When Ziva had taken off running after seeing him at the diner, everything in Tony had yelled at him to follow her. He'd wanted to, but by the time he let himself over analyze the outcome of that decision, she was gone. He thought about trying to go by her apartment and talk to her, but in all honesty, he couldn't muster up the courage. Seeing her like that had absolutely terrified him.
He hates that he keeps seeing her like that in his mind. No matter how hard he tries to push the images away, they're stuck strong, imprinted into his brain. He doesn't want to see Ziva so scared like that. The Ziva he's known for so long wasn't afraid of anything and it petrifies him to think that maybe she isn't his Ziva anymore. He shouldn't think like that, though, and he knows it. His Ziva is still in there, somewhere. She's a little broken and lost, fighting against something that wants to break her, but she's there. She has to be.
His curiosity gets the best of him and he finds himself wondering what exactly it was that made her so terrified, and when he happens to bring it up to one of the people who saw everything, they say that a customer was hitting on her and she just freaked.
"She was kind of acting nervous all night," the man in question tells him seriously. "I'm not sure what was wrong with her, but there was something bothering her pretty bad."
He knows that it has to be linked to the summer she spent in Somalia, and the fact that Ziva is apparently struggling with the aftermath of what happened to her irks him to the point that he can't focus on anything. It drives him crazy and makes him wish he had some superpower that could help her, erase all of the bad memories and get her back to herself.
He isn't sure how he's going to, but he spends all night awake because he can't think of anything else. He doesn't know how, but he knows he has to help her. He can't just sit back and watch her lose even more of herself in the terror of the memories haunting her.
The following morning, he's still turning information over in his mind despite his exhaustion when Gibbs comes in with a case. It's a good one, complicated enough to keep them busy for an extended period of time. When he happens to nearly fall asleep propped up on his hand while McGee is giving them information on a suspect's mysterious wife, Gibbs pops him on the back of the head and the unexpected action combined with how tired he is results in his forehead hitting his desk.
"Ow," he complains halfheartedly, a yawn escaping him as he rubs his hand over the now sore area.
"Did you get any sleep last night, DiNozzo?" Gibbs asks then, and Tony feels obligated to be honest with him.
"Not much, not really, no."
Gibbs gives him a look that he can't really describe but then just asks him to get more coffee and try to pay attention. His tone is very unlike the tone they're all used to, and while McGee gives Gibbs a strange look, Tony just nods and leaves to do so. Tony can feel McGee's eyes on him, but he doesn't take the initiative to look back and see what expression McGee is wearing now. He figures it won't make him feel any better, so there isn't really a point.
"DiNozzo, you gotta focus," Gibbs tells him later as he flips the switch in the elevator on the way to Abby's lab.
Tony sighs, looking down at the ground and putting his hands in his pockets. "I'm trying," is the only response he can offer the man standing next to him. He hesitates, giving Gibbs a side glance before returning his gaze to the floor. "I'm worried about Ziva."
"I know," Gibbs replies simply without any pause in conversation.
Tony swallows, pressing his lips together to attempt holding himself together. "Do you think she can stay mad at me forever?"
"I think," Gibbs begins, flipping the emergency switch back to put the elevator in motion. "That she has more on her plate to worry about right now than being pissed at you, DiNozzo." The elevator dings open and Gibbs steps out, only to turn back to him again. "And I think that the person you might need to talk to is down in autopsy."
Knowing that Gibbs is right, Tony heads down to Ducky in the first free minute that he can find. He waits patiently while Ducky finishes an opening monologue of sorts, and is relieved when Ducky finally turns to him.
"Did you need something, Anthony?" he asks, as if he's just realized that Tony walked down without any need for case related information.
"Yeah, I wanted to... I had some questions for you," Tony replies, feeling a little nervous.
"Concerning what?" Ducky questions in return, raising an eyebrow. He puts down a tool that he was holding in his hands, giving Tony his now undivided attention.
"Well... I'm worried that... I think Ziva might be having a... a tough time with... everything." It takes a few attempts to get the words past his lips, and he can't figure out why his nerves are acting up in such a way other than the fact that it has to do with Ziva. But at the same time, Ziva is the reason that he's down there and it's seeing her face in his mind that forces himself to stay composed and accomplish what he came down to autopsy to do. He goes to add on to his statement in order to try making himself more clear, but then Ducky's expression softens exponentially.
"I had a feeling she was not doing very well either," he says, looking off to the side at nothing in particular, his lips pursed thoughtfully. "Have you see her recently?"
"I saw her last night at her new job," Tony tells him, and the words sound strange to him. Shrugging a little, he sits down in the extra chair by Ducky's desk, twining his fingers together in his lap. He stares at his hands hard, as if trying to find his answers there. "I was just stopping by because I was curious. I... was already a little worried about her and... I just wanted to check on her. When I got there she was running out. She looked absolutely terrified, and when she looked at me... it was like she wasn't really seeing me."
"Did you say anything to her?" Ducky asks inquisitively.
"I didn't really get a chance. She, uh, ran off before I could. I thought about following her but..." He stops, not really wishing to finish the statement. "When I asked someone there about it, they said she had been acting pretty nervous all evening. She seemed kind of anxious on the plane back, too, but I didn't think anything of it because... I mean we'd just pulled her out of the Sahara Desert. I figured it was normal to be a little shaken."
"Yes, well Jethro came to me a few days ago acting very concerned for Ziva as well. He believes that while she was staying with him, she had a nightmare of sorts. He heard her wake up in the middle of the night and she was very disoriented when he tried to speak to her afterwards. It is very likely that the nightmares were related to her time spent in Somalia." Ducky seems to be showing his age all of a sudden and his gaze is very serious.
"Nightmares?" Tony says to himself quietly, feeling his heart break for her. "And all those things that I just shrugged off on the plane because I figured either she was still upset with me or she was just tired... does that have to do with it, too?"
Ducky nods slowly, sitting down in his chair with a somber expression on his face. "It would seem that Ziva has quite a strong case of Post Traumatic Stress Disorder. In order for an individual to be diagnosed with PTSD, doctors usually look for at least one re-experiencing symptom, such as flashbacks or nightmares, accompanied by avoidance symptoms that can range from simply feeling guilty to having trouble remembering the event. There is also usually some hyperarousal symptoms involved."
Tony furrows his brow and looks up. "Hyperarousal?"
"Yes," Ducky begins, and Tony can see him recalling nearly everything he can on the subject even as words start to leave his mouth. If the conversation weren't so severely sobering, Tony would take a moment to admire that about his coworker. But this isn't the time for that. "That would include feeling nervous, having angry outbursts, experiencing difficulty sleeping, being easily startled... And while re-experiencing symptoms and avoidance symptoms are often triggered, hyperarousal symptoms are constant. They do not have to be triggered by a place, person, object, etcetera."
Tony nods slowly, trying to process the information, recalling how Ziva had been jumpy every time he'd seen her, how she'd snapped at him when he stopped by. "That sounds about right." There's a long silence as Tony's brain tries to catch up to what he just heard. "She has PTSD."
The statement sounds so out of place to him, and the words have trouble forming because it isn't fair for Ziva to have PTSD. Why should she have to relive the terrible things that happened to her? Why should she go through every day feeling nervous and guilty? His stomach turns at just the thought of it. "Okay, so... how do I help her?"
Ducky gives him a sympathetic look and it takes a lot of effort for Tony not to lose his patience. He's really getting sick of receiving sympathy when he isn't the one who it should be directed towards. "I'm afraid that you yourself can't do much," Ducky tells him slowly. "She needs to be seen by a medical facility that can cater to individuals with PTSD symptoms. Only they can administer treatment or medication to truly help her."
"What treatment?" Tony asks, wishing he knew more about this. It would make things a lot easier.
"Well, psychotherapy, or getting the patient to talk openly about their experiences to rise above them, is one common method used. Every case is different, however. Some people may respond better to exposure therapy, where they are faced with the thing haunting them in a safe environment so that they can better overcome it. Others may need cognitive restructuring to help them make sense of the event or situation that is bothering them. But all of this is best done with therapists who are well aware of how to deal with what they are going through and get them out of it better." Ducky fixes him with a stern gaze. "I'm sorry, Anthony, but the most you, or anyone for that matter, can do is... ease her in that direction, urge her to see someone and get some help. Until she wants to get the help, there isn't much that can be done."
Tony nods, the weight of everything making his shoulders sag forward. "She... she won't really talk to me. But maybe I can... talk to Gibbs. I can see if maybe she'll listen to him. I have to get her help." His head is beginning to hurt and he rubs a hand over his forehead.
He knows that if he looks up at Ducky, all he'll see is another sympathetic expression, so he simply ducks his head and walks out, coming up with a plan A, B, C, and more in his head, because if it's the last thing he ever sees to, he's going to see to it that Ziva gets better.