NEWTOWN -- It can be as routine as the sound of a siren or as innocuous as the sight of a child's lunch box.
But for those who saw first-hand the unspeakable carnage on Dec. 14, even everyday sights and sounds can bring those traumatic memories flooding back.
More than three months after Adam Lanza shot and killed 20 first-graders and six staff members at Sandy Hook Elementary School, police officers continue to feel the after effects of the tragedy and find themselves unable to properly perform their duties.
One officer has been unable to work since shortly after the shootings, and as of last week, four were on sick leave, Police Union President Scott Ruszczyk said.
But two of them were different than the four who had been out a few weeks previous, and several officers are being treated for Post Traumatic Stress Disorder, an anxiety disorder that can develop after a person has been exposed to a psychologically traumatic event.
The yo-yo effect has been going on for months, as officers think they are able to return to their jobs, eventually realize they aren't, and have to go on leave again, he said.
Symptoms include reexperiencing the original trauma through flashbacks or nightmares and people suffering from it can also have difficulty falling or staying asleep.
They can also become easily angered, said Michele Novella, a psychiatric nurse practitioner with a private practice in Danbury, who has treated many patients suffering from PTSD, including combat veterans and first responders in the Sandy Hook tragedy.
For each of the officers, what sets off the memories is different.
"It could be anything from the sound of siren coming up behind them to seeing a lunch box or a pool of blood that makes them remember.
"It doesn't have to be something traumatic that triggers it," Ruszczyk said.
A bill recently approved by the Legislature and signed into law by Gov. Dannel P. Malloy provides short-term financial relief to the affected police officers and other first responders who are unable to return to work.
The Sandy Hook Workers Assistance Program will be privately funded and administered by the Office of Victim Services within the state's Judicial Branch, and pay them up to 70 percent of their salaries for 52 weeks, if they are unable to work.
"They should start to process the applications as of April 1, and that's going to be helpful," said Eric Brown, attorney for Council 15 of the American Federation of State, County and Municipal Employees, which includes the Newtown Police Union.
But union leaders are also concerned about those who may be affected for longer periods, and are still pushing for a change in the state's workers compensation law that would treat PTSD like any other workplace injury.
"But even if they get the long term bill passed, that bill probably will not be retroactive," Ruszczyk said. "We're still going to have to find a way to help these guys who are suffering beyond 52 weeks."
Fortunately, PTSD "is positively treatable," Novella said.
A variety of therapies have been proven successful, including training in stress-relieving techniques, dietary supplements and exercise, she said.
"The sooner a person experiencing the traumatic event seeks care and treatment, the higher the likelihood they will experience full or near complete recovery. Think how this didn't occur after Vietnam," she said.