The noose was around Anthony Doran's neck. He leaned against a door as his weight cinched away his life. He began fading out.
“I got really scared,” Doran remembers. “I didn't want to die but I didn't know how to live. … I stopped myself.”
Unfortunately, many active duty military personnel and veterans have been too overwhelmed by isolation or other problems to stop their suicide attempts. As the nation remembers its fallen soldiers and veterans on Memorial Day — and nearly 17 years after the war on terror began — suicide continues to challenge the military branches.
Earlier this month, a Shaw Air Force Base airman was found dead in a hotel room from a self-inflicted gunshot wound, according to the Sumter County coroner. About a year ago, another Shaw airman committed suicide inside his home, and last fall an airman assigned to the 31st Intelligence Squadron in Fort Gordon, Georgia, which is supported by the 20th Fighter Wing at Shaw Air Force Base, also took his own life.
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“Suicide is a challenge that the entire Air Force faces, and we recognize that to remain the world's supreme air power, we must care for our people,” a Shaw spokesman said in a release. “The Air Force provides many programs that can enhance Airmen and their families' abilities to effectively manage stress, from the normal ups and downs of everyday life to stressful situations that are unique challenges to those serving in the military."
Last year, 285 active duty military veterans committed suicide. While that's down from the 2012 peak of 321, it's also a slight uptick from the last few years.
Both civilian and military suicides have increased since the wars in Iraq and Afghanistan began, but military suicides have outpaced the general population's in recent years. The suicide rate amongst veterans is also double that the civilian population.
To Doran and others, solving the problem can only be accomplished if military senior officials prompt fundamental shifts in how both mental health and suicide prevention are perceived through the ranks.
The military mentality is "Suck it up," Doran says. "'No one cares. Suck it up.'
“Suck it up only takes you so far until you can’t suck it up anymore.”
The geography to mental health
Doran served in the Army's 25th Infantry Division where, as he’ll tell you, he proudly fought with A Company 2-35 Infantry. He did a tour of duty in Afghanistan from 2004 to 2005 and was honorably discharged in 2006. While some of the issues that led to his suicide attempts began overseas, it was when he came home that he fell into substance use and depression.
The military gave him structure and surrounded him with people he considered brothers and who he knew would give their lives for him — as he would have for them.
But his experiences in Afghanistan — “Things I’ve seen, things I’ve done, and the people I was with.” — caused post traumatic stress disorder to set in when he returned to the United States. Depression and anxiety made him feel isolated.
“I drank every single night . . . when I first got out,” he recalls. “I didn’t know what else to do with myself."
He took more prescription opioids while trying to address his PTSD through programs at the Department of Veterans Affairs. Those programs didn’t work for him because he still had the opioids. When he no longer could get the quantity of pills he said he needed, he turned to heroin, which he never thought he’d do. Twice he tried to kill himself through heroin overdoses.
Doran, who lives in New Jersey, now works with Vets 4 Warriors, an organization that connects veterans, services members and their families with peers who understand their life experiences and challenges in order to provide support. One frequent concern Doran hears regularly from veterans is access to a VA facility.
“They don’t have access to the help. … People might be hundreds of miles from the nearest VA,” he said.
A solution is to connect veterans and service members with civilian mental health services, Doran says. That’s what Vets 4 Warriors does through another organization, Give an Hour, a non-profit with a network of professional therapists who donate time to veterans and others who need support.
“We’ve had a lot of success of people going off-base to therapists,” Doran says.
That's how Doran got help, he said. He recovered and regained control of his life through a private rehabilitation program that he entered through an anonymous donation to a treatment facility. The VA programs, he says, weren't working for him because “I was still using those prescribed medications.”
Outside the VA, "I was able to be abstinent from everything I was taking,” Doran says. “Without that I probably wouldn't be standing here. I know I wouldn’t.”
In 2011, the Department of Defense created its Defense Suicide Prevention Office. Better resilience training and support to deal with problems was implemented throughout the military.
The Department of Veterans Affairs responded similarly, creating its Veterans Crisis Line in 2007. Most recently, President Trump signed an executive order to provide increased assistance to recent veterans.
Jennifer Miller of Lexington, South Carolina, has been both on base as a soldier and off base as a counselor. While she’s worked to help veterans and their families, she’s also been touched by suicide.
The invisible wall
Miller, a staff sergeant and heavy equipment mechanic, was out of the Army after serving in Iraq from 2002 to 2004. She had a newborn child and had purchased a home. She had just been with her battle buddies at a military awards ceremony and was dining at a restaurant when she got the call.
Her closest friend while deployed had committed suicide.
Initially, she was numb with shock. Eventually, survivor’s guilt set him.
“We survived the war. We made it home alive, but then he killed himself,” Miller says. “That’s a very confusing concept.”
She started asking herself why she didn’t do something. “Why I didn’t talk to him or he didn’t talk to me?”
The death, in part, led her to become a counselor, and she now primarily works with military veterans, their families, and first responders.
Not talking about mental health concerns is the most prominent barrier to combating military suicide, she and others say. Believing that they may be seen as unfit for the job if they reach out creates a stigma about mental health for service members.
“When you’re in such an ego-dominated environment, it’s tough to say, ‘That was rough and I’m having a hard time processing it,” Miller says. With all the traumatic things that service members see, "if you don’t process them they become a poison inside of you.”
“A lot of people feel they can’t go through the leaders with their issues,” Doran says. “If they do they’re labeled as a weakness in the link.”
Their career, along with their livelihood and insurance, are threatened, the service members believe.
At Shaw Air Force Base, nobody has publicly said what may have caused the airman to kill herself earlier this month. But military studies show that relationship problems are a leading cause of suicides.
Steve Creech, a former Sumter mayor who represents Shaw on South Carolina's military base task force, said the Air Force puts a heavy strain on relationships and families.
The frequency of training and deployments in the Air Force and at Shaw plays a part in the airmen’s strained personal relationships. Shaw's F-16 pilots were the first into the Middle East and Afghanistan on what's known as the SEAD and DEAD mission, meaning they seek and destroy enemy air defenses, a role they continue while increasingly doing close air support.
“It’s a tough life,” Creech says. “We got folks going all the time.”
For six months of every two years, pilots and their units of hundreds of Air Force members are deployed. With that kind of schedule, "your wife's going to tell you to get another job," Creech says.
“Sometime or another we got to bring them home from war. The Air Force has got to have a break.”
Veterans who are considering suicide often show signs of depression, anxiety, low self-esteem, and/or hopelessness. Here are signs relatives, friends and others should look for:
Appearing sad or depressed most of the time
Clinical depression: deep sadness, loss of interest, trouble sleeping and eating, especially if the symptoms don't go away or get worse
Feeling anxious, agitated, or unable to sleep
Neglecting personal welfare, deteriorating physical appearance
Withdrawing from friends, family, and society, or sleeping all the time
Losing interest in hobbies, work, school, or other things one used to care about
Frequent and dramatic mood changes
Expressing feelings of excessive guilt or shame
Feelings of failure or decreased performance
Feeling that life is not worth living, having no sense of purpose in life
Talk about feeling trapped—like there is no way out of a situation
Having feelings of desperation, and saying that there’s no solution to their problems
Some behaviors suicidal veterans might enact are:
Performing poorly at work or school
Acting recklessly or engaging in risky activities—seemingly without thinking
Showing violent behavior such as punching holes in walls, getting into fights or self-destructive violence; feeling rage or uncontrolled anger or seeking revenge
Looking as though one has a “death wish,” tempting fate by taking risks that could lead to death, such as driving fast or running red lights
Giving away prized possessions
Putting affairs in order, tying up loose ends, and/or making out a will
Seeking access to firearms, pills, or other means of harming oneself
Source: Veterans Crisis Line. veteranscrisisline.net/SignsOfCrisis/Identifying.aspx
Where to get help
Military Crisis Line - 800-273-8255, press 1
Marine Corps DSTRESS Line - 877-476-7734
Coast Guard Suicide Prevention - 855-247-8778