BAGHDAD — A military culture that values strength and a "can do" spirit is discouraging thousands of soldiers from seeking help to heal the emotional scars of war in Iraq and Afghanistan, despite top-level efforts to overcome the stigma, commanders and veterans say.

Up to one-fifth of the more than 1.7 million military members who have served in Iraq or Afghanistan are thought to have symptoms of anxiety, depression and other emotional problems. Some studies show that about half of those who need help do not seek it.

"It's a reality that for some — certainly not all, but for some — there's a stigma to stepping forward for behavioral health," Maj. David Cabrera, who runs counseling services at a military hospital in Germany, told the Associated Press.

"Our goal is to eradicate the stigma," he said. "We're not there yet."

Encouraging more soldiers to seek help, and training leaders to spot signs of trouble, have taken on new urgency since the fatal shooting last Monday of five U.S. service members at a counseling center at Baghdad's Camp Liberty.

Army Sgt. John M. Russell has been charged with five counts of murder. He was finishing his third tour in Iraq and had been ordered to seek counseling at the center, the Army said.

Sergeants on their third or fourth assignments to Iraq or Afghanistan are more than twice as likely to suffer mental health problems as those on their first assignment to a combat zone, according an Army study last year.

Combat stress is common in every war — including "battle fatigue" cases in World War II and the lasting trauma still suffered by thousands of veterans of the Vietnam conflict.

What makes the current conflicts different are the frequent, repeating rotations. Most soldiers spent just one or two assignments in Vietnam, but many American soldiers and Marines are on their third or fourth tours in Iraq and Afghanistan.

Units return home to the U.S. or Germany, only to soon begin preparing for their next deployment, adding strains on both the soldiers and their families.

Military officials insist they are keenly aware of the growing stress problem in the ranks and are moving quickly to expand counseling facilities not only in war zones but at bases in the U.S. and Europe for troops who return from the fighting.

Most major bases in Iraq maintain combat stress clinics, where soldiers can visit counselors and relax for a few days away from the pressures of their jobs.

Two of the officers killed last Monday at the counseling center had been visiting units in the Baghdad area in the weeks before their deaths, explaining programs the counseling centers offer and encouraging soldiers to take advantage of them.

"The only way we're going to keep our soldiers fit to fight, if you will, is to make sure it is a holistic approach, not just the physical but mental readiness," said Lt. Gen. Kenneth W. Hunzeker, an Iraq veteran and corps commander in Germany.

Some senior officers, notably Gen. Carter Ham, who now commands U.S. Army forces in Europe, have spoken openly about suffering from combat stress, including sleep problems and exaggerated emotions, after going through traumatic experiences on the Iraqi battlefield.

Ham, who commanded U.S. troops in the northern Iraqi city of Mosul during major fighting there, said he spoke out to encourage others to face the emotional scars of war.

"Frankly, it's a little weird to me that people are making a big deal about it," Ham told the Stars and Stripes newspaper in an interview last January. "Like lots of soldiers I needed a little help, and I got a little help."

But changing attitudes in the ranks has proven a tougher challenge. Young combat soldiers don't want to seem weak in front of comrades. Sergeants who are supposed to be role models worry about endangering their careers.

Sgt. 1st Class Gary Frey, 36, on his second tour of Iraq, said the Army does not consider it a bad mark against a soldier if the soldier seeks counseling. But going to a combat stress center "may be viewed as a weakness by individuals," he said.

"We are alpha males in the infantry," he said.

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..."You get worried that it's going to affect your career. You get worried that it's going to affect people's confidence in your ability," a 31-year-old Long Island soldier who served in Afghanistan told the Daily News. "There's this whole pride thing. Nobody wants to admit they're going through stuff."

With multiple deployments, combat stress and problems on the home front taking their toll on the troops, military officials admit they face a challenge.

"As long as the demand on forces stays what it is right now and the supply of forces remains the same, it'll be very difficult for us to do anything with that stress," said Army Vice Chief of Staff Peter Chiarelli. "But we've got to help soldiers understand how they can cope."

The Pentagon threw $300 million into post-traumatic stress disorder research last year. It's also released suicide numbers, and is ordering prevention training for leaders.

Veterans groups are pushing for more face-to-face evaluations and mental health professionsals in the battlefield, especially at remote bases. There's also a public-relations offensive aimed at removing the stigma of asking for help on the battlefield. Some top generals have spoken publicly about their own struggles.

Still, many soldiers said the idea of leaving their unit for therapy, red-flagging their problems for the chain of command, would stop them from seeking help.

"You can say that there's no stigma, but the first thing that's going to happen is that you're put on a 'no-weapons status,'" said a 30-year-old Iraq vet from Queens. "That's a scarlet letter."

So soldiers often rely on each other to cope.

"We dealt with a lot of our problems in house," said Zac Barnes, 24, an Army vet from Watertown, N.Y., who served with the 10th Mountain Division in Afghanistan in 2006. "You don't have to be a professional to listen to somebody and help them."