As Anzac Day commemoration services take place across the country, dozens of ex-service personnel will be forced to confront distressing memories from their time at war.
"It is difficult, because it brings back all of the memories of what happened," said Derek Pyrah from Dapto, on the New South Wales South Coast.
He was diagnosed with Post-Traumatic Stress Disorder following a deployment to Iraq with the Air Force, in 2003.
"My wife at the time picked it as soon as I got off the plane from the Middle East," he said.
"Actually, my whole family did.
"I didn't walk, talk or look the same."
Mr Pyrah has received treatment for his mental illness inside ward four at South Coast Private Hospital.
The ward at the Wollongong facility is dedicated to helping those battling with PTSD — and most of the patients are former members of the Australian Defence Force.
Psychiatrist Dr Irwin Pakula said Anzac Day is often a powerful trigger of the traumatic experiences that have caused the psychological scars.
"A number of the patients have been telling me that Anzac Day is one of the worst days of the year for them," Dr Pakula said.
"Some will discuss it but will avoid many of the commemorations.
"For some it's just too traumatic."
Each year, staff at the facility prepare cautiously for Anzac Day inside the ward.
"Over a number of weeks there are increases in some behavioural problems," Dr Pakula said.
"Heavy drinking, arguments at home.
Dr Pakula said the hospital had a plan in place for such occasions.
"We're ready for it," he said.
We discuss it weeks in advance and on the actual day on Anzac Day, and for weeks afterwards as well, because there is a flare up in the anxiety and depression," he said.
Several of the patients will watch as a nurse from ward four lays a wreath on their behalf at a service in Wollongong this Anzac day.
