September 7, 2012

Effects of Suicide on Family Members-The Mourning After

Suicide is a devastating loss for families, unimaginable to most of us for whom life is precious.  We cling to life and fight to relish and enjoy every possible moment.  The pain and suffering that cause someone to end their own life is unfathomable to almost everyone.  For the loved ones left behind, part of the agony is having to think about the suffering that preceded that final act.  The living are condemned to imagine that horror and agony in a way that is very different from dealing with the loss of a loved one that most people experience.  I imagine it comes closest to the feelings experienced by those who have lost a loved one due to violence perpetrated by another person.  Suicide is indeed a violent act, someone does commit a murder even if the the victim is oneself.

Suicide also creates a great deal of confusion and guilt for survivors.  Anger is almost always a part of the picture-“how could they do this to ME.” And, in fact, suicide at times IS done to punish others, most commonly after the breakup of a relationship.  Some anger, to the surprise of many, accompanies the loss of almost anyone  we love-“why aren’t they here when we need them so much.”  This is magnified with suicide as the intentionality of the act is undeniable.  As family members grieve it is hard not to think about the pain that was deliberately brought to the survivor.  There is also, almost always, some level of guilt.  Our minds torture us in this way, “I shouldn’t have let her go away to school”, “I shouldn’t have insisted that he postpone his plans”, “I should have been more forceful at insisting she get help”, “I should have realized earlier how bad it was.”  No matter what the particular circumstances, it is our nature to think we could have done something to prevent what occurred.

A common misconception is that we shouