Alex remembers taking his wife to see a psychic. The psychic came highly recommended by her doctor. Danielle was struggling. Pete, her son from a previous relationship, had killed himself in 2004. He was only 13.

Alex drove 180 miles west from Rock Springs, Wyoming, where the couple lived, to Rainbow Gardens in Ogden, Utah. They drove through Sweetwater County’s extraterrestrial rock formations, its oil and gas fields, its mines. There was nothing to see for miles but sage-covered high desert, a landscape of stark beauty and eerie desolation.

The psychic told them that some people’s spirits were solitary, and that other people inhabit and leave this world in clans. Pete wouldn’t have learned anything new in this life, the psychic continued. He needed to die and wait for his clan to die so they could all start life over with him.

In the years that followed, one after another of the family clan died.

Danielle’s sister died from a prescription drug overdose in 2009. That same year their mother died of cancer. In 2015, Danielle died, following 15 years of opioid addiction. Just two months later one of her children’s paternal grandmothers died after years of alcoholism.

•••

For years now, the US has been engulfed in an unprecedented epidemic. America’s white suicide rate is the highest it has been in 30 years, with Wyoming leading at three times the national average. While the life expectancy of Americans of color has increased continuously, the mortality rate of non-Hispanic, middle-aged whites – particularly those with little formal education – has risen dramatically.

In Wyoming, the number of people with diabetes has risen steadily, and heart disease is expected to affect four times as many people in 2030 as in 2010. The Center for Integrated Behavioral Health Policy, a research center based at George Washington University, estimates that more than 16% of Wyomingites suffer from alcoholism and addiction to illicit drugs.

But Wyoming is not alone with this problem: the national average is just under 14%. One difference is, however, that in the least populated state in the US, mental healthcare can be hard to come by. Wyoming has one of the lowest number of psychiatrists – and the fewest child and adolescent psychiatrists – per capita.

The theories surrounding the causes of addiction are varied: childhood abuse and neglect, trauma, mental illness and incarceration of a parent are often blamed. Experts point to the role of epigenetics, the inheritability of genetic code and gene expression. Inner isolation and the lack of a supportive community also appear to play a role. Family systems are more fragmented today than they were 50 years ago, and the church, which used to be the center of people’s communal and spiritual life, has lost its importance for many Americans.

Addiction and suicide are democratic, swallowing up individuals across all education and income levels. America’s medical and mental healthcare and Veterans Administration systems are struggling to address problems that may have been averted by strong family and community systems in the past. The story of Alex and his family illustrates how a series of tragic events can snowball to claim an entire family. Suicide, mental illness and addiction are never due to just one cause; they are the results of a perfect storm.

•••

Alex in front of the trailer where Pete died. Photograph: Sabine Heinlein

At 42, Alex is burly and almost bald. When I visit him around Christmas – a few days before what would have been his stepson Pete’s 26th birthday – he offers to take me on a tour of the places in Rock Springs that are connected to his family’s downward spiral.

Clad in beige vinyl siding, the mobile home where Pete killed himself looks neat but impersonal. It hadn’t yet snowed enough to sugarcoat the scenery. Alex tells me that Danielle wasn’t able to return home after Pete’s suicide. She grabbed her pets and daughters and moved in with neighbors. The couple quickly decided to sell.

Trudging through snow under big gray skies that portend a storm, Alex and I visit Pete’s grave. Someone has put an artificial flower and a small American flag next to a piece of an antler. The antler is there because Pete was supposed to learn how to hunt that year. There is also an ashtray because Pete liked to smoke. Alex appears detached, and I ask him what he is feeling. He has come to terms with Pete’s suicide, he tells me. His mission is now to understand the forces that ravaged his family.

•••

Danielle and Alex met in the mid-1990s. They were drawn to each other because they were both “unique”, as Alex puts it. Alex was shy – he still is. One of Danielle’s arms was stunted due to a birth defect, and she was supporting herself by working at a gas station.

The youngest of more than a dozen children from several different sets of parents, Danielle was “daddy’s girl”. But according to Alexandria, her longtime friend, her family’s home was filled with emotional abuse. “There was always heartache and one addiction after another,” Alexandria remembers. The home was never clean, and her parents’ rules were idiosyncratic. “They gave her whatever she wanted. They didn’t push her to do things for herself.”

