There are times when Trinette Johnson's life seems to stall, when she finds herself staring at the ceiling fan in her bedroom, watching the blades spin, her mind hung on nothing -- not her receptionist job, not her fiance, not her ailing father or her four children.

Not even the war.

The war, of course, is always there somewhere, she said, an unseen force in her life, sometimes producing moments of blank detachment, sometimes stirring up anger like nothing she has ever known.

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More than two years after returning from duty in Iraq, she has found herself yelling and cursing at other drivers on the road. Panicked in crowds. Seized with fear at the sight of highway overpasses and tunnels that might suddenly explode.

Doctors gave the 32-year-old Johnson, who served in the D.C. National Guard, a diagnosis of post-traumatic stress disorder, which has plagued thousands of U.S. troops after combat in Iraq -- bringing on flashbacks, numbness, rage and anxiety and leaving many at odds with their old lives, families and jobs.

More health coverage
How women are affected after combat is only starting to be probed. This is the first war in which so many women have been so exposed to hostile fire, working a wider-than-ever array of jobs, for long deployments.

"This is a really unique experience, and we just don't know," said Ronald C. Kessler, a Harvard University professor and author of a landmark study of post-traumatic stress disorder.

'It's not the same mommy'
For women who are mothers, combat-related PTSD may have added significance. Often, after war, "it's not the same mommy who left," said Yale University associate professor Laurie Harkness, who runs a Veterans Affairs mental health clinic in Connecticut. Although the same can be said for fathers, she said, "mothers in general are the emotional hub of a family."

For Johnson, it was a doctor at Walter Reed Army Medical Center who first uttered the letters P-T-S-D, a defining moment that came after she spent nine months working the bomb-blasted roads near Baghdad. Her job with the 547th Transportation Company was hauling -- troops, supplies, equipment -- and security. At one point, she helped transport dead Iraqis to their wailing relatives.

In one particularly bad period, a roadside bomb claimed the life of a 21-year-old soldier in her unit, Spec. Darryl T. Dent. Later, another bomb severely wounded Johnson's best friend, Spec. Antoinette Scott, a mother of four.

That fall in 2003, Johnson was riding in a truck with her M-16 rifle pointed out the passenger-side window. Out of nowhere came a deafening blast. Her five-ton vehicle swerved and nearly flipped. There was fire. White smoke. Flying debris. A bomb, hidden along a guardrail, had detonated.

Johnson received a Purple Heart for hearing loss in her left ear but stayed in Iraq for several more months, working the same roads. "It seemed like once every other or three days somebody was getting hit," she recalled recently.

But the enemy was elusive. She never fired her M-16.

Unexpectedly, in January 2004, she was shipped home three months early, sidelined with severe kidney stones. Later, at Walter Reed, the dreams started: violent dreams, with exploding mortars and hordes of barking dogs. She mentioned them to a doctor.

This was while she was living on the hospital grounds, seeing specialists and worrying about whether anyone in her unit had been injured or killed. She called her unit in Iraq every day. But she had not seen her kids.

A counselor prodded her to visit them -- three were being cared for by Johnson's sister in Falls Church, and one was in Richmond with the child's paternal grandmother. None of the children lived with their fathers.

"Mommy! Mommy!" her youngest daughter, then 2, shrieked during a visit in Falls Church, climbing all over her.

Johnson had been a mother since she had her son at age 14. Now she felt overwhelmed. She rose to leave.

"I can't do this," she told her sister.

In her car, she sobbed, wondering how she could feel so disconnected. "I realized that I just walked out on my babies."

Unprecedented risk
In nearly 3 1/2 years of war, more than 137,000 female troops have served in Iraq and Afghanistan, some exposed to the most profound stresses of combat: ambushes, mortars, bombs, fallen comrades. They have fired M-16s and grenade launchers, killed people and been shot at.

As these women have returned home, Army researchers studying the psychological fallout of Iraq have noted a surprising trend in early studies: Women appear to be showing symptoms of post-traumatic stress disorder and other mental health troubles at roughly the same rates as men.

If this result holds true, it would stand out because women studied in the overall population show markedly higher rates of post-traumatic stress disorder than men -- about twice as much.

"It's not definitive, but it's encouraging," said Patricia A. Resick, director of the Women's Health Sciences Division of the National Center for PTSD, part of the Veterans Affairs Department. Resick said more research is needed.

While studies of the war's effects continue, one fact is clear: A generation of U.S. military women is at risk of combat-related stress disorder as never before.

A recent study showed that, overall, more than one in three U.S. troops sought mental-health care in the year after returning from Iraq. An earlier study found that about one in six showed signs of PTSD, major depression or anxiety after Iraq.

"From our data, what it looks like is that women serving in combat have the same risk as men of getting PTSD or other mental health conditions," said Charles W. Hoge of the Walter Reed Army Institute of Research.

For Johnson, treatment at Walter Reed made things better, with group sessions, art therapy and combat-stress counseling. "You're in there with other people who are going through the same things," she said, "and you kind of feel like, 'Okay, now I don't feel crazy.' "

The most wrenching day, as she remembers it, was when she was sent home: Oct. 3, 2004. No longer did she have the supportive environment of the hospital. She was on her own, medically discharged from the military because of the stress disorder.

Outwardly, Johnson looked much the same: bright eyes peering through delicate glasses, big smile, always seeming on the verge of a laugh. "Dee," everyone called her. But much had changed. "I don't even know this life," she said one day.

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