When a Loved One Dies by Suicide

The death of someone you love is incredibly painful, and healing can take years. Grieving is a process that may never really end, though its pain will almost certainly soften over time. Sadness, disbelief, anger, shock, denial, pain, bargaining and acceptance are a part of the framework that makes up the process through which we learn to live with the loss of someone we love.

When someone you love dies by suicide, grieving their death can be especially complex and traumatic. The devastating grief experienced after a suicide is often compounded by feelings of guilt, anger, abandonment, confusion and betrayal. Feelings of sadness, loss and loneliness are often magnified. Attempting to understand why your loved one died by suicide and trying to make sense of it can be overwhelming.   

The National Institutes of Health (NIH) reports that nearly 1 million people die by suicide globally each year. Suicide is one of the top ten leading causes of death across all age groups. It is estimated that 85 percent of people in the United States will personally know someone who has completed suicide. 

The NIH offers this definition of suicide, along with some guidance about sensitivity when using the term: suicide is when people direct violence at themselves with the intent to end their lives, and they die because of their actions. It’s best to avoid the use of terms like “committing suicide” or a “successful suicide” when referring to a death by suicide as these terms often carry negative connotations. A suicide attempt is when people harm themselves with the intent to end their lives, but they do not die because of their actions.

People of all ages, economic backgrounds, genders and ethnicities can be at risk. Suicide does not discriminate.

The NIH identifies the following as the main risk factors for suicide.

• A prior suicide attempt
• Depression and other mental health disorders
• Substance abuse disorder
• Family history of a mental health or substance abuse disorder
• Family history of suicide
• Family violence, including physical or sexual abuse
• Having guns or other firearms in the home
• Being in prison or jail
• Being exposed to others’ suicidal behavior, such as a family member, peer or media figure
• Medical illness
• Being between the ages of 15 and 24 years or over age 60

The behaviors listed below may be signs that someone is thinking about suicide.

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty, hopeless, or having no reason to live
• Planning or looking for a way to kill themselves, such as searching online, stockpiling pills, or newly acquiring potentially lethal items (e.g., firearms, ropes)
• Talking about great guilt or shame
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable pain, both physical or emotional
• Talking about being a burden to others
• Using alcohol or drugs more often
• Acting anxious or agitated
• Withdrawing from family and friends
• Changing eating and/or sleeping habits
• Showing rage or talking about seeking revenge
• Taking risks that could lead to death, such as reckless driving
• Talking or thinking about death often
• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, making a will

Grieving a Suicide

The process of grieving a suicide involves acknowledging and accepting feelings of rejection or abandonment. You may feel that your loved one left you behind when they didn’t have to or wonder why your relationship with them wasn’t enough to keep them alive. “Grieving a death by suicide is very different than deaths caused by other means. Suicide leaves loved ones wondering what signs they missed, wondering what they could have done to prevent it.  People sometimes blame themselves or look to blame others,” said Terri Larkin, LPC and therapist with INTEGRIS Decisions mental health and substance abuse treatment programs. 

Suicide survivors are often driven to try to make sense of the suicide and to gain an understanding of why their loved one decided to take his or her life. Even when a note has been left or reasons given for the suicide, unanswered questions remain and survivors are left to grapple with the unknowable. 

A completed suicide can trigger powerful emotional reactions and stages of grief in those who loved the person who died.

• Shock. You may feel unable to believe that the suicide has happened. Emotional numbness may leave you feeling stunned and ‘blank.’ This is also referred to as the dissonance phase. Devastation, anguish and emotion wash over you leaving you quite unable to process or even acknowledge what has happened. Panic, incrimination and blame may also rear their heads during this shock/dissonance phase.
• Debilitation. Despair. You might have a physical or mental collapse or even consider suicide yourself. You may be unable to complete daily tasks or you might be gripped by sadness, loneliness or helplessness/powerlessness. It’s normal in this phase to feel alienated from those who do not share your loss. You may feel that you have no control over your life.
• Anger. You may feel anger at yourself for missing signs or being unable to prevent the suicide. You may feel anger toward anyone who you feel may have missed signs or cues that suicide was imminent. You might be angry with your loved one for abandoning you and leaving you with such life-changing grief.
• Guilt. You might replay "what if" and "if only" scenarios in your mind, blaming yourself for your loved one's death. You might ruminate about your last interactions with your loved one, looking for signs.
• Confusion. Many people try to make some sense out of the death or try to understand why their loved one took his or her life. But, you'll likely always have some unanswered questions.
• Feelings of rejection. You might wonder why your relationship wasn't enough to keep your loved one from dying by suicide.
• PTSD. Some suicide survivors develop post-traumatic stress disorder (PTSD), an anxiety disorder that can become chronic if not treated. In PTSD, the trauma is involuntarily re-lived in intrusive images that can create anxiety and a tendency to avoid anything that might trigger the memory

Individual counseling with a qualified mental health professional can be very beneficial. Find a skilled therapist who is experienced in working with grief after suicide. The therapist can support you in many ways, including the following.

• Helping you make sense of the death and better understand any psychiatric problems the deceased may have had
• Treating you, if you're experiencing PTSD
• Exploring unfinished issues in your relationship with the deceased
• Helping you cope with differing reactions of family members
• Offering support and understanding as you go through your unique grieving process

People who are bereaved by a suicide may find it hard to ask for support. The stigma of suicide, the difficulty we have in understanding suicide and a reluctance on the part of survivors to confide that their loved one’s death was by suicide often mean that survivors receive less support than they need. When others do know the circumstances around a suicide death, they may feel less certain about how to help.

To help a friend who has lost a loved one to suicide, offer support and compassion. Spend time remembering their life. Be a good listener. Offer to help with chores, run errands. Help out with practical things, offer to water the garden, walk the dog, watch the kids.   

As a survivor, you might continue to experience intense reactions for weeks or months after your loved one's suicide — including nightmares, flashbacks, difficulty concentrating, social withdrawal and loss of interest in usual activities — especially if you witnessed or discovered the suicide. 

Find a support group for people dealing with loss from death by suicide. Connect with fellow survivors. Survivors of Suicide Support Groups are offered locally. INTEGRIS Decisions Mental Health and Addiction Recovery Programs  also can be very helpful to those who have lost a loved one by suicide. 

The INTEGRIS grief support program provides a step-by-step approach for those who wish to resolve their loss issues and soften the pain of their loss. Meeting once a week for six weeks, these groups are led by licensed professional counselors specializing in the field of grief and loss.

Open to the community, INTEGRIS Health grief support groups are confidential, and offered at no cost to participants. For more information, please call 405-848-8884.

IF YOU OR SOMEONE YOU KNOW IS IN CRISIS OR CONTEMPLATING SUICIDE HELP IS AVAILABLE. IF DANGER IS IMMINENT CALL 911. THE 24-HOUR SUICIDE PREVENTION LIFELINE IS AVAILABLE BY CALLING 800-273-8255.