Tina Reiter was treating one of her Iraq War veterans when he got the text message from his mom: an Army psychiatrist with orders to ship to the Mideast, a major no less, had just shot up a room full of soldiers preparing to deploy to war.

"He was clearly stressed," said Dr. Reiter of Maj. Malik Nidal Hasan, charged in the shootings.

She's a little thrown herself.

Tina Reiter was a major in the Army Reserve. She's a psychiatrist. And four years ago she was sent to Iraq on the same kind of mission: treat the psychic wounds of American troops.

"When a soldier gets deployed, it's normal to have an adjustment period where they're anxious and scared," said Dr. Reiter. "What's not normal is hurting someone -- what he did."

As the trauma of Thursday's shooting rampage at Fort Hood settled in at the nation's largest military base, military psychiatrists assessed what it meant to have one of their own engage in the very behavior they are sent among soldiers to prevent. It is a specialty little heralded and known chiefly through actor Allan Arbus' portrayal of Army shrink Sidney Freedman on TV's "M• A• S• H."

"It's a scar. It's an added scar to a military that's already under psychological stress," said Dr. Reiter, who now counsels Iraq and Afghanistan vets at the Veterans Affairs Hospital in Lincoln-Lemington.

The job in the states involves counseling soldiers who suffer from a variety of ailments common to the general population -- from depression to psychosis. Dr. Reiter said there is, understandably, a higher level of post traumatic stress disorder for veterans of wars.

In Iraq, the psychiatrists are stationed with various units. When soldiers can't get to the doctors, they sometimes go into the field, in what she called "walkabouts," just to check on morale.

Sometimes those walkabouts took her to forward positions where mortar fire could reach.

"We would just go talk to them, say, 'How are you doing?' " she recalled.

Sometimes soldiers were debriefed after bombings or high impact incidents.

A major complaint? Insomnia -- something as easily attributable to the eight-hour time difference as the specter of combat.

It adds up, she acknowledged.

"These guys are under a tremendous amount of stress by not sleeping well and being in that adrenaline mode. And they all have weapons," she said.

And rarely do they turn them on their own.

Mental health professionals counseled against drawing too many conclusions about Dr. Hasan's motives and mental state.

But they also warned against assuming that military life, even at the front lines, is a certain ticket to mental illness.

"I think the majority of our soldiers are resilient and are strong and rise to the challenge and do well with the resources that they have -- their unit and friends and families," Dr. Reiter said.

She saw hundreds of troops during her three-month stint with an Army combat stress unit in Iraq. Of those, the prevalent complaints were insomnia and stress -- often as not a stress brought on by separation from home, where issues would arise and they felt helpless to do anything.

Of those soldiers, she sent home only two.

One appeared to have psychosis, a condition she later found he'd suffered before his deployment to the war. Another spoke of wanting to kill a fellow soldier, but he came to her voluntarily to report his problem.

"I really think the war has problems associated with it: adjusting to it. And there are a number of people that develop post-traumatic stress disorder," she said. "But does it make you psychotic? I don't think so."

What fueled Dr. Hasan's psychosis is the matter of much speculation.

Clyde Flanagan, who spent decades as an Army psychiatrist, said Dr. Hasan's reported unhappiness over his field tour -- first from Washington to Fort Hood, then on to the war zone -- seems to be one potential factor.

"We refer to it as a hostile depression," said Dr. Flanagan, now in private practice in Columbia, S.C.

"My inference is that he was depressed and angry and when you get depressed, you don't think clearly."

That, of course, is an inference, as Dr. Flanagan stresses.

"There's just too much to guess about here," said Norman M. "Mike" Camp, a former Army psychiatrist who spent time in Vietnam and now lives in Virginia.

He cautions against any generalizations if only because Dr. Hasan's profile doesn't match the ordinary.

"You are not going to get many Muslim military psychiatrists who are going to be deployed to Iraq and Afghanistan," said Dr. Camp.

What confounds all of the experts was an Army psychiatrist turning his weapon on soldiers facing the same trauma he apparently feared.

"If he were to have seen lots of military individuals suffering from re-entry problems, his sympathies would have been drawn to those people," said Dr. Camp. "But instead the people he apparently shot were people about to undergo that same experience -- a foreign deployment."

Washington correspondent Daniel Malloy writes the "Pittsburgh On The Potomac" blog exclusively at PG+, a members-only web site of the Pittsburgh Post-Gazette. Our introduction to PG+ gives you all the details.