Flashes of rage jolted them awake. Outbursts made it hard for them to hold down jobs. The downward spiral to post-traumatic stress disorder has affected thousands of military veterans of all eras. But there is hope for a better future. As Veterans Day nears, the Globe visits with those who are moving forward by going back to college, buddying up with a service dog, and seeking the compassion of fellow veterans.
Army veteran Michael Saunders awoke in a flash, his knees buckling, his body numb.
"It was a blinding rage that I had never felt before," said Saunders, 34, who lives in Peabody. "I thought I was having a stroke."
An emergency room doctor assured him "You're fine," he recalled of that night in 2012. Doctors at the Bedford VA hospital later diagnosed him with post-traumatic stress disorder.
Saunders, who served from 2002 to 2006, deployed twice to Iraq, where his unit raided houses, swept for bombs, and destroyed the enemy's ammunition.
"We'd dig up enemy weapons and blow them out," he said.
He started therapy at the VA outpatient clinic in Lynn, where a counselor suggested he focus on a new mission: going to college.
"She said I would make more money with a college degree," said Saunders, who worked for a lumberyard after his discharge from the Army.
He enrolled in VITAL — an acronym for Veterans Integration to Academic Leadership — a national program that helps veterans transition from soldier to student.
VITAL brings VA services, including mental health counseling, to college campuses.
"Some of them have a lot of anxiety about being in a classroom," said Eunice Kwon, a psychologist at the VA in Bedford who counsels students at Middlesex Community College, which has campuses in Bedford and Lowell. "We work with them on stress management, organizational skills, or anything that will help them reach their educational goals."
According to Pam Flaherty, dean of students, Middlesex Community College had nearly 600 student veterans in 2014-15. In the last year, 70 who have PTSD have taken part in VITAL and received mental health care on campus, said Alisa Bennett, the program coordinator at the Bedford VA.
"It's the signature wound of this war," said Bennett. "We're here to help them make progress, and give them a boost when they're having a bad day."
The Bedford VA also offers the VITAL program at Bunker Hill Community College in Charlestown, Mount Wachusett Community College in Gardner, Northern Essex Community College in Haverhill, North Shore Community College in Danvers and Lynn, Endicott College in Beverly, and Salem State University.
Saunders, who graduated from Everett High School in 1999, is in his second year studying liberal arts at Middlesex Community College in Bedford. He has discovered a talent for writing, and hopes to transfer to Emerson College next year.
"It was a rough start, but I'm doing fine now," said Saunders, who also has a job at the college's Veterans Resource Center. "Had the VA not had the service in place here, I wouldn't have come."
The skills he learned in therapy to manage his PTSD have helped him succeed in college, he said.
"I can sit in class now, for an hour and 20 minutes," Saunders said. "I couldn't sit still for 10 minutes before."
He has a lingering fear of crowds, so he adjusted his seat in the classroom.
"I have to be able to see the door, and I don't like anybody behind me," Saunders said. "If I can't do that, I can't focus."
For one class, Saunders wrote a story called "The Dark Is Afraid Of Me," a fictional account of a military mission in Iraq.
"It was really easy for me to tell the story," Saunders said. "When the professor read the paper, she was like, 'You need to go see a publisher, now.' Maybe I will."
Army Ranger Veteran Brian Zagata, Concord
A yellow Lab mix with white paws, Franklin has a deep sense of duty to former Army Ranger Brian Zagata.
They go everywhere together: home to Concord, to work at CrossFit Ares in Wilmington, out to dinner with Zagata and his girlfriend.
"He brings me happiness and companionship," Zagata, 35, said as he rubbed Franklin's floppy ears. "Hey, bud, I'm talking about you."
Zagata got Franklin from Operation Delta Dog, a Chelmsford-based nonprofit founded in 2013 to provide service dogs to veterans who have post-traumatic stress disorder or a traumatic brain injury.
"We hope to make a change in the lives of both the veterans and dogs," said Trisha Blanchet, a daughter of a Vietnam veteran, who so far has placed 18 dogs.
Zagata, who graduated from Concord-Carlisle High School in 1999, enlisted in the Army after graduating with a degree in psychology from Wesleyan University in 2003. He served from 2004 to 2008 with the elite Second Ranger Battalion of the 75th Ranger Regiment.
He was deployed three times to Iraq, where he participated in more than 100 special operation intelligence missions.
"Usually, [Rangers] are looking for a specific person, instead of just patrolling," he said. "You go to that area. You clear it. You find that person and bring them back. Or you gather more intelligence and find out where else to go."
Zagata was diagnosed with PTSD in the years after his discharge.
"Your time in the service seems to end pretty quickly. There is not a lot of preparation for it, " he said. "It's very challenging. The military structure is just so different than civilian life."
At night, his mind would wander back to combat missions conducted in the dark in central Iraq.
