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Suicide is a death like no other

Published on November 25, 2013 by Deborah Serani, Psy.D. in Tw o Takes on Depression

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Grief is a universal experience all human beings encounter.

Though death inevitably touches our lives, research shows that
many people grieve in varying and different ways. From the
textures of emotions, to length of time in mourning, to even the
kinds of rituals and remembrances that help heal the
irreplaceable loss. Grieving the death of a loved one is never,
ever easy.
Suicide, however, has been described as a death like no
other[i] ... and it truly is. Death by suicide stuns with soulcrushing surprise, leaving family and friends not only grieving
the unexpected death, but confused, lost and frozen by this
haunting loss.
artwork c reated by Out of the Ashes - Fac ebook

Who is a Survivor of Suicide Loss?

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Despite science supporting a neurobiological basis for mental illness,

suicide is still shrouded by stigma[ii]. Much of the general public believes
that death by suicide is shameful and sinful. Others consider it a choice
that was made and blame family members for its outcome. And then
there are people who are unsure how to reach out and support those who
have lost a loved one to suicide, and simply avoid the situation out of
ignorance[iii]. Whatever the reason, it is important to note that the
underlying structure of grief for survivors of suicide loss is intricately
complicated.
When someone dies by suicide, research shows that at least 6 people are
intimately traumatized by the death. Those who are directly affected
include immediate family members, relatives, neighbors, friends, fellow
students and/or co-workers. And because 90% of people who die by
suicide have a psychological disorder, mental health clinicians are also
included as a survivor of suicide loss[iv].
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A personal essay

From the nearly 800,000 suicides reported from 1986 through 2010 and
using the 6 survivors per suicide estimate, it is believed that the number
of survivors of suicide loss in the U.S. reaches 5 million people[v].

Why Cytochrome p450 is a phrase

you should know

Understanding Suicide
Based on the accounts of those who have attempted suicide and lived to
tell about it, we know that the primary goal of a suicide is not to end life,
but to end pain. People in the grips of a suicidal depression are battling
an emotional agony where living becomes objectionable. Most people who
die by suicide have a significant depression narrowing their problem
solving skills. Corrosive thinking reduces optimism, the hope of possibility
and increases feelings of helplessness. The depressive illness itself
makes it virtually impossible to hold onto any semblance of pain going
away. While some may argue that a person who dies by suicide has done
so by their own choice, I argue that serious mental illness, in fact, limits
choice[vi]. Studies of those who have survived their suicide attempt and
healed from their depression report being astonished that they ever
considered suicide.
Why Grieving is Different
Research has long known that suicide survivors move through very
distinctive bereavement issues [vii]. Family and friends are prone to
feeling significant bewilderment about the suicide. Why did this happen?
How did I not see this coming? Overwhelming guilt about what they should
have done more of or less of become daily, haunting thoughts.
Survivors of suicide loss often feel self-blame as if somehow they were
responsible for their loved ones suicide. Many also experience anger and
rage against their loved one for abandoning or rejecting themor
disappointment that somehow they were not powerful enough, loved
enough or special enough to prevent the suicide[viii].
These mistaken assumptions plague survivors of suicide loss for a very
long time. Many struggle for years trying to make sense of their loved

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ones deathand even longer making peaceif at allwith the

unanswerable questions that linger[ix].

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For ALL Kids
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Society still attaches a stigma to suicide. And as such, survivors of suicide

loss may encounter blame, judgment or social exclusion - while mourners
of loved ones who have died from terminal illness, accident, old age or
other kinds of deaths usually receive sympathy and compassion. Its
strange how we would never blame a family member for a loved ones
cancer or Alzheimers, but society continues to cast a shadow on a loved
ones suicide.
What also makes grieving different is that when we lose a loved one to
illness, old age or an accident, we retain happy memories. We can think
back on our loved one and replay fond memories, share stories with joyful
nostalgia. This is not so for the suicide survivor. They questions the
memories, Where they really good? Maybe he wasnt really happy in
this picture? Why didnt I see her emotional pain when we were on
vacation? Sometimes it becomes agonizing to connect to a memory or to
share stories from the pastso survivors often divorce themselves from
their loved ones legacy.
Survivors of suicide loss not only experience these aspects of
complicated grief, they are also prone to developing symptoms of
depression and post-traumatic stress disordera direct result from their
loved ones suicide. The unspeakable sadness about the suicide
becomes a circle of never ending bewilderment, pain, flashbacks and a
need to numb the anguish[x].
Ways to Help a Survivor of Suicide Loss
If you know someone who has lost a loved one to suicide, there are many
things you can do[xi]. In addition, by reaching out, you also help take
stigma out of the equation.
1. Dont be afraid to acknowledge the death. Extend your
condolences, express your feelings of sorrow. Make sure you use

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2.

