On Aug. 4, 2009, Master Sgt. Jason Swain says he dumped all his medications into his hand. Cupping the little pile of pills, he flashed back to his brother's attempted suicide, and the image of his mother's pain-distorted face.
Every day, on average, 18 American veterans commit suicide. Through the haze of guilt and pain, Swain realized he didn't want to be one of them.
Swain's voice quivers as he talks, as if sobs are just one random memory away. But the 38-year-old's first words betray the nearly clinical training of the Army intelligence analyst he is.
"I've been here since Aug. 5, suffering from some bad complications from my PTSD, severe depression and suicidal ideations."
In the Miami Veteran's Affairs Hospital's Post Traumatic Stress Disorder ward, Swain is in the middle of a 14-week inpatient program.
In the wake of the shooting rampage at Fort Hood, Texas, Nov. 5, that left 13 people dead, allegedly at the hands of a fellow soldier, Army Maj. Nidal Hasan, soldiers who struggle with stress like Swain, have come back into the spotlight.
When he was posted in the 1st Cavalry in Fort Hood, Swain worked across the street from the site of the rampage.
"My first thought was there is no way that just happened at Fort Hood. I sat there watching the television as the reports got in and I actually got tearful, I actually sobbed," Swain said.
Rates of PTSD, which may or may not have played a role in Hasan's case, along with traumatic brain injuries, are soaring, and are a leading cause of suicide among veterans and active duty troops, officials say.
By some estimates, as many as 40 percent of veterans of the wars in Iraq and Afghanistan suffer from one of the two, or both.
Veterans Affairs officials blame the dual hazards on multiple deployments and roadside bombs.
During the Vietnam War, said Dr. Daniella David, program director of the Miami Veteran's Affairs Hospital's PTSD ward, troops were only deployed for about 14 months during each four-year enlistment period.
Today, troops are often deployed twice in the same time span.
And because of the randomness of roadside bombs, or IEDs, everyone is, in effect, serving on the front lines.
"Soldiers who are not traditionally in combat roles, such as truck drivers, mechanics, cooks, who are on the road a lot, are very much exposed to combat experiences because they are exposed to IEDs," David said. "They are exposed to seeing dead bodies and civilians and enemy combatants getting killed."
According to David, there is no "rear" any more for U.S. troops in Iraq and Afghanistan -- there is only the front line.
As a result, she says, calls for help are up.
"I think it puts a little more pressure on us," she said, "but at the same time, I think it's something that we want to have happen in order to help earlier."
For Swain, it didn't happen early enough. Round-faced, with the paunch of a soldier who never had to run for work, he confesses that, as an imagery analyst, he'd never been in a combat unit.
But the violence came to him one August day in Iraq. He had changed the shift of one of his charges, 22-year-old Sgt. Princess Samuels. As she walked back to her bunk after her shift, an incoming mortar killed her.