For Johnnie Larmore, a veteran of three combat tours in Vietnam, living with post-traumatic stress means bursts of anger followed by wells of depression.
Last week, the Port Angeles man left a recently expanded treatment program at VA Puget Sound American Lake Division in Lakewood.
He calls it the best staff and the best facility hes seen in his 41 years seeking help coping with Army combat-related PTSD.
Larmore, 62, spent five weeks in the Mental Health Residential Rehabilitation Program, which now has 64 beds for veterans who need close care but not enough that theyre committed to a round-the-clock in-patient hospital.
Its a well-established program at American Lake, but it has a new polish with a recently completed $7.3 million renovation.
It also added four beds for veterans diagnosed with PTSD, bringing the total to 20. Twenty-four beds are reserved for veterans with substance-abuse problems; 20 others are for homeless veterans who want to rejoin the workforce.
Theres a several-week waiting list for all the beds.
Outside American Lake, the program offers another 24 beds in five homes for veterans making transitions to full-time work. Suicidal or homicidal veterans are admitted to the VA hospital in Seattle.
We have more caring opportunities for PTSD than ever before, said Joel Mitchell, director of outpatient behavioral health programs at American Lake.
The VA on Thursday invited news media to tour the residential program Larmore just completed. The agency wants to show what its doing because its nationwide behavioral health staff is often depicted as overwhelmed by the surge of Iraq and Afghanistan veterans leaving the military.
Last month, the VA announced an initiative to hire more mental health professionals. The VA Puget Sound last year cared for about 4,000 patients seeking care for PTSD.
Vietnam veterans still make up the majority of those patients. But the residential programs at American Lake have a slightly different mix, with about 60 percent of patients having served in Iraq or Afghanistan.
Richard Pollard, director of VA Puget Sounds community and residential care services, said the agency is changing some programs to reflect the requests of recent war veterans.
For example, the VA is trying to condense its PTSD program at American Lake. Normally, it takes about five weeks to complete, with therapy filling about three hours a day.
Recent veterans prefer more intense therapy that would help them get back to their families in less than four weeks, Pollard said.
They might have to take the PTSD or substance-abuse programs several times before achieving a breakthrough that leads to lifelong changes. Some only need one run through the resident program.
We never give up on anybody, Pollard said.
Much of the treatment at the residential program takes place in group therapy. Activities such as fishing and photography also are available.
Larmore said he embraced his opportunity at the residential program to mentor younger veterans dealing with the same issues he faced in the 1970s.
Its about helping veterans who have borne the battle, he said. Some of these guys are coming back having experienced horrific things.
Those traumatic events can cause surprising triggers for veterans if the former service member cant reorganize them into a healthy lifestyle. Larmore said he still can feel the heat of Vietnam in unexpected flashbacks decades after his service.
The anger that can come back over the years can be devastating, he said.
Hes going home to pick up his carpentry and woodworking. Im going continue the process (of healing) the best I can.
Adam Ashton: 253-597-8646