Nov. 7--An Army major suspected of killing 13 people and wounding 30 Thursday at Fort Hood, Texas, was one of the people whom soldiers with combat stress talk to when they return home.

It was the job of Army psychiatrist Maj. Nidal Malik Hasan to counsel and treat soldiers who suffer from post-traumatic stress disorder.

But listening to troubled soldiers day after day can take a toll, even on mental-health professionals.

"Helpers don't always have the chance to help themselves or aren't always good at it," said Jeremy Kaufman, director of psychological health for the Ohio National Guard.

"Sometimes we have to take a step back."

He said the Guard created a program to ask mental-health professionals questions about how they're coping with the stress of their jobs.

"There are some pretty intense stories, and it's up to you to make sure you're taking a care of yourself," Kaufman said. "But the focus is on the vet or the service member to get help."

There are circumstances when mental-health professionals take on the stress of their patients. It's called secondary trauma or compassion fatigue.

"When you work with traumatized individuals, over time you can develop symptoms of post-traumatic stress disorder yourself," said Dr. Radu Saveanu, chairman of psychiatry at Ohio State University.

"They start to identify with the victims, and that can happen over prolonged periods."

Saveanu said secondary trauma can occur in other professionals, such as lawyers or medical personnel who work in intensive-care units and emergency departments.

People who can't deal with the stress of their patients can experience burnout, and often leave their jobs. Those who stay might development defensive mechanisms to deal with the stress, lose interest in their jobs or, in some cases, develop depression.

"It's a known syndrome," Saveanu said.

Kathleen Chard, PTSD and anxiety-disorder division director at the Cincinnati Veterans Affairs Medical Center, said counselors worn down by their patients should talk with other therapists. "Take time off. All those things that I tell my clients, I'd tell other therapists," she said.

Those things include eating right, getting rest and exercise, and having hobbies.

Chard said she makes sure her co-workers get all those things -- plus take their vacation days and go to conferences -- so they can stay healthy to help veterans.

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