In elementary school, Danielle’s teachers and fellow students marveled at how fast she could get dressed. Though Danielle had only the one hand, she was faster than anyone else in her class. But in middle and high school, rewards became harder to achieve and expectations crumbled.

In seventh grade, Danielle got involved with “the bad kids” who hung out at a local gas station. Parties took place in the mountains, even in the middle of winter, and it was (and still is) common for kids to start drinking in their early teens. In rapid succession, Danielle had two kids, Pete and Melissa, from two different fathers.

Then Alex came along.

“I wasn’t one of those arrogant assholes who exude so much confidence,” Alex says. “I have a soft spot for people who are handicapped or the underdog. Danielle was always smiling and happy, with a sense of conviction you can only get from being a parent. ‘I’m going to do it this way and no one can tell me different.’ She taught me that about myself.”

Soon after the couple got married, Danielle insisted they follow their friend Alexandria’s family to Louisiana. They took their new baby girl Tammy and Danielle’s eight-year-old son Pete with them. Seven-year-old Melissa stayed in Wyoming with her biological dad, who was addicted to alcohol.

“Things were drying up here,” Alex remembers. “I sold everything and decided, OK, for better or worse, here we go. But things were drying up down there, too.” In Louisiana, there were additional obstacles. “Louisiana is a buddy-buddy thing. If you’re not Cajun, then you’re a nobody.” He admits: “It’s the same here in Wyoming. Any outsider you look down on.”

At wit’s end, Alex joined the army. To his surprise, he enjoyed it. “I was becoming something more than what I was,” he explains. “Growing up, every time I got a friend in school they’d move. The majority of my life I have been by myself.”

For the first time ever, the lone wolf felt like part of a pack. His family was getting a foothold in a more stable life, and things seemed to be looking up.

•••

In May 2000, Alex was driving with his family. They had just bought carpeting for their home on the base because Danielle worried the children would hurt themselves on the tiled floor. Seven months pregnant with Ashley, the couple’s second child, Danielle sat next to Alex. In the backseat were nine-year-old Pete and the couple’s baby daughter Tammy.

Alex saw the traffic lights change to yellow. He decided to stop. As soon as the car eased to a halt, he felt the impact of the loaded semi-trailer truck behind them. The kids were fine, but Alex and Danielle suffered herniated discs in the neck.

“It seemed like a big old snarl that started the snowball rolling down the hill until the big crash at the bottom,” Alex says about the accident.

Alex and Danielle were both in severe pain, and doctors in Louisiana were quick to prescribe opioid painkillers. Alex can’t remember whether doctors ever told him or Danielle that the painkillers were addictive, but while he didn’t like how hazy the medicines made him feel, Danielle soon couldn’t live without them.

Once, Danielle tried to go off the drugs cold turkey, ending up in the hospital. Doctors there said she could have killed herself. “That’s when arrangements were made to send her to a [rehab] facility,” Alex remembers. But the program was only a week or two long, and Danielle, who seemed to be in constant pain, relapsed soon afterwards.

Both Alex and Alexandria wonder whether Danielle exaggerated how much pain she was in to get more drugs, but they are careful about making assumptions. Danielle always seemed to feel every desire, every hurt, more intensely than others. Maybe she felt pain more strongly, too.

Alex’s neck pain developed into migraines, and he was no longer able to do the army’s morning calisthenics. Once, while driving a truck, he blacked out. He came to on the wrong side of the road.

His military career stalled. He had become what his superior officer called one of “the broke-ass people”. He explains: “When you are injured, you are frowned upon. You are hazed. Because you are not up there doing everything with the big dogs.”

Alex’s second daughter, Ashley, was born two months after the accident, addicted to oxycodone. When she was just 24 hours old, Ashley stopped breathing and almost died. Doctors gave her a Narcan injection, commonly used to treat withdrawal syndromes in babies exposed to opioids before birth. Suffering from withdrawal and in pain, the baby cried all the time.