3.

4.

5.

the loved ones name. My heart is so sad that John died.

Ask the survivor if and how you can help. Though they may
not be ready to accept help, asking signifies that you are there
not avoiding or distancing during this tragic event. The notion of
being there if needed is extremely comforting for survivors.
Encourage openness. Be accepting of however survivors need
to express their feelings. It may be with silence, with sadness or
even anger.
Be patient. Dont set a time limit for a survivors grief. Complicated
grief can take years to process. Moreover, dont limit a survivors
need to share and repeat stories, conversations or wishes.
Repetition is a key factor in grief recovery.
Listen. Be a compassionate listener. This means dont look to fix
things. The greatest gift you can give someone you care about who
has survived a suicide loss is your time, reassurance and love.

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Ways to Help Yourself if Youre a Survivor of Suicide Loss

1. Ground yourself: It may be very painful, but you must learn to
hold tightly to the truth that you are not responsible for your loved
ones suicide in any way, shape, or form.
2. Dont put a limit of your grief. Grieve in your own way, on your
own time frame. It will take time to find a place for your sadness and
loss. It may take even more time for you to feel hope again and
envision possibilities.
3. Plan ahead. When you feel ready, assist your family in finding
ways to mark your loved one's birthday, family holidays or other
milestones. Understand that new moments, experiences or events
will be met with sadness, even with emotional setbacks. Preparing
for how you will move through these calendar dates will help
minimize traumatic reactions.
4. Make connections. Consider joining a support group specifically
designed for survivors of suicide loss. The environment can
provide a mutually supportive, reassuring healing environment
unlike anywhere else.

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5. Give yourself permission. To cry. To laugh. To seek

professional help if you need it. Remember that you are moving
through the most difficult of lossesand you can take control of the
path to healing.
[i] Redfield-Jamison, K. (2006, July). Suicide Prevention Action Network
USA, National Awareness Event, Washington, DC.
[ii] Cvinar, J.G . (2005). Do suicide survivors suffer social stigma: A
review of the literature. Perspectives of Psychiatric Care, 41(1):14-21.
[iii] Feigelman, W., Gorman, B.S. & Jordan, J.R. (2009). Stigmatization
and suicide bereavement. Death Studies, 33(7):591-608.
[iv] Hendin H, et al. (2000). Therapists' reactions to patients'
suicides. American Journal of Psychiatry, 157(12):20222027.
[v] Young, I. T. et. al. (2012). Suicide bereavement and complicated
grief. Dialogues in Clinical Neuroscience, 14(2):177-186.
[vi] Serani, D. (2011). Living with Depression. Lanham: The Rowman &
Littlefield Publishing Group.
[vii] Jordan, J. (2001). Is suicide bereavement different? A reassessment
of the literature. Suicide and Life-Threatening Behavior, 31: 91102.
[viii] Sakinofsky I. (2007). The aftermath of suicide: Managing survivors'
bereavement. Canadian Journal of Psychiatry, 52(6):129S136S.
[ix] Sudak, H., Maxim, K., & Carpenter, M. (2008). Suicide and stigma: A
review of the literature and personal reflections. Academic Psychiatry,
32(2):136-142.
[x] Crosby, A. E. & Sacks, J. (2002). Exposure to suicide: Incidence and
association with suicidal ideation and behavior: United States,
1994. Suicide and Life-Threatening Behavior, 32: 321-328.
[xi] Jordan, J.R. & McMenamy, J. (2004). Interventions for suicide

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survivors: A review of the literature. Suicide and Life-Threatening

Behavior, 34(4):337-349.
Dr. Deborah Serani is an awardwinning author. Her
books Depression and Your Child:
A Guide for Parents and
Caregivers and Living with
Depression are published by
Rowman & Littlefield

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