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.
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 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.