"I just had a lot of issues, especially at night sleeping," he recalled. "When we were overseas, I was always on a reverse cycle. When most people are getting ready to go to bed and rest, I would get ramped up, because it would be time for me to go on a mission."
He enrolled at the University of Massachusetts Amherst, graduating with a nursing degree in 2010. He worked a couple of different nursing jobs, including a brief stint at Boston Children's Hospital.
But Zagata found it hard to relate to his coworkers on a busy hospital floor.
"I was always really good with the patients," he said. "I just wasn't able to work in the hospital with other people."
He started receiving counseling at the Lowell Vet Center. He also learned to practice yoga and meditation to manage stress.
"I felt they were two tangible practices that I could build into my daily [routine], " he said. "The VA is great, but it's only open from 9 a.m. to 4 p.m. There is no one there to help you when it really matters, like the middle of the night. So you need to find a way to get beyond it."
He thought a service dog might help. A social worker in Lowell put him in touch with Operation Delta Dog about two years ago.
Zagata met Franklin at a training session in Chelmsford.
"They brought him over to me, and he gave me a big hug, and I was like 'sweet,' " Zagata said.
The doe-eyed dog is trained to respond to commands, such as shielding Zagata from crowds.
"He creates some distance for me," he said.
At night, Franklin is a natural watchdog.
"He hears anything long before I do," Zagata said. "He's made a big difference for me."
Women’s Integrated Treatment and Recovery Program, Brockton VA
I'm a Fort Hood survivor," Angel Allen, 33, said quietly. "The first Fort Hood shooting, on Nov. 5, 2009. I had only been in the Army for one month."
"My career started out as an absolute disaster," said Cheryl Cooper, 53, who joined the Army reserve in 1980. "Within a month of getting assigned to Fort Devens, I was sexually assaulted. . . . I started down a path of destruction."
"I have severe depression linked to my service," said Hyacinth Graves, 56, a former Army police officer who served from 1984 to 1988. "I used substances to try to make myself feel better."
The 10-week residential program, which accepts eight women per session, is open to veterans who have both PTSD and drug or alcohol addiction. Most also have survived sexual assault in the military.
Through individual counseling and intensive group therapy, the women learn about coping skills, and the relationship between trauma and addiction.
"Their substance abuse is very closely tied with PTSD," said Carolyn Mason Wholley, manager of the women's programs at the Brockton VA. "We want to teach them coping skills to address them both."
Group sessions address addiction and recovery; managing difficult emotions; health and safety awareness; and interacting with other people. Participants also must take turns leading meetings of Alcoholics Anonymous or Narcotics Anonymous.
"It's very challenging," Cooper said, just after leading an AA meeting. "We have a lot to learn here. A lot to think about, especially ourselves. . . . I thank my stars I have this program."
Since starting eight years ago, the program has treated 246 female veterans referred from VA facilities around the country. The current group — which is due to graduate later this month — served in the Army, Navy, and Air Force. They live as far away as Tennessee and Texas, and as close as Brockton and Springfield.
As part of a group project, they wrote a poem called, "What It Means To Be A Female Veteran," which they planned to read Nov. 6 for Women Veterans Appreciation Day at the State House.
"The women who come here really are extraordinary," said Sharon L. Baker, the program director and a licensed psychologist. "They've survived so much."
"They're not all better when they leave here," she added. "But we want them to leave with a foundation, and a better understanding, of their own life pattern."
For some, sharing their stories has helped them to become more confident.
"It's helped me, in certain ways, to come out of my skin," said Graves. "I was a recluse. The great thing about this is that we are all veterans . . . and certain groups speak directly to what we're dealing with."
"The groups are not group counseling," said Ali Kilpatrick, 54, an Air Force veteran. "They're group learning."
Others say the all-female setting is critical to their recovery.
"I went to another program and half the time I was the only woman in the group," said Sharon Ham, 55, an Army veteran. "It was very awkward. I'd shut down and not talk."
"I was the only female on the unit where I live and it was pretty rough," said Allen, who said she developed PTSD and experienced sexual assault after the shooting at Ford Hood, an Army base in in Killeen, Texas. "I didn't think I could be real trusting to them, talking about my issues."
She was waiting to deploy with her unit to Iraq, when an Army psychiatrist, Major Nidal Malik Hasan, burst into a room and started shooting. Thirteen people were killed, and 31 wounded in the attack.
"I was shot at but he missed," Allen said. "I crawled under a desk. Myself and another woman started pulling the wounded behind the desk, so that he wouldn't go back and shoot them again."
Allen was diagnosed with PTSD in the months after the attack and assault. She went to therapy, and took medication. "But when the medication didn't work, I started drinking and using drugs."
But Allen now is focused on a new and hopeful day.
"I'm working on being a victor, not a victim," she said.