His name is Valor. He's half Labrador retriever, half Great Dane, and goes everywhere with Sgt. Charles Hernandez. But Valor is more than a pet -- Hernandez considers the dog a personal physician.
When Hernandez was having seizures, Valor would nibble on the side of Hernandez's leg before the veteran realized anything was wrong. And the dog pulls him away from conflicts and jumps on him during anxiety attacks to calm him down. In combination with medications, Hernandez says the dog has helped his symptoms of post-traumatic stress disorder.
"I'm alive again," says Hernandez, 49, of the Bronx, New York, now retired from the U.S. National Guard. "What keeps me going is my dog."
A growing number of Americans are getting dogs for mental health needs, experts say. In the case of psychiatric service animals, such as Valor, they are trained specifically to help people with mental illnesses, in much the way seeing-eye dogs are taught to help to blind people.
PTSD in returning veterans is a major reason for the increasing demand for these dogs, said John Ensminger, a New York attorney and author of "Service and Therapy Dogs in American Society."
Unlike guide dogs for people with more obvious physical disabilities, there's a lot of gray area regarding who gets to have a dog accompany them to places -- from restaurants to stores to airplanes -- where animals are usually not allowed.
Why people get psychiatric service dogs
There's pretty good evidence that in some people, interacting with pets produces biochemical changes in the brain, says Hal Herzog, professor of psychology at Western Carolina University.
"In a way, we could all use a psychiatric service or therapy dog because of the incredible amount of stress that we're all under," says psychiatrist Dr. Carole Lieberman, author of "Coping With Terrorism: Dreams Interrupted."
Caring for a pet helps people become less frightened, more self-sufficient and secure. It takes the attention off their own fears, she said. Through owning a pet, you can "prove to yourself that you can take care of another living creature," she said. It "reassures you that you can take care of yourself."
Several categories of dogs that provide care to people with mental health issues have arisen, as the organization Heeling Allies describes:
The first is psychiatric service dogs, which is where Valor falls. These are individually, intensely trained dogs for people with mental disabilities. The Psychiatric Service Dog Society has extensive information about these dogs and how to get a dog trained. Heeling Allies calls them "mental health service dogs" because of the stigma associated with the term "psychiatric."
Then there are emotional support dogs, which provide comfort and motivation to people with disabilities. They may be taken on planes and live in housing situations where animals are not usually allowed, with proper documentation.
Finally, there are therapy dogs, which help a large group of people. For instance, Ensminger's dog Chloe is a therapy dog, and he voluntarily takes her to hospitals to comfort patients.
One of Lieberman's recent patients, for whom the psychiatrist wrote a letter to help a dog get certified, was a woman whose husband has a serious, progressive medical disorder, and she felt stretched to the limit taking care of him.
Her standard poodle "provided the emotional support when she was out of the house without her husband, that her husband used to provide," Lieberman said.
Another patient, also female, is undergoing stress because her home was put in foreclosure. She's also involved in a lawsuit and a countersuit regarding the potential loss of her multimillion-dollar property, Lieberman said.
The woman has to travel a lot because her children live across the country, and her mental state is such that sometimes she can't get out of bed. In this case, Lieberman compares the therapy dog to a baby blanket: evoking feelings of warmth and being taken care of. "It reminds her of when things were less traumatic," she said. "It's a tie to the past."
Hernandez joined the National Guard in 1996 and was one of the first responders at ground zero on September 11, 2001. He was deployed to Iraq from 2004 to 2006.
While in Iraq, Hernandez suffered a spinal cord injury that limited his ability to walk and a traumatic brain injury. Inside, he had changed, too. He became violent and agitated. And he had nightmares, uncomfortable thoughts and dreams.
"Not all wounds are visible," he said. "That's how I explain it to people."
Hernandez received a service dog in 2010 through Project HEAL, part of ECAD, an organization that trains and breeds assistance dogs. Project HEAL sets up veterans with PTSD with service dogs. Hernandez still volunteers with Project HEAL.
"He knows if something is wrong, and I can't figure it out," Hernandez said of Valor. "The dog has the extra Spider-Man sense." Hernandez still takes medication for PTSD.
Paul Aragon, a 29-year-old retired veteran, also has PTSD, but his only treatment is his service dog. Aragon got his service dog, Zoey, in October after his medication stopped working. Zoey "keeps me calm," he says.
Aragon, who studies motorcycle mechanics at Universal Technical Institute in Orlando, takes Zoey everywhere: dinner, movies, plane trips, even sometimes to school.