Soldier's heart, battle fatigue, post-Vietnam syndrome, the names for post-traumatic stress disorder have been around as long as there has been war.

The treatment, at least for Vietnam veterans, is getting better, veterans said.

"Many veterans with PTSD have suffered in silence for a long time, but they don't enjoy life anymore," said Allen Eason, coordinator of the post-traumatic stress disorder clinical program at Veterans Health Care System of the Ozarks in Fayetteville.

Waiting out the symptoms of chronic post-traumatic stress doesn't make it better, Eason said. Family members usually recognize the symptoms early.

Denial is the number one problem with post-traumatic stress, Jack Jones said.

Today, the Centerton resident works with support groups for veterans. He arrived in Vietnam in 1965 as a Marine Corps lance corporal. He left six months later as a sergeant. Jones was in the infantry, but when a radio operator was killed, he took over. It was a dangerous position.

"They figured you could call in support, so they shot you first," he said.

It wasn't a gunshot that sent him home. Six months after he arrived, he stepped on a land mine, his heart stopped and he saw a bright light before coming back to life, Jones said.

He first learned about post-traumatic stress disorder by watching a television program in the late 1970s. He was training to help other veterans and realized he had the symptoms.

The intensity and duration of combat makes being on guard ingrained, Jones said. He still wakes up at 3 a.m., no matter the time zone. Attacks in Vietnam came at first light, just about 4 a.m., he said.

His post-traumatic stress has regressed, and Jones works through flashbacks with breathing exercises and by reminding himself of the difference between the past and present.

A few weeks ago he ended up in the hospital. The nurse started an IV and he saw blood dripping off his fingers, triggering a memory he didn't know he had.

It was as if he wasn't in the emergency room, but in a rice paddy performing a field tracheotomy, his fingers covered in blood. A corpsman was shot. Jones pried the primer out of a spent casing, wrapped it in a bit of T-shirt and popped it into the man's neck so he could breathe.

Jones told himself it was a flashback, told himself that it was OK. He started talking to the nurse, dragging himself back into the present.

When he didn't know about flashbacks, he thought he was going crazy.

"What I used to do is, I'd run," he said.

Talking about what happened is a process, Jones said.

"They send young men to war. They teach them to kill people, but they don't teach them what to do with it afterward," he said.

Post-traumatic stress disorder is a normal reaction to an unnatural event, one involving extreme fear or horror, said Elsbeth Fast, a social worker at Veterans Health Care System of the Ozarks.

Reaction changes thinking patterns. People who suffer from post-traumatic stress may have intrusive thoughts or nightmares, Fast said. They might have an increased emotional or physical reaction to a situation such as sudden anger or tears. They might avoid people, places and things that trigger those memories. The person could be emotionally numb and feel like he or she is on autopilot.

Hyper-vigilance is another telling symptom. Sometimes she'll see a veteran in the waiting room, back to the wall, eyes scanning the room.

Patients can get results in 10 sessions of prolonged exposure, where they recount their experience until it's more like a story they know and less of an uninvited visitor, Fast said. Other therapies can help veterans retrain their brain to know they didn't cause a traumatic event, she said. There are also therapies that help insomnia, Eason said. The hospital's mental health division is adding a therapy called "calm brain training" next month.

About five months ago the hospital added an hourlong orientation for new patients so they understand all the therapies offered. Medication isn't the only answer, and patients can refuse it even if it is recommended, Fast said.

"The veteran drives the bus," she said.

Counseling, biofeedback and nontraditional therapies such as classes in tai chi, art and yoga are available through the Vet Center in Fayetteville, said Tom Miller, team leader. The center provides readjustment counseling for veterans who have seen combat.

"Our largest population is Vietnam vets," Miller said.

Patients asked for the orientation at the hospital, said Jim Hale, of Kingston and a member of the mental health consumer council at the Veterans Health Care System of the Ozarks.

He advocates for new ways to treat post-traumatic stress. This week he tried eye movement desensitization and reprocessing. The treatment took a black cloud and made it a shadow, Hale said.

"It's amazing," he said.

When he was first diagnosed with post-traumatic stress, he received only medication and counseling, Hale said. It took him years to get navigate the system to find help.

Hale said when he was discharged as a staff sergeant from the Air Force in 1969, a Veterans Administration representative came to Saigon and told the men that without a service-connected disability, they wouldn't receive veteran's benefits. Hale knew something was wrong in 1974, and he went to a psychiatrist. Post-traumatic stress disorder wasn't a recognized diagnosis.

"They gave me two bottles of pills and no follow-up appointment," Hale said.

He filed disability paperwork in 1978 and was refused a year later. He started an appeal in 2004 that became a five-year process.

"It was horrible," he said.

Being turned down the first time is standard, Hale said.

The average appeal still takes more than a year, said Stele James, director of veterans service for Benton County.

Most of the applications for post-traumatic stress benefits he sees are from Vietnam-era veterans. James said part of the reason is there are more Vietnam veterans than recent combat veterans. Vietnam veterans are retiring from their careers and have more time to think about the past, he said.

Younger veterans worry a post-traumatic stress diagnosis will keep them from getting jobs, or show up on future evaluations. Medical records are confidential by law, James said. Stigma is a problem. People get the picture that post-traumatic stress is only about depression and violence, he said.

"That's not all of us," said James, who served in Iraq in 2004, 2005 and 2006 with the Arkansas Army National Guard.

Today it's safe for Vietnam-era vets to admit to post-traumatic stress, Jones said.

For enlisted soldiers it's not, he said. It could mean a medical discharge and ruin a career.

Younger soldiers know they will be redeployed, Jones said.

"If you're going back, you keep your PTSD. That's what keeps you alive," he said.

They might come home and not want to get too close to family because they know that next time they might not come home.

Just because a veteran has experienced combat or trauma doesn't mean he or she has post-traumatic stress, Fast said.

Some people may just have difficulty adjusting to civilian life, Eason said.

Transitions home are different for soldiers from different combat eras, Jones said.

During World War II soldiers went and returned as a unit, and the boat trip allowed them to process some of what they saw together, Jones said.

During Vietnam, a soldier could be slogging and shooting his way through the mud one day, then fly home and be sitting at mom's kitchen table like he had never left the next. Raised in a world of "thou shalt not kill," the returning soldier didn't know how to explain a world where every decision, every day, was his life or death. The lack of support can lead to isolation, he said.

"Don't judge me until you walk a mile in my combat boots, and I won't judge you," Jones said.