, guiding them or providing balance.

Trainers say that for veterans suffering mental disabilities such as PTSD or Traumatic Brain Injury (TBI), dogs can be trained to help avert panic attacks and wake them up as they enter a nightmare. The animals can be taught to remind veterans to take medications and alert them if they have left a burner lit on the stove.

Luis Zaragoza, 28, who suffers PTSD from his service in the Iraq war, says he's experienced more progress in a month with his service dog, Cheyenne, than in all the years visiting the VA since his discharge in 2004.

"For eight years I was just in limbo, but now I’m seeing glimpses of the old me — the me I was before I joined the military," he said of the service-dog program.

The program, designed by Illinois-based nonprofit This Able Veteran, paired Zaragoza with the dog and a therapist. The dog is there to help the veteran re-enter mainstream life at intervals recommended and monitored by the therapist.

In Zaragoza's case, the dog is trained to detect a tic — Zaragoza’s leg begins to shake — at the onset of a panic attack, and divert the veteran’s attention by bumping his leg. Cheyenne will do this a second time — more insistently — if Zaragoza fails to respond the first time. This happens up to five times a day, said Zaragoza, who lost nine soldiers in his company during two bruising stints in Fallujah and Ramadi, Iraq.

The veteran says he is regaining his ability to get out of the house and do things — like go to the shopping mall — that he has avoided because of the anxiety and hyper vigilance that is common to combat-related PTSD. Zaragoza says he sleeps more, functions better in the day, and interacts with more with other people rather than choosing to isolate himself. He’s lost 15 pounds because he is more active.

That was progress he had not seen despite years of visiting VA psychiatrists and doctors who prescribed medications for his PTSD symptoms.

"At the VA, what they tend to do is pump you with medicine," he said. "That’s not a solution to any issue like PTSD or anxiety. They just kind of numb you. I knew that wasn’t the right choice for me. I was looking for an alternative."

But Zaragoza’s opportunity remains relatively rare and unaffordable for many veterans.

The cost of providing custom-trained Cheyenne was about $20,000 said Behesha Doan, president of This Able Veteran. The costs — for training, as well as Zaragoza’s travel expenses, veterinary bills, and equipment — were funded by private donations. Zaragoza was one of six veterans assigned a PTSD dogs by the nonprofit.

But he is disappointed that the VA won’t pick up the bill so that more veterans can get this kind of assistance.

As an employee of U.S. Fish and Wildlife in Chicago, he is able to handle the cost of maintaining Cheyenne — things like food, kennels for work, home and cars, and vet bills. Even these costs would challenge many fellow combat veterans, he said.

"There are other veterans who can’t go to school or hold a job because their PTSD is so bad," said Zaragoza. "A lot of these guys live on $600 a month."

Stories like Zaragoza’s prompted members of Congress to push for the VA to provide more canine assistance to veterans, and recommended more research to explore how dogs might best help veterans suffering two of the most common mental disabilities from combat in Iraq and Afghanistan — PTSD and TBI.

As NBC News' Rebecca Ruiz reported in August, a team of epidemiologists, mental health providers, veterinarians and other experts were conducting a study at the Veterans Hospital in Tampa, Fla. Proponents were eager for the three-year study to deliver data to demonstrate benefits and help create a framework for training mental disability service dogs.

But the research was temporarily suspended from January to June after a young girl was bitten by a dog. VA declined to be interviewed about the study, but told Ruiz that the project resumed after it increased monitoring through phone calls and home visits by the researchers and service dog providers.

Training PTSD dogs is tricky because the illness ranges from very manageable to very severe, according to Corey Hudson, President of the North American chapter of Assistance Dogs International, a coalition of not for profit organizations that train and place canines worldwide. "You have to be careful what you’re getting into, and make sure you are qualified to train a dog for that situation," he said.

He said that his understanding was that the VA wanted the results from the PTSD service dog research to show what was effective before making a decision on benefits.

Doan, of This Able Veteran, said continued research, properly done, could help the VA set standards, and weed out service dog providers which have proliferated in the last few years. She stresses that pairing dogs and veterans without careful screening and training poses risks to both, and could just be a waste of resources.

"In order for this to be taken seriously, we’ve got to show that we have considered all the aspects of what could potentially go wrong and maintain all the efficacy of what goes right," she said.

She is hoping that the VA, in its decision not to cover PTSD dogs is merely taking a cautious, go-slow approach, not ruling out benefits for the future or merely dragging its feet.

"If it’s done right we’ve got a helluva program going on," she said. "If it’s not, you’ve got Joe Bag-a-donuts out there grabbing some dog off the street and calling it a PTSD dog."

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