Post-traumatic stress disorder is usually associated with soldiers returning home from war. But experts in psychological trauma say they now see the condition in residents of Oakland and other American cities with high rates of gun violence. Unlike soldiers returning home from the battlefield to relative safety, though, there is no safe place to escape for those traumatized by violence in their own community.

While business may be thriving downtown, now home to high tech tenants such as Uber and Pandora, residents living in marginalized Oakland neighborhoods east and west of downtown say their communities are seeing little of that economic growth, and worry a lack of opportunity means no escape from the cycle of violence and trauma.

"It’s absolutely true that people [in Oakland] have PTSD, but it’s not the same as a soldier," said Anne Marks, the executive director at the Oakland non-profit Youth Alive! "A soldier goes to war and they come home and they’ve left the battlefield. We work with young people who get shot, go to the hospital, get their treatment, and go back to the same community, maybe the same home they were shot in front of. Maybe there are bullet holes in the door. So there’s no ‘post’ in the traumatic stress. It’s continuing traumatic stress disorder, and that’s unique."

NBC Bay Area’s Investigative Unit spent six months in Oakland visiting with residents, interviewing health experts and speaking with the perpetrators and survivors of violence, finding the effects of this trauma have had a profound impact on many Oakland neighborhoods and the people who live there. The consensus was that gun violence has touched far too many lives in Oakland, but those affected by violence have the most power to break the cycle for a new generation of Oakland youth.

"I absolutely have PTSD”

John Jones, 41, stands in front of the former headquarters for the Safeway supermarket chain at International Boulevard and Seminary Avenue. The building, now more or less abandoned and tagged with graffiti, is where Jones’ grandparents worked in the 1960s. They owned a home three blocks away and raised a family with the income those jobs provided. Jones says those job opportunities dried up a long time ago.

"There was money here," Jones said. "It moved out. This part of town they call deep East Oakland, the further removed you are from downtown, the further East you go. The deeper east [it gets], you’ll see the transition in these neighborhoods."

Jones works as an outreach coordinator at the Ella Baker Center for Human Rights in Oakland.

But years ago, his life used to be much different. Jones said that when he was younger and growing up on these streets, he got involved with drugs and guns, eventually serving time for his involvement in a gun homicide when he was still a teen.

"I never fathomed the idea that I could go to college," Jones said. "Never thought about that. What was in front of us was drugs."

The psychological toll of growing up in a neighborhood with few opportunities and a lot of violence began early for Jones. He can still vividly recount the time, as a kid, seeing a dead body lying in the street outside his apartment for eight hours before anyone removed it.

"When you see a human being lying in the street dead for eight hours, talk about just being devalued," Jones said. "I can’t imagine a dog lying there for eight hours without somebody coming to scoop the dog up. So when you start seeing that, you start to make connections in your young, but still forming mind, about this idea of being black in America."

Stephen Stock tours East Oakland with longtime resident John Jones.

When crack cocaine hit the streets in the 1980s, Jones said drug dealers were the only ones making any money, becoming larger than life figures for the kids growing up there. He remembers watching the funeral procession for one of the city’s most notorious drug kingpins.

"I was 12 years old," Jones said. "And you would have thought that this was the funeral of the president or a movie star or something. He had a clear casket and he had all of these black horses pulling the casket."

But when the drugs came, the violence took on a new intensity.

Gun fire was so common that Jones and his friends could identify weapons based on their sound alone. It didn’t take long to become a target himself, Jones said, describing several close calls where he was almost shot.

As Jones looks back on all of those traumatic experiences, he doesn’t hesitate when asked if he suffers from PTSD today.

"Absolutely, without a doubt," Jones said. "If I got into a restaurant or a store or business, I can’t sit with my back turned to the door. I can’t sit with my back to a window. Even when I’m out on the streets now, I’m looking around, I don’t like having my back to traffic. Just too many stories about people getting shot in the head."

While Jones walked through his East Oakland neighborhood, he ran into Tim Smith, who also went from being in a gang to becoming a community organizer in Oakland. Smith’s family grew up in East Oakland too and he now raises 8-year-old son there. He worries about the violence his son has already been exposed to.

"He’s seen five dead bodies now in East Oakland," Smith said. "My little guy, and he’s eight. I mean you come out of the store and the body is on the ground and you’re telling your guy, ‘Hey, look over there.’ It’s unescapable."

Signs of PTSD

Mental health experts who spoke at length to NBC Bay Area for this series, say they see clear evidence of PTSD among Oakland residents. It’s a common phenomenon in many of America’s more violent cities.

As NBC Bay Area’s Investigative Unit reported in 2014 in a partnership with the independent investigative group, ProPublica, researchers in Chicago reported more than half of all gunshot wound victims treated at Cook County Hospital had signs of PTSD. And a federally funded study of nearly 8,000 residents living in Atlanta’s most violent neighborhoods found about 30 percent had symptoms consistent with PTSD, a rate as high as or higher than veterans returning from war.

The evidence shows that this issue is also divided along racial lines.

According to a 2013 Kaiser Family Foundation health tracking poll, African Americans are far more likely to know a victim of gun violence or be personally worried about gun violence than white respondents. The poll found 42 percent of African Americans personally knew someone who has been the victim of gun violence, compared to only 15 percent of white respondents. African Americans were also more than twice as likely to be personally worried about gun violence, the research found.

Behind the scenes look into the challenges that come along with raising children in East Oakland.

Jones said trauma begins at a young age for kids living in Oakland’s violent neighborhoods.

"It doesn’t start when you’re 18," Jones said. "It starts when you’re six, seven, eight [years old]. Because by the time you’re 18, you’ve had teen years’ experience of what it’s like to not be valued as a person. And I’m talking from every institution in your community, from the corner store to your school. So there’s two things you can do. You can either turn it inwardly, maybe do drugs or commit suicide, or you do it outwardly and then you begin to hurt other people."

Data shows that gun violence is a daily occurrence in Oakland. The gunfire detection system ShotSpotter captured, on average, nearly ten incidents of gun shots fired per day in the first nine months of 2015, which is the most recent data available.

Of the 30 homicides in Oakland between August 2015, and February 4, 2016, all but five occurred in east Oakland or west Oakland. In east Oakland, the vast majority of those murders happened along or near the International Boulevard corridor where Jones grew up. The clusters for other gun crimes and assaults are very similar. According to data from the US Centers for Disease Control, homicide by firearm is the leading cause of death for African American men between the ages of 15 and 34. 2015.

Heat Map of Gun Crime in Oakland

Not the same as a soldier

Staff at the Oakland non-profit group Youth Alive frequently sees the effects of trauma on Oakland residents. The organization has a crisis response team that visits every family victimized by gun violence in Oakland, often before police finish their investigation. Marks, the organization’s executive director, says the kind of continuing PTSD suffered by some inner city residents is different than the PTSD suffered by a soldier returning from war.

Marks says that some of the symptoms and results of this trauma seen in Oakland’s victims includes impulse control, the ability to focus and the ability to differentiate between real and perceived threats. Marks said she sees a direct connection between trauma and the violence on Oakland’s streets.

"People talk about trauma as something that’s really interconnected to violence and some people talk about it as the result of violence," Marks said. "But I would say that trauma is really the root of violence in many ways."

Prolonged exposure to violence is not something that the human mind is built to withstand, Marks said, although it’s something many growing up in Oakland are forced to deal with.

"We had a young man that worked with us who did a couple tours in Afghanistan in the army," Marks said. "Came back unharmed, got shot here in Oakland. So it can be really upsetting to be in these communities where things like that can happen to you and the psychological toll it takes, but the kind of work we’re doing really helps."

Despite the data and the reality of these communities, Marks said she isn’t discouraged. She said she doesn’t subscribe to the notion that solving inner city gun violence is an exercise in futility. "Hurt people hurt people," she said. But, it’s equally true that "healed people heal people," Marks said.

"So, I don’t feel discouraged, I feel hopeful," Marks said. "I mean I wish there was less violence, I wish young people had less adversity to deal with, but I think we are more equipped than ever and more willing than ever to address those things."

Healed people heal people

Lorrain Taylor is one of those healed people, although she says she’ll never fully recover from losing her twin sons to gun violence on the same day in 2000.

"I sat on my bed the other day and I just broke down because I miss them so much," Taylor said.

But Taylor has channeled her grief into organizing and creating the non-profit 1000 Mothers to Prevent Violence.

Through 1000 Mothers, Taylor works with other families who have lost loved ones to gun violence, often bringing over groceries or just being there for grieving families to talk to. She offers support for as long as families need it, and each year holds the PURPLE Gala, an event to remember victims of violence and honor their families. In some cases, Taylor has remained connected to families of victims of gun violence for a decade or longer.

Taylor said PTSD is very real for people and families touched by violence, and said she strives to get families support before that trauma causes them to hurt themselves or someone else.

"Support is what most people need and that’s what they were not finding," Taylor said. "1000 Mothers to Prevent Violence offers ongoing compassionate support and services."

While Taylor is dismayed that more than 1,000 people have been gunned down in Oakland since her two boys were killed, her passion for helping surviving families hasn’t diminished.

"Every day I get a call," Taylor said. "Last night I was on the phone with a father who just can’t handle it."

Lorrain hopes one day her services won’t be needed, but until then, she’ll continue to help families with their grief while at the same time dealing with her own.