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LAS VEGAS — <\/span>Six years before packing a rental truck with firework mortars and gas cannisters before shooting himself in the head — an act he called a “wake-up” call to America in a note later found by law enforcement — Army<\/a> Master Sgt. Matthew Livelsberger told an ex-girlfriend he was spiraling.<\/p>\n “Sometimes, I get so hopeless and depressed, it’s [expletive] ridiculous,” he texted, at one point describing a close-range firefight in which he killed two men.<\/p>\n “By far the worst of my life,” he wrote in 2018.<\/p>\n The violent death of Livelsberger, a 37-year-old decorated war veteran and Green Beret, on New Year’s Day is reviving questions about the unique risks that military personnel, and in particular special operations forces, face in their jobs and whether enough is being done to identify members in crisis.<\/p>\n Experts say the military has dramatically ramped up access to mental health support in recent years but that special operations forces in particular still remain vulnerable, in part out of fear that if they seek help their careers will be sidelined.<\/p>\n SOF personnel are more frequently exposed to the kinds of severe mental trauma that can trigger post-traumatic stress syndrome, as well as repeated concussive blasts from high-powered weapons<\/a> that military officials suspect cause scarring and other physical changes to the brain.<\/p>\n SEE ALSO | <\/strong>Las Vegas Cybertruck explosion suspect used ChatGPT to plan attack: police<\/a><\/p>\n Acute stress and relationship problems also can play a role in a person’s deteriorating mental state. In a 2020 study sponsored by U.S. Special Operations Command that examined the suicide deaths of 29 special operations personnel, nearly all of them experienced emotional trauma in their first deployments. But other issues factored in as well, the study found.<\/p>\n “The downhill trajectory with compounding relationship issues, financial issues and legal issues occurs over many years,” the report found, noting the “large number of variables” typically involved.<\/p>\n In the case of Livelsberger, the Army will soon have to decide whether his nearly two decades of service as a special forces soldier with nine overseas deployments contributed to his death.<\/p>\n Enlisted by the Army in 2006 to train as a member of its special forces, Livelsberger became a member of the 10th Special Forces Group, which conducts counterterrorism and training missions around the world. He deployed five times to Afghanistan, as well as had stints in Ukraine, Tajikistan, Georgia and Congo.<\/p>\n Livelsberger was awarded five Bronze Stars, including one with a valor device for courage under fire. He also was awarded an Army Commendation Medal with valor.<\/p>\n His ex-girlfriend Alicia Arritt, who shared her text exchanges with Livelsberger with ABC News, said she remembered the Green Beret as funny, generous and kind and someone who loved children. He also liked art, basketball and fast cars. She said he was not impulsive.<\/p>\n If the Army finds that his suicide was caused by his service and “in the line of duty,” Livelsberger’s survivors would receive increased benefits.<\/p>\n With an FBI investigation ongoing, the Army has said only that Livelsberger participated in a holistic treatment program offered to special operations forces called the “Preservation of the Force and Family” program but that there were no red flags. The program, called POTFF, includes “physical, cognitive, medical and support resources as appropriate to each individual.”<\/p>\n Livelsberger, who was stationed in Germany at the time, didn’t display any “concerning behaviors” and was granted personnel leave shortly before his death, a spokesperson said.<\/p>\n “We encourage our Soldiers, if they need help, mental health treatment or need to speak with someone, to seek proactive behavioral health treatment either on base or online. They also have the option of talking to an Army chaplain,” Brig. Gen. Amanda Azubuike, chief of Army Public Affairs, said in a statement.<\/p>\n Dr. Rachel Yehuda, a professor of psychiatry and the neuroscience of trauma at Mount Sinai’s Icahn School of Medicine, said there are risk factors that seem to explain why some people are more vulnerable to PTSD than others.<\/p>\n This can include a person’s family history, exposure to trauma at a young age and biological factors that could make it more difficult for a person to “recalibrate” their nervous system after a traumatic event.<\/p>\n Yehuda, who is not involved in Livelsberger’s case and did not want to speak to his particular situation, said the trauma faced in general by service members in combat can be particularly challenging because it often occurs overseas when members are far away from close family and friends who can provide support. That support system, she said, can be critical to calming the nervous system.<\/p>\n “I think that we have to understand that trauma is a real thing. And it can really be detrimental to mental health, especially if you’re not in an environment where people can help you cope with all the things that you’re carrying,” she said.<\/p>\n Fran Racioppi, a former 10th Special Forces Group officer who hosts a podcast on Green Berets and leadership, said the profile of a Green Beret soldier is unique because it’s someone capable of “extreme degrees of compassion” while also capable of going to war and maintaining the highest standards in warfighting.<\/p>\n “Whenever we have an incident when the behavior of a special operator drastically deviates from the standard profile, we need to understand the driving cause of that change and what contributing factors may cause a grievance,” he said.<\/p>\n Racioppi said he thinks the resources are there to support personnel like Livelsberger.<\/p>\n “But the first step will always be an operator’s self-assessment and willingness to seek help for themselves,” he said.<\/p>\n The SOCOM-sponsored study, conducted by the American Association of Suicidology, found at the time of its review, from 2012 through 2015, that many personnel were reluctant to raise their hands out of fear of getting sidelined, with suicide prevention training seen as a “check in the box.”<\/p>\n Livelsberger’s ex-girlfriend Arritt said he told her he feared getting help “because he wouldn’t be deployable.”<\/p>\n