By DAMIEN CAVE


For Vivienne Pacquette, being a combat veteran with post-traumatic stress disorder means avoiding phone calls to her sons, dinner out with her husband and therapy sessions that make her talk about seeing the reds and whites of her friends’ insides after a mortar attack in 2004.

As with other women in her position, hiding seems to make sense. Posttraumatic stress disorder distorts personalities: some veterans who have it fight in their sleep; others feel paranoid around children. And as women return to a society unfamiliar with their wartime roles, they often choose isolation over embarrassment.

“After all, I’m a soldier, I’m an NCO, I’m a problem solver,” said Mrs. Pacquette, 52, a retired noncommissioned officer who served two tours in Iraq and more than 20 years in the Army. “What’s it going to look like if I can’t get things straight in my head?”

As of June 2008, 19,084 female veterans of Iraq or Afghanistan had received diagnoses of mental disorders from the Department of Veterans Affairs, including 8,454 women with a diagnosis of post-traumatic stress .





In Iraq and Afghanistan, the military has quietly sidestepped regulations that bar women from jobs in ground combat. W omen are fighting in ways that were never imagined by their parents or publicly authorized by Congress. And they have distinguished themselves in the field.

Officials with the Department of Defense said studies of male and female veterans with similar combat experience showed that mental health issues arose in roughly the same proportion .

And yet, experts and veterans say, the circumstances of military life and the way women are received when they return home have created differences in how they cope. A man may come home and drink heavily with his war buddies while a woman is more likely to suffer alone.

For those with husbands or young children, finding a social equilibrium is especially difficult. Veterans like Aimee Sherrod, 29, a mother of two, say they constantly struggle to balance their urge to hide with demands from loved ones to interact.

Ms. Sherrod said that five years after her last deployment to Iraq, she still makes only a few trips a week outside her home in Jackson, Tennessee, usually to drop off or pick up her 4-year-old son at school.

She often feels like a failure because her son pushes for what she cannot handle. The noise of game arcades makes her jumpy. “Take him to a park? It’s a lose-lose,” she said. “I don’t like open spaces.’’

When Mrs. Pacquette joined the Army in the ‘80s, men often told her she did not belong. Even before she was deployed to Iraq in 2004, however, she sensed that war would be an equalizer. And it was.


CHIP LITHERLAND FOR THE NEW YORK TIMES

Gunshots arrived on a bridge in Baghdad. Soldiers took up positions outside their vehicles, and an Iraqi was killed. “It was my birthday,” Mrs. Pacquette said. “I remember thinking, ‘Oh my God, I’m going to die.’ ”

Instead, she surprised even herself by remaining calm. “As a leader, I had to keep my fear inside,” she said.

But later on, the war’s consequences began to weigh more heavily. After a mortar attack, she saw three of her friends torn up beyond recognition.

Recalling the scene nearly five years later, Mrs. Pacquette’s eyes dart back and forth, as if looking for another rocket. This emotional flashback is just one in a long list of post-traumatic stress symptoms that female veterans now know intimately, including fits of rage, insomnia, depression, survivor’s guilt and fear of crowds.

When Heather Paxton started working at the V.A. hospital in Columbia, Missouri, two years ago, she discovered something she did not expect: no one saw her as a veteran. Despite her service in Iraq, patients assumed she knew nothing of war. A male colleague who chattered about weapons dismissed her like a silly little sister when she joined in. “He’d just walk away,” she said.

Female veterans also see their sacrifice overlooked in bars, where strangers slide past them to buy drinks for men who were never deployed, and at “welcome home” events where organizers ask for their husbands.

Tammy Duckworth, a former Black Hawk helicopter pilot who lost her legs to a grenade in Iraq, said such experiences show that “we’re going through a change - just like in World War II with African-Americans, the military is ahead of the American public.”

What many do not realize, said Ms. Duckworth, who is now the assistant secretary of public and intergovernmental affairs for the V.A., is that in war today, “it’s not a question, Can women can do a combat job. They just are.”


Heather Paxton, above and top right, says male co-workers do not take her combat experience seriously. Aimee Sherrod, far right, is afraid to take her son to the park. / CLOCKWISE FROM ABOVE: COURTESY OF HEATHER PAXTON; ED ZURGA FOR THE NEW YORK TIMES;COURTESY OF AIMEE SHERROD



“It was my birthday. I remember thinking, ‘Oh my God, I’m going to die.’ ”
VIVIENNE PACQUETTE Iraq war veteran with P.T.S.D.