For veterans and others struggling with addiction or depression, a winding down of hostilities in Iraq could be just the beginning of an effort to tamp down demons unearthed by war.

Images of U.S. tanks rolling through Baghdad and toppled statues of Saddam Hussein could ease anxiety, but many people won’t easily be able to shake off visions of bombs and bloodshed, say mental health experts.

The war in Iraq has caused many veterans with post-traumatic stress disorder to enter a hypervigilant state of watch, said Bridget Cantrell, a Bellingham mental health counselor who treats veterans with PTSD and their families.

“They’re glued to the TV. They’re wanting to kind of hunker down and wait to see what happens,” said Cantrell, noting some of her patients are stockpiling food and ammunition in anticipation of a conflict closer to home.

“They’re wondering, ‘Is there something lurking that hasn’t occurred?’ ” she said. “It’s like the calm before the storm.”

Vietnam War veterans especially are inclined to be skeptical, Cantrell said. A prolonged conflict, dissension at home and the lack of a successful resolution in Vietnam have left many veterans of that war suspicious of the government’s intentions.

“They’re still apprehensive and saddened by all this,” said Cantrell.

To combat war-related despair, Cantrell has a box in her office where patients can donate lip balm, videos, chocolate bars and other items for the Red Cross to distribute to American troops in Iraq. She’s also passing out lists of Web sites for patients to contact the troops.

“This is a healing thing for my veterans,” she said.

Others who treat veterans with PTSD say their patients are also experiencing intensified symptoms, including nightmares, difficulty sleeping, excessive attention to war news, irritability and unwanted memories.

At the Veterans Administration Puget Sound Health Care System, which provides inpatient and outpatient medical services for veterans throughout the area, officials say they’ve seen an increase in PTSD symptoms since the war started.

“It’s not true that it’s just business as usual,” said Miles McFall, director of PTSD treatment programs at the VA.

And veterans aren’t the only ones in pain.

Callers to King County’s mental health crisis hot line are reporting more acute stress- and depression-related symptoms, including thoughts of suicide, severe panic attacks and domestic violence.

The perpetual threat of terrorist retaliation will continue to fuel high levels of anxiety, said Kathleen Southwick, executive director of the Crisis Clinic, which operates a 24-hour mental health crisis hot line for King County.

“In many ways, that’s more real,” said Southwick. “The war is over there.”

Teenagers and adults with drug and alcohol addictions are also relapsing at higher rates than usual since the war began, said Ramona Graham, substance abuse program manager at the Center for Human Services in Shoreline.

Many of the teens Graham’s agency treats say they feel hopeless in the face of continued warnings of terrorism and the prospect of U.S.-led wars in other countries.

“They’re saying, ‘Why should I even try to stay clean and sober? We might be blown up,’ ” said Graham.

Rick Hartwig, a Vietnam veteran who repaired engines on river patrol boats for the Navy, was diagnosed with PTSD in the early 1980s. Cotton candy reminds him of the smell of Napalm. Fire and smoke trigger memories of an onboard fire that killed two of his buddies.

Lately, images from Iraq have brought his war back, making sleep difficult.

Hartwig skims headlines and tries to stay away from television news. “I don’t want to get into the details of it.”

Still, Hartwig, who grew up in Bellevue and left for war right after high school, is keeping his PTSD symptoms in check these days.

Two weeks ago, he started the first full-time job he’s had in 15 years.

But memories resurrected by the war won’t soon fade.

“The war’s over, but it’s still going on inside your head,” said Hartwig, 57. “That doesn’t go away.”

TIPS AND RESOURCES

Veterans and others who experience or witness a life-threatening event can develop post-traumatic stress disorder, and traumatic events, such as the war in Iraq or terrorist attacks close to home, can trigger symptoms. While there is no cure for PTSD, symptoms can be managed with counseling and lifestyle choices, say mental health experts.

COPING:

Limit the amount of time you spend each day exposed to war- and terrorism-related information.
Take part in activities unrelated to the war, such as hobbies or exercise.
Seek support from family and friends.
RESOURCES:

1-866-427-4747 or 461-3222 from the Seattle area. A 24-hour hot line to report mental-health crises in King County.
crisisclinic.org is a Web site offering tips for recognizing and coping with war-related stress.
www.dva.wa.gov is the Washington State Department of Veterans Affairs Web site, which provides an explanation of PTSD and a list of counselors available around the state. Or call 1-360-586-1076.
Seattle Vet Center is a program of the Federal Veterans Administration that offers group and individual counseling for combat veterans. For information, call 206-553-2706.
P-I reporter Julie Davidow can be reached at 206-448-8180 or juliedavidow@seattlepi.com

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