In 2001, Danielle had neck surgery, but her pain still didn’t subside. Soon afterwards, she was back to spending much of her time in bed, high on drugs. Alexandria, who more than once tried to talk to her about her addiction, remembers. “She never took responsibility for her own actions. [Therapy] was scary. It was always somebody else’s fault.”

Alex was placed on desk duty. He couldn’t believe how quickly the military had written him off. Instead of supporting him on his difficult journey, his doctors started the process of medical discharge. Shortly after he was let go, his unit shipped out to Iraq. “I wasn’t able to fulfill my investment. I felt like a piece of crap,” Alex says.

In 2002, Danielle and Alex moved back to Rock Springs to be closer to their clan. Melissa, Danielle’s oldest daughter, was back in the picture, helping them raise her two young stepsisters.

With Alex’s discharge from the army, Danielle’s spousal insurance was terminated, and due to her pre-existing conditions no insurance company would take her. Alex was paying more than $500 a month for Danielle’s drugs. Eventually, a doctor put her on methadone – a prescription painkiller more commonly known for helping heroin addicts detoxify – as a less expensive alternative.

In 2006, Danielle and Alex received a quarter-million-dollar settlement from the accident. Alex kept $10,000 to start a welding business. The rest he gave to Danielle. Danielle hired a housekeeper, bought a doublewide trailer home and an SUV. She gave money to relatives, took her kids on vacation and dragged Alex to the mall to buy $1,500 worth of clothes. Within a year she had blown all the money.

•••

Rock Springs is three hours from the closest metropolitan area, Salt Lake City. But that’s in good weather conditions. When it is snowing, it can take more than twice that long. During blizzards, I-80 sometimes closes altogether.

A bust-and-boom town, Rock Springs wasn’t hit as hard by the Great Depression as the rest of America; everybody still needed coal. The proud community had splendid gardens to grow their own vegetables. Ethnic minorities put on cultural events featuring food, drinks and dances. Established as a safety net for workers, the Mutual Aid Society hosted balls, and Union Pacific organized parades and first aid competitions. The prevalent sentiment was: “We built this community out of the desert, we made a great a home for ourselves” says Brie Blasi, the executive director of the Sweetwater County Historical Museum.

It wasn’t all rosy, however. Alex leads me to a big painting at the Rock Springs Library that depicts one of the worst incidents of anti-immigrant violence in American history. While Rock Springs celebrates itself as “Home of 56 Nationalities”, it is anything but diverse, and not exactly known for being accepting of outsiders. Sweetwater County is 94% white, and its immigration history is fraught with alienation and bloodshed.

Years of unjust labor policies that favored whites and fomented xenophobic sentiments culminated in the 1885 “Chinese Massacre”, in which a mob of 150 white men murdered at least 28 Chinese miners. Dozens more were injured, robbed and driven from their shacks at Bitter Creek.



“How many white people were murdered?” Alex asks the librarian. The answer is none. The Chinese didn’t carry guns.

Castle Rock, Wyoming. Photograph: Sabine Heinlein

Rock Springs’ last coalmine closed in 1963. Social clubs closed or became less active. People no longer huddled together where they worked but had to drive out of town to the oil and gas fields and the mine that extracted trona (a mineral used to make baking soda, glass, detergents and textiles). Closely dependent on the mineral prizes, the economy seesawed.

For many years, Rock Springs’ white, working-class people enjoyed an atmosphere of social cohesion that today is hard to find. But as stark differences in wealth are paraded in schools and on social media, the general atmosphere has become one of “one-upmanship”, Alex says. “Something has to change.” He thinks that Donald Trump will bring the change America needs.

Maybe change has already been under way. In recent years, thanks to its minerals, Sweetwater County has been doing well economically – very well, in fact. Between 2000 and 2015 the median family income rose from $54,173 to $81,592, well above the national median of roughly $56,000.

Alex’s welding business, too, went well for a while – but he was powerless over Danielle’s spending habits. “I wanted things to work out,” he says. “That’s why I did everything she asked for. When the economy tanked, I would have been able to survive had I treated it like a business and not like her personal piggy bank.”

