The defense admits that the 47-year-old was the shooter who killed eight people at the Pinelake Health and Rehabilitation Center in Carthage on March 29, 2009.
Rebecca Powell, a registered nurse who treated Stewart at Moore Regional Medical Center the day of the rampage testified he told her he had been depressed and that he and his wife had separated.
Powell told the jury that Stewart shared with her that he wanted to go see his wife, but was nervous about it so he took six nerve pills.
Stewart told Powell he drove to see his wife Wanda Luck - who worked at the nursing home - and then everything went foggy. He told Powell the next thing he remembered was being arrested by police.
Powell also testified that she thought Stewart was suicidal and asked him what he would do to end his life. She said he replied that he would shoot himself.
The jury also heard from the Moore County medical examiner Thursday, who is also a volunteer with the Carthage rescue squad.
Max Muse was one of the first people to respond to Pinelake and told the jury that he found a gruesome scene with several elderly victims shot to death in their wheelchairs.
He also tried to help 39-year-old nurse Jerry Avant after he found him shot multiple times.
Muse said he was able to talk to Avant, who had appeared to have a fractured femur, but within minutes his condition worsened. Muse testified Avant said he knew he was dying and asked someone to pray with him.
Muse said it was very eerie to hear Avant say those words. Avant later died of his wounds.
Stewart's estranged wife managed to hide in a bathroom in a locked area for Alzheimer's patients and was not injured in the attack.
Despite Stewart's lawyers saying a combination of drugs caused what happened that day, prosecutors say Stewart knew what he was doing and are seeking the death penalty.