At the Dallas-Fort Worth National Cemetery, we encountered Cheree Barrett as she uttered an especially emotional, “Hello Jame.’” The greeting came exactly a year after Cheree said a final goodbye, “I know I am never going to be over it. I miss my son every day. And I am so proud of him," she said.

Her son, 33-year-old Army Sergeant James Barrett, served two tours in Iraq. She says he came back much different than he was when he left, “When he walked up to us I looked at him and thought oh my God, I am never going to have my son back. He just looked like he wasn’t living in the same world I lived in anymore.”

She says James was diagnosed with Post-Traumatic Stress Disorder, “He couldn’t sleep. He had nightmares every night. The people who had died in his unit, he felt they would come back at night to talk to him.”

Cheree went with him to speak to a VA case manager, “I sent him off somewhere to get something and I looked at her and said he cannot come back home the way he is.” She says James started getting treatment, but backed out because he didn’t like group sessions. He would talk to his mom about his struggles, though. She remembers one call she got from him while she was at work, “He is telling me all this information and I don’t know what to do. I have to stay here but I feel like he needs me so I listen to him talk and he tells me about war time and all the things he has seen and it was really tough that I can’t be there and hold him as if he were my baby again."

In some ways post-traumatic stress can be harder on the family than on the person who has been diagnosed, says Dr. Madhukar Trivedi of the Psychiatry Department at UT Southwestern, “Their immediate family sees it personally and it is very disruptive. They feel more helpless than the person actually going through it. They are the first ones to notice changes in the person, changes in their behavior; whether there are anger outbursts more, they are not sleeping well, they are more withdrawn, they are not meeting with buddies or loved ones. That should be a tell-tale sign and families should not be fearful of addressing that…of almost confronting the person and saying we notice this…let’s get an evaluation. The earlier you get an evaluation the better it is, and not wait until it becomes much harder to treat.”

Cheree felt helpless every night when her son would get his gun and go through the motions of a troubling new routine: “He would go out at night on patrol. He would tell me he was going outside and he did. He would walk around our house on patrol making sure everything was secure--the cars were secure, the dogs were secure, everything was fine. I stayed up until he got through with that. He would go out three or four times a night.”

Those are some of the classic symptoms of PTSD, says Dr. Trivedi, “The re-experiencing of trauma or the war situation is there. There is also significant vigilance or alertness so they are always perceiving something of a threat.”

Cheree was certainly worried about her son’s behavior. But we couldn’t tell when we first met her in May of 2016. She and other mothers of military members, known as Blue Star Moms, were making care packages for troops overseas, even though their own kids had returned safely.

But in fact Cheree’s son wasn’t safe. Just a couple of months after we met her, she says he went on one of his armed nighttime patrols outside the family home and never came back in.

“The next thing I know there is a real loud knock on our door and I was like who is at the door," she said.

She recounts that it was a deputy who was responding to a suicide, “He was telling us our son was in the front yard and I said what are you telling me? And I thought he was going to tell me he had been taken to the hospital or something like that and he said I am telling you that your son is dead in the front yard. And of course I just lost it”

A fellow Blue Star Mom came immediately, “She was there. Before hour was up she was there and she came in and took care of me, talked to the other moms, and had it all organized for people to come be with me. And isn’t that what family does? I love those women and those women love me.”

But In the year since, she says some of the moms she has been close to and even some parents she didn’t know before, have also come to her, “Saying I need help. My son is spiraling out of control and I don’t know where to go or who will help.”

They’ve recognized a problem just like she did. Dr. Trivedi says awareness about PTSD has improved. “People are beginning to understand this is a brain disorder and needs treatment--that this is not some kind of a weakness.”

According to the Subcommittee on Disability and Memorial Affairs of the House Committee on Veterans’ Affairs, a Veterans’ Benefits Administration official recently testified that, “there are currently over 940,000 veterans who are service connected for PTSD and receive a monthly benefit payment. This population equates to approximately 22 percent of all Veterans receiving disability compensation benefits. This is a 172-percent increase compared to the end of fiscal year (FY) 2008, when approximately 345,000 Veterans were service connected for PTSD. The increase is a result of the veterans increased awareness and understanding of PTSD and several associated changes VA has implemented.”

Still, in part because there is a stigma associated with PTSD, it can be difficult to convince a loved one that they need help. Dr. Trivedi recommends a comprehensive effort, “If you cannot convince them I suggest you find other people to talk to them and help them so that it is not just the mother and the father or the brother or the spouse convincing them. It is the friend or the neighbor or anybody who can help them because not getting treatment is worse than confronting the person.”

Ultimately, he adds, “The goal of treatment should be kept in mind so that we are aiming to get better, aiming to go back to work, aiming to actually reintegrate into society. Those three goals need to be kept in mind but the treatment can vary depending on where the patient is. “I think one of the other mistakes we make as a healthcare field is that we think there is a one size fits all…that there is one kind of help and that if the patient doesn’t accept it, they don’t accept it. There are many modalities of treatment and we should be offering that to the patient.” And he cautions, “like any other brain disease or chronic medical disease, it gets better but that doesn’t mean it stays well. There are ups and downs and we have to expect that and be ready to intervene if it happens.”

Cheree says she and her family tried repeatedly to help James. After the devastating loss, she is now trying to help other families cope with PTSD. She recently staged a run in Abilene to raise money for the newly created James R. Barrett Foundation to assist other PTSD families.

“I have to think that somewhere down the line God is using me and the death of my son to help other people. And I think ‘Jame’ would want that," she said.

But one year on, even that doesn’t make the final goodbye any easier. We watched a mom at the national cemetery tell her boy goodbye after marking the somber one-year anniversary of losing him, “I love you son. I wish there was a way you didn’t have to be here,” she said, voice wavering, before leaning down and kissing his grave marker.