Meanwhile, Danielle’s son Pete had been sucked into his own pain. “Pete was ruined before I came around,” Alex says, adding, seemingly ashamed, that an uncle had shown porn to Pete when he was just two or three years old. “He was distraught over a lot of things, and the biggest one was being rejected by his biological father. He couldn’t understand why I wanted something to do with him and his dad didn’t.”

In school, Pete was in constant trouble. He was bullied for his “emo” style, and once another kid hit him with a rock, splitting his head open. At home, he was screamed at and hit by Danielle over the smallest infractions. Alex was often away, working 12-hour shifts in the fields.

The counseling and the different drugs doctors tried out on Pete didn’t seem to do much.

When a young family friend was taken to an institution for emotionally challenged juveniles and Pete saw her improve, he demanded to be taken there, too. According to his sister Melissa, he wanted to be somewhere where he could get one-on-one focus all the time to work out his issues and not have to worry about the family life. But since he wasn’t considered high-risk, there weren’t any immediate options available for him.

•••

Melissa, the oldest of Danielle’s three girls, remembers the tragic day in 2004 clearly. Then 12 years old, she had caught 13-year-old Pete smoking marijuana with a cousin. She told Danielle. As part of his punishment, he was to sit in his room, with no books, magazines or video games.

As she recalls the story, Melissa is calm and thoughtful, not unlike her stepfather. She seems like the kind of person who has everything under control, but as you dig deeper, her struggle emerges.

When Alex came home from work that day Danielle was in bed, like most of the time. The first thing he did was check in on Pete. He found him reading a magazine that Melissa had slipped him. “Mom said nothing is nothing,” Alex said, taking away the magazine. He went to light the BBQ to make dinner. It was a warm summer evening, and Melissa was playing horsey with her three- and five-year-old half-sisters.

Suddenly, Melissa heard Alex screaming. “When I walked over to the bedroom door and looked in, I thought that they were fighting,” she remembers. “But when Alex laid my brother on the ground, I saw that he wasn’t breathing, that he was purple and blue. I ran and woke up my mom, and she started freaking out, so I grabbed the phone and called 911. Then I grabbed my little sisters and my cousin and I told them that they needed to go outside.”

Alex says it couldn’t have been more than 15 minutes until he went back to check on Pete. He had hanged himself in his closet.

After breaking through the cloud of the initial shock, Melissa went to see her junior high school counselor. It would be better if she didn’t talk about her stepbrother’s suicide, she remembers the counselor telling her. Better not give other children any ideas (she adds that this policy has since changed and counselors are more open and engaged with the problem now). Over the next few years, Melissa would see several of her schoolmates attempt suicide and die of drug overdoses.

•••

Like Danielle, Alex considers himself spiritual but doesn’t go to church. For him, organized religion has lost its message. “It is not as complicated as people make it out to be,” he tells me. Whatever Alex’s and Danielle’s beliefs, the family couldn’t let go of Pete’s young soul.

After his death, they would sometimes hear their little daughter Ashley giggle in her room. “Pete, stop tickling me,” she would squeal. Once Alex and Danielle thought they saw his white pant-leg duck into the bathroom; another time the couple heard an indefinable growling under the bed. “It wasn’t a cat,” Alex says, locking eyes with me.

The cemetery where Pete is buried. Photograph: Sabine Heinlein

In the midst of all this, Danielle’s sister had also become addicted to painkillers. One day, she was found unconscious in the shower. She had overdosed and hit her head badly. Pill bottles with Danielle’s name were found in her home. Suffering from memory problems, the sister lost her job before dying of an overdose in 2009. It was never determined whether her death was accidental.

The calamities didn’t stop there. Four years ago, Danielle asked Alex to sit down. She had to tell him something. Their daughter Tammy wasn’t his child after all. A DNA test had confirmed it.

For a week, Alex lay in agony, curled up in a ball. “That was the worst pain I ever had,” he told me. “I didn’t want to kill myself, but if my heart was going to stop, I’d be OK with that.”

It is not that Alex has never tried to access the mental healthcare system. He and Danielle had taken their daughters to family therapy after Ashley, their youngest, had threatened to kill herself in 2012. Alex partially blames himself for Ashley’s self-harm ruminations: he was working 12-hour shifts to make ends meet, and Ashley, who had always been the calm one in the family, wasn’t getting enough attention. But family therapy was “like World War Three”, Alex remembers. “All the feelings were coming out – it might have been better to leave them all bottled up.” The family soon dropped out, but the fighting and heartache continued.

For Alex, psychiatric help never seemed available when he needed it most. The local clinic that serves veterans didn’t have an appointment available for another month, and the nearest VA hospital was 160 miles away. Alex didn’t want to call the VA suicide hotline because he didn’t feel comfortable having an intimate conversation about his pain on the phone.

In 2013, Danielle and Alex separated; the kids stayed with Danielle, but Alex came around frequently. Soon, Danielle’s new boyfriend moved in. Alex tried to go back to college but dropped out because his girls begged him to come home.

Danielle’s health began to deteriorate rapidly. Going back and forth to get medicine from doctors in Utah and Wyoming, she switched from methadone back to OxyContin. She tried to go to rehab in Laramie, Wyoming, but it was too late. Danielle had developed a rare blood clotting disease, diabetes and lung problems. A doctor also suggested that she suffered from bipolar disorder, a diagnosis that, only in hindsight, made sense to her family and friends.

Then Danielle suffered several strokes, with the third one causing mobility and speech problems. She briefly went to physical and speech therapy but quit when she suffered another major bout of depression around the anniversary of Pete’s death. In 2014, she was diagnosed with early stages of dementia.

In March 2015, a few days after her 43rd birthday, Danielle died of kidney failure. A couple of months later, Melissa’s paternal grandmother died at 69, after years of alcohol abuse. .

In the span of a decade, Alex and the three girls had lost their brother, aunt, mother, and two grandmothers. A big part of their clan was now gone.

•••

The snowstorm has ended when I drive through the trailer park where Tammy and Ashley live. The black night is partially lit by a timid half-moon, and the packed snow on the streets gleams cold blue. Tammy and Ashley, now 15 and 17, still live in Danielle’s old mobile home, together with a roommate and the man they continue to call “mom’s fiance”.

Tammy, the 17-year-old, sports a curly wild mane that matches her extroverted demeanor. She welcomes me warmly while rapidly wiping kitchen counters. Ashley quietly sits on the beige couch with the roommate who is cradling an infant the girls agreed to babysit for the night. Across from us is a dusty shelf filled with memorabilia. There are photos of Pete and Danielle, as well as some of her favorite objects, among them a clay ashtray Pete made for his mother in grade school.

“Mom said Pete had the darkest blue eyes. ‘Nothing I have ever seen before.’ As if he was a god,” Ashley tells me. A cat and dogs of various sizes squirrel around us. Tammy says she just rescued a pregnant cat whose paws had gotten stuck on the ice. The atmosphere exudes warmth and openness.

Tammy and Ashley both dropped out of school. The girls now do what teenagers do when left to their own devices. They sleep much of the day, watch TV and go to Walmart for a stroll. Later, over dinner at their favorite diner, they talk about why they didn’t like school. They were bullied, they say. “Unless you have a certain family name or you’re one of the best athletes or super smart, you get bullied,” Alex agrees.

Alex has tried to get Ashley to go to therapy after a friend of hers told him that she was cutting herself. He is concerned. Earlier that day, he received a call from a local counselor asking whether Ashley would come back. He can’t drag her there, Alex told the counselor.

If Alex knew what his daughters needed, he’d give it to them. For now, he just wants to give them time to process their loss.

•••

As I am leaving Rock Springs behind me, fiddling with the radio to find something other than pop music, Christian sermons, commercials or Christmas songs, I think back to what Alex said about his hope that Donald Trump would bring change.

What kind of change does he and his family need? The old coalmining days are long gone. People no longer dance and garden with each other. Parents can no longer rely on their offspring’s upward mobility.

The pride of hard, manual labor has faded, and family emergencies rarely bring whole communities together. The mental healthcare system in the US continues to struggle to fill the gaps that the changes have created. In a secluded, thinly populated area where both mental illness and therapy are met with suspicion stemming from both shame and fear, those who are down and out often have no place to go.

Danielle’s name was changed, alongside the names of her children