Having each other and a community that cares has proved useful to the survivors of and responders to the Jan. 8 mass shooting.
Keeping busy has helped, too.
While many survivors reported significant anxiety after the shooting, and at least one suffers from post-traumatic stress disorder, the balm of communal understanding has been soothing.
"They've been a tremendous source of comfort to us," said Ken Dorushka, who was shot in the arm while shielding his wife, Carol, from the gunfire. So, Dorushka said, has "knowing that people care for all of us that were injured that day."
That hasn't stopped anxiety from welling up in many of the survivors over the year since the shooting. They've experienced a typical variety of responses from sleeplessness to flashbacks to depression.
After such a traumatic experience, many people will have symptoms, such as difficulty sleeping, fear, anger or sadness, said Dr. David Benedek, an Army psychiatrist at the Uniformed Services University of the Health Sciences in Bethesda, Md. Fewer will suffer more serious symptoms and the smallest group face more persistent problems such as post-traumatic stress disorder or major depression.
Ron Barber, who was shot in the upper left leg and cheek, has found himself in the worst-hit group, diagnosed with PTSD.
"For the first two months after the shooting, I had nightmares two, sometimes three times a night, re-living the shootings," Barber said. "Until early March, I only slept two or three hours uninterrupted."
"For the first few months, I was observing myself, Gabe, Gabby, John Roll being shot, Barber said. "It was like watching a movie."
Three main categories of symptoms characterize post-traumatic stress disorder, said Patricia Haynes, a psychologist and assistant professor of psychiatry at the University of Arizona:
• a tendency toward "hyper-arousal" - panicking at the sound of a loud noise, getting little sleep, outbursts of anger, among other signs.
• avoiding reminders of the traumatic event, including seeing affected people, talking about memories, going to places that recall the trauma.
• recollecting the event through nightmares, unwanted playbacks of the event, flashbacks, among other symptoms.
For the symptoms to be categorized as PTSD, the victim must have been present at the traumatic event and the symptoms must persist for than 30 days.
Barber began treatment for PTSD about two months after Jan. 8, he said, and got his first good night's sleep soon thereafter. The dreams dissipated but have returned in recent weeks as the anniversary approached.
For Dr. Steven Rayle, who helped hold down the shooter and treat victims at the scene, flashbacks and other symptoms began three or four weeks after the shooting. After a while, he made a conscious decision to move on.
"I don't like when people bring it up and want to talk about it now. I don't want to talk about it. It makes me feel uncomfortable," Rayle said. "At the present time, it's sort of non-operative. I don't know if it's a healthy place, but I've just sort of quashed it down."
Sara Hummel Rajca, a former Giffords employee who was working at the event that morning, recently watched an interview of herself from the days after the shootings. She couldn't believe how smooth her delivery was. "I realize now how much in shock I was afterward," she said. "It was like it didn't happen, sort of. I wasn't there yet."
Ironically, she didn't arrive back at the truth of the experience until after she moved across the country to South Carolina in March. Reunited with her husband, who had moved there earlier for a job, she began to have sleepless nights and eventually went on sleeping medication.
Now "I can get stuck in a funk, but I don't go through that 30 seconds over and over in my head," she said. "There's a conflict between not wanting to forget and not wanting to relive it over and over again."
What Hummel Rajca has missed by being 2,000 miles away is the activity and communion that fellow survivors have shared.
For Barber that's been good medicine. He's started a foundation, started working half-time and engaged in numerous activities with survivors.
"I'm pouring myself into that, because I think that's what I'm supposed to do," he said. "The busy-ness has been therapeutic for me."
Suzi Hileman, who brought 9-year-old Christina-Taylor Green to the Giffords event and was shot three times herself, faces frequent anxiety. At a December press conference announcing upcoming anniversary events, the symptoms were there:
"I showed up here, and the first thing I thought was, 'Where's the security?'"
But like Barber and others, she's tried to keep active, "staying busy, but not with mindless busy-ness."
"I think I'm healing by spreading the love. Otherwise I'd be on my couch with a blanket pulled over my head."
For Ken and Carol Dorushka, being home wasn't a bad thing - it was the only thing.
"Staying at home and being around family and friends was the modus operandi for a long time," Dorushka said.
Then bit by bit they ventured out, sometimes to see others who had been through what they'd been through. That's been scientifically verified to be helpful, said Benedek, the Army psychiatrist.
"Across most studies of post-traumatic recovery, one of the common denominators is social support and connectedness," he said. "It's good to talk with other people who have been in the experience and understand the experience."
The approach of the anniversary undid some emotional recovery for some survivors. Many reported gradually recovering in the months after the shootings, only to start suffering symptoms again in recent weeks.
"We probably gradually got better, up until shortly before the holidays again," Ken Dorushka said. Then, he said, there was "the recollection of the fact that January was approaching and the fact that so many families were going to be without their loved ones."
Roger Salzgeber has grown tired of the reporters' calls and the constant reminders of Jan. 8.
"I am looking forward to Jan. 9 in a huge way," he said. "I would just like to put this in my rearview mirror."
Contract reporter Tim Steller at 807-8427 or firstname.lastname@example.org