WASHINGTON -- The United States has now been at war for the longest period in its history; nearly 11 years in Afghanistan and more than eight years in Iraq.
The U.S. response to the 9/11 terrorist attacks 10 years ago set into motion a massive military effort that to date has deployed more than 2 million U.S. soldiers abroad.
But for many returning veterans, joining the military has proven easier than leaving it.
For reasons ranging from the emotional toll exacted by multiple deployments to the lack of jobs back home, readjustment to civilian life in the post-9/11 era carries a difficult set of challenges.
U.S. President Barack Obama recently paid tribute to what he called "the 9/11 generation" of military members -- more than 5 million American men and women who have served in the ranks of the U.S. armed forces since 2001.
"They were there, on duty, that September morning, having enlisted in a time of peace, but they instantly transitioned to a war footing," he said. "They're the millions of recruits who have stepped forward since, seeing their nation at war and saying 'send me.'"
Wars have always filled hospital beds, but the conflicts in Iraq and Afghanistan have brought advancements in battlefield medicine and body armor that have dramatically increased survival rates -- even for soldiers with horrific wounds inflicted by insurgent fighting techniques like roadside bombs and improvised explosive devices (IEDs).
For every U.S. soldier killed in World War II, 1.7 soldiers were wounded. In Operation Iraqi Freedom and Operation Enduring Freedom, for every U.S. soldier killed, seven are wounded.
Department of Defense figures now put the total number of wounded veterans from Iraq and Afghanistan at more than 40,000.
Army First Lieutenant Cameron Kerr is among them. While helping to clear an area near a village in Afghanistan's Kandahar Province in February of this year, he stepped on an IED. His left leg had to be amputated below the knee. From the military hospital outside Washington, D.C., where he's recuperating, he maintained that it's mostly younger soldiers, many of whom enlisted in the army right out of high school, who sustain the worst injuries.
U.S. Army and Afghan troops carry a wounded US soldier through a dust cloud to a medevac helicopter in Kandahar Province.
"They come in, they get injured, sometimes radically changing their life, some guys become very depressed," he said. "There are people that lose everything up to the waist, including genitalia, which is a huge blow to a young man.
"If they don't have kids already, it just means they'll never be able to have kids. So those guys especially, you can tell those guys are just severely depressed, unfortunately, and that's where you see some suicides."
Stress Disorders And Major Depression
The number of suicides among not just Iraq and Afghan veterans, but currently serving military members, has been rising in recent years -- driven by what experts say are psychological problems caused by traumatic experiences and the stress of multiple deployments.
Some 800,000 troops have been sent to war more than once, and four and five deployments are not uncommon.
In 2010, suicide rates across all military branches rose 20 percent, to 468. That's more than the number who died in combat in Iraq and Afghanistan that year.
A RAND Corporation study found that 20 percent of Iraq and Afghanistan veterans have symptoms of post-traumatic stress disorder (PTSD) or major depression.
This past July, the army recorded its highest monthly toll of suicides ever: 32.
In 2010, suicide rates across all branches of the military rose 20 percent, to 468. That's more than the number who died in combat in Iraq and Afghanistan that year.
Kerr, who claims he hasn't experienced major symptoms of PTSD, sees plenty of fellow soldiers who are struggling with it. "Obviously the injury itself is pretty traumatic in most cases. Getting blown up, I can tell you, is not a fun experience I would wish on anybody," he said.
"Some guys were lucky and they blacked out, but a lot of us were conscious the whole time, which makes it even worse. And then most guys have been deployed several times now [and] have seen things that nobody else should have to see, especially at ages 19 or 20, or whatever they are."
Substance Abuse And Addiction
To try and cope with the disturbing memories that they bring home, it's not uncommon for veterans to turn to alcohol, and sometimes drugs, to numb their emotions.
The number of alcohol-addicted vets has roughly doubled in the last five years, according to the latest figures from the U.S. Army. Some 13,000 soldiers were treated for substance abuse in 2010.
Nancy Schiliro was a U.S. Marine serving in Al-Asad, Iraq, in February 2005 when a mortar round exploded a large fuel tank she was standing near. The blast shattered one of her retinas, which became infected and led to the complete loss of her right eye.
Back at home, she found herself sinking into a well of depression. "I [was] a 25-year-old female and I had to wear a patch on my eye and I had no eyeball in my head," she said.
"I didn't leave my house. I was on heavy medication for the pain and for depression and I was starting to feel myself abuse it more and more because, after a while, I wasn't taking my medication for my physical pain. I realized I was taking my medication for the emotional anguish I was dealing with. I didn't want to think, I didn't want to feel."
A counselor and friend convinced Schirilo to attend a meeting of Project Odyssey, which is run by the veterans' assistance group Wounded Warriors.
The group's mission is to empower and honor wounded veterans, while also helping them transition to the civilian workforce through a variety of programs, including physical health and mental wellness.
The organization says it wants to create "the most successful, well adjusted generation of wounded warriors in the nation's history."
Schirilo's story is one of the group's success stories. She found the help she needed and now counsels other vets who turn to Wounded Warriors for help.
Despite the alarming statistics, there is a growing consensus among veterans' advocates that the military has made great strides in recent years in both recognizing and treating the psychological wounds of war.
The Veterans' Administration has expanded its mental-health and job-counseling services, and set up 24-hour crisis hotlines. It recently promoted National Suicide Awareness Week, on September 4-10. And this summer it announced that it would increase its staff of substance abuse counselors by 30 percent.
The message to vets in need is that they needn't suffer in silence.
Psychologist Dr. Shari Balter (center) has been treating
U.S. Army veterans for more than 20 years.
Psychologist Dr. Shari Balter has been treating veterans for more than 20 years and since 2001 has worked for a veterans' assistance group in Florida called Faith Hope Love Charity Incorporated. She works daily with former military members struggling with postmilitary life.
"A number of our veterans experience significant losses," she told RFE/RL. "It might be death of fellow soldiers, friends, the loss of limbs or some physical functioning, relationships, even dealing with the loss of close attachments they made while on the battlefield. A number of our veterans are dealing with addiction and substance abuse."
She maintains that many have nightmares and sleep difficulties, and suicidal thoughts "are not uncommon" as veterans re-experience traumas they've been through. Multiple deployments compound the problems, because the violent incidents they've been through "just build upon each other."
Balter also believes the absence of designated safe zones in the current conflicts means that soldiers are constantly under combat stress during their entire deployment -- unlike the U.S. war in Vietnam, for example, where demilitarized zones existed.
Balter's group also runs Stand Down House, a place where homeless veterans who are struggling with addictions or mental health problems can find a safe place to live, recover while also trying to rebuild their lives.
Homelessness is another growing problem for returning vets. Not just because the debilitating effects of PTSD can disrupt lives and lead some down the crippling road of substance abuse.
Difficulties Readjusting To Civilian Life
The U.S. economy has been experiencing some of its highest unemployment rates in decades, with the official figure now at 9.1 percent.
Military veterans, who have been out of the civilian workforce for years and are trying to find a job in this dismal economic climate, face long odds.
Phil Landis, the head of Veterans Village of San Diego
No one knows that better than Phil Landis, the head of Veterans Village of San Diego. Landis is himself a veteran of the Vietnam War, and his group helps more than 2,000 homeless vets each year who have hit bottom.
Most of the veterans who come to Veterans Village have addiction or mental health issues, but all have fallen through existing social safety nets and ended up economically destitute.
Veterans Village is the country's largest nonprofit agency providing troubled vets with everything they need to get back on their feet, including medical and mental-health care, job training and job-search help, housing, food, clothing, and legal services.
According to Landis, for many veterans of the post-9/11 era, things "don't seem to fit as well as they did before" they went to war. The day-to-day challenges of civilian life can seem at once overwhelming and terribly ordinary to someone used to the structure and pace of life in a foreign war zone.
"When you're involved in combat and you leave the military, the world isn't always as understanding as you would like it to be," Landis said. "Society doesn't always take into consideration those bits and pieces that you bring back with you from combat that may shade your own sense of awareness. It certainly doesn't help with patience."
Landis served one tour of duty as an infantryman in Vietnam, and his experiences there -- and now with veterans of Iraq and Afghanistan -- have convinced him that the scars of war look the same, regardless of the generation of soldiers.
"One year was enough for me. I can't imagine the effects on these young men and women from having multiple tours - deployment after deployment after deployment," Landis said.
"Trauma layers upon itself. It doesn't really go away. So with these young men and women, they have a tour in Iraq or Afghanistan, and they're home for six or seven months, or eight months, and then they go back," he added.
"They never really stand down. They never have an opportunity to disengage from being on alert or on the mission. The effects are deep and very disheartening."
The goal of Veterans Village is to help vets find "sobriety, self respect, self esteem, and a sustainable job."
Landis maintains that the group helps around 400 vets a year find jobs, and has a success rate in its residential treatment program of about 50 percent.
The plight of unemployed U.S. veterans, who now number more than 1 million, has become so urgent that the White House has taken notice.
In a speech last month to a veteran's group, President Obama unveiled a plan of tax credits, retraining, and education that he hopes will help veterans reenter the workforce.
"We ask these men and women to leave their careers, leave their families, and risk their lives to fight for our country," Obama said. "The last thing they should have to do is fight for a job when they come home."