When President Barack Obama presented the Medal of Honor to Staff Sgt. Ty Carter on Monday, he not only heralded Carter's heroism on the battlefield at Combat Outpost Keating during one of the deadliest attacks in Afghanistan, he pointed out that Carter has made it his mission to destigmatize the post-traumatic stress experienced by hundreds of thousands of U.S. troops and veterans.
Carter was once a skeptic of what he calls "PTS"; he does not want to add the D, saying it is not a disorder.
"I didn't believe it was real until I experienced it. I thought it was just an excuse to get out of duty or not do a job. But once it hit me and I realized it, I was blown away. How could I be so ignorant?" Carter said.
During the horrific battle at Combat Outpost Keating, an enemy RPG explosion caused Carter to lose some hearing.
"Ever since that day, I've had this high-pitched ringing in my ears," Carter said. "It's still difficult to be anywhere that's really quiet, because the quieter the room, the louder the ringing."
In the dark, quiet moments, the constant ringing in his head brings him back to the battle.
"That's when the memories start kicking in. And you can't sleep, because, you know, the whole, 'I should have done this; I could have done that.' And then you see the faces of the soldiers that died or the soldiers that are wounded.
"And you hear the cries in the night. I remember, you know, sleeping right next to the bodies of the soldiers who were not sleeping, just laying there. And, you know, it's just -- not very good happy memories," Carter said.
Since he left the outpost, Carter has been receiving regular treatment for post-traumatic stress disorder. The treatment allows him to continue his career path in the Army.
Someone not so fortunate was one of Carter's battle buddies, Pvt. Ed Faulkner Jr., who struggled with both PTSD and a drug problem and was discharged from the Army a few months after the battle at Combat Outpost Keating.
When Faulkner returned to his parents' home in Burlington, North Carolina, he would lament to his father that he could have done more to save a friend's life. He had nightmares. He would stay up late watching videos of the attack that insurgents posted online in September 2010.
Less than a year after the attack, Faulkner overdosed on methadone and Xanax. There was no evidence of suicide. Friends felt that his death was a result of the horror of his time in battle.
"I honestly believe that, yes, he was the ninth victim of Combat Outpost Keating. And I also believe that he won't be the last," Carter said.
Some question whether the Pentagon -- indeed, society in general -- understands what a crisis PTSD is for hundreds of thousands of troops.
"I think the Army understands. The problem is that getting help has to start with the soldier," said Carter.
A 2008 RAND Corp. study found that nearly 20% of U.S. military personnel returning from Iraq and Afghanistan had PTSD or depression. Many troops think that is a very conservative estimate, but even if it is not, that would be 500,000 of the 2.5 million who have served in those war zones to the present day.