April 13, 2009 -- First in a series on the Columbine shootings, 10 years later.
At his worst after he survived the Columbine shootings in Littleton,Colo., chemistry teacher Kent Friesen would become physicallyill, often throwing up. Now, a decade later, certain triggers canstill set off crying jags.
Friesen remembers running past the bodies of two students in thescience wing that day as he tried to get help for girls' basketball coach DaveSanders, who was gunned down and eventually bled to death in themelee.
"I knew he was going to die," said Friesen, who has had to unearththe trauma again as the victims, the country -- and the media -- bracefor the 10th anniversary of the most iconic of allschool shootings.
On April 20, 1999, Columbine High School seniors Eric Harris and Dylan Klebold, wieldingautomatic weapons, slaughtered 12 students and one teacher. Another24 were injured in the 45-minute rampage.
Columbine High School Students, Teacher Report Flashbacks
Though Columbine is now a decade old -- and a larger shooting at Virginia Tech that left 32 deadfollowed in 2007 -- the wounds of this tragedy are stillraw.
A number of books have tried to dissect the motives of thekillers and the truth behind the event that played out on televisionscreens across America, but no studies have ever examined thepsychological effects of the massacre on those left behind, according to Dr. Frank Ochberg, a former FBI psychiatrist who guided thecounseling teams in the aftermath of Columbine.
"There were relatively few who were right at the heart of [theshootings] and were direct post-traumatic stress syndrome candidates,"Ochberg told ABCNews.com. "But there were relatively many for whomColumbine was their Gettysburg."
"It changed them, and if they were young, they grew up fast," he said. "Within that group, some are better and some are worse."
Friesen had been holed down in his classroom for three hours that day,with the incessant blaring of the school alarms, exploding pipe bombsand students' screams.
"A gun and holster is the worst one for me," said the 58-year-old, whohas retired from teaching and lives in Littleton. "But you live withit. You learn to cope."
Post-Traumatic Stress Lingers
That takes him back to the frenetic day when Special Weapons andTactics, or SWAT, teams, as confused as those already inside theschool, roughed up Friesen, initially believing he was asuspect.
He said the easiest part of dealing with the shootings was getting freecounseling for his post-traumatic stress disorder, but many neversought help.
"She saved my life," he said of his counselor. "It was the worst thing I have ever gone through," Friesen toldABCNews.com. "Post-traumatic stress can happen to anybody. It'smind-boggling to know that people still don't believe in it. It'sreal, and it's one of those things that just won't go away unless youget help."
According to Ochberg, who specializes in treatingpost-traumatic stress and the effects of violence, "The healthiestthing, hard as it is, is to grieve a loss.
"Grief is good and normal," said Ochberg, the former associatedirector of the National Institute of Mental Health.
But when distress becomes disorder, post-traumatic stress -- or whatwas once called "shell shock" or "battle fatigue," is oftendiagnosed.
PTSD is Medical Condition
"PTSD is when a person undergoes something really traumatic, horrificand terrifying, but their reaction is not proportional," said Ochberg.
"The brain isn't operating the way it should. The equivalent of kidneyfailure or a ruptured spleen, it becomes a medical condition."
Ochberg helped identify PTSD in 1980, when returning Vietnam veteransand rape victims' advocates and counselors reported an array ofsymptoms: reliving of the event; avoidance of "normal things that youhave an appetite for" -- joy, love and food; and a sense of beingalways "hyped up."
Treatment should be "collegial," attempting to "normalize" thepatient's life, "even though the brain is broken," he said. Educatingpatients about the disorder, re-establishing eating and sleepingpatterns and working with "humor and spirituality," is key.
Sometimes Ochberg allows the patient to experience flashbacks in acontrolled and safe setting, so eventually they become lessdebilitating.
"Together, we try to get our arms around it," he said. "You canactually grow from it."
"It says nothing bad about you if you've got PTSD," said Ochberg."That's what you got. You were in the fire and got burned. Some peopledeal with burns better than others."
Shooters Paralyzed Teen
Such was the case with Anne-Marie Hochhalter, who got shot in thechest and was permanently paralyzed from the waist down. Eighteen monthsafter the massacre, her mother committed suicide and an experimentaltreatment to try to help her walk again failed.
Now 27, Hochhalter said she has climbed out of a "dark hole" and hasforgiven the shooters.
Today, after four surgeries, Hochhalter, Columbine's so-called"miracle girl" has a degree in business management and is a part-timemanager at a local Bath and Body Works store.
"It's not at the forefront of my mind," she said in talking about what she'd endured," she told ABC's Kate Snow in an interview to air on ABC's "Good Morning America." "And it, it helped me, you know, [to] believe in faith as well that I'm here for a reason. ... Ihave a lot more to give to the world."
"I've tried to move on, you know, with my life. But I do think aboutit sometimes, with the anniversary coming up."
But like other students and teachers who survived the shootings,flashbacks still persist.
Nail Polish Sets off Flashbacks
Hochhalter said the smell of nail polish or formaldehyde can set her off,reminding her of her recovery in the hospital, where doctors stitchedup a hole in her vena cava, a pair of veins that deliver blood to theheart, and literally glued her liver back together.
Automobile "backfirings are probably the worst, and fireworks," shesaid. "I can't do fireworks at all.
Others haven't fared so well, and the fallout of Columbine has sentthem on a downward spiral.
At 16, Mark Taylor survived a barrage of rapid-fire bullet wounds(somewhere between six and 13), but the years that followed have beentough. Today, Taylor lives with PTSD and mental illness, according tohis father, a janitor who lives in Denver.
"For about two years, he was doing really good," Mark Taylor Sr. toldABCNews.com. "Then he had a mental breakdown. He used to be normal,and now it's almost like talking to a blank wall."
Taylor, who was once close to his son, has not talked to his son inmonths. Young Mark and his mother live with a relative in Espanola,N.M., surviving on food stamps and disability income.When ABCNews.com talked to Mark, his speech was slurred andincoherent. His mother, Donna Taylor, was equally distraught. "We areliving like gypsies," she said.
"I need help so much," she told ABCNews.com, intermittently coughingand crying. "I'm so scared. He's almost choked me several times. Hecannot think logically anymore."
Mark could only manage to say, "I don't want to talk about it anymore.It's America's guilt."
His father described Mark as "paranoid and delusional," and saidmental health officials diagnosed his son with a genetic bipolardisorder that was exacerbated by the trauma of Columbine.
Mark, whom police referred to as "dead kid walking," was hit when thekillers aimed at students sitting on the grassy knoll adjacent to somesteps. He fell to the ground and played dead while three othersescaped uninjured.
'Bowling for Columbine'
He spent 36 days in the hospital and was tutored during hisconvalescence but never graduated from high school. "It was pretty horrific," said his father. "Basically, you're in shock."
After the shootings, Mark participated in the making of MichaelMoore's 2002 anti-gun documentary, "Bowling for Columbine," and wrotea book about his inspirational recovery, "I Asked, God Answered: AColumbine Miracle."
The book logged some sales early on, but Mark was "not in a state" topromote it, said a spokesman for Tate Publishing, which released thebook in 2006.
Donna and Mark Taylor, who have six other children, divorced in theaftermath of Columbine. Their son experienced several mentalbreakdowns and was hospitalized three times, according to bothparents.
Mark's mother believes the antidepressants doctors prescribed were"killing" her son, and she took him off all medications. In 2006, theybegan a three-year odyssey moving from Colorado to Kansas City to livewith friends. For a while, they were living in a homeless shelter inBuena Park, Calif.
Shooting Victim Too Sick to Work
Today, the 26-year-old is too sick to work and has only a Lexus toshow for the estimated $185,000 he received from the Columbinevictim's fund.
"He blew it all," said his mother. "It's hard to control someone thatage."
Like the rest of the nation, 10 years after Columbine's massacre, DonnaTaylor "cannot let this thing go," said her ex-husband.
"The mere fact is that guns aren't the only problem," said DonnaTaylor. "Life is so full of darkness. School should be the safestplace, not the most dangerous place for your child."
Retired teacher Kent Friesen has channeled his own grief into the plight ofreturning Iraq War veterans, many of whom suffer frompost-traumatic stress.
"I am passionate about this," he said.
A 2007 American Psychiatric Association survey of soldiers showed overall prevalence of PTSD was 16.6 percent. But 31.8 percent ofthose wounded or injured reported having the disorder.
Today, Friesen cannot talk about the veterans without breaking down."I admire those men," he said. "I hope they get the help that theyneed."
These days, he finds solace making furniture in his workshop andvolunteering for a church youth group. Friesen cannot view violentmovies without crying, but he relies on the patience of his wife andtwo sons, 30 and 32, to steer him clear of emotional triggers.
"I will put this [interview] on a back burner and deal with it later,"Friesen told ABCNews.com. "I probably won't sleep well tonight. Thethoughts and things race in my mind.
"But that's OK," he said. "That's what I have to do. I don't want tobury it, and my release is my tears."
Next: The Columbine Shootings, 10 Years After: Portrait of the Killers
ABC's information specialist Nicholas Tucker contributed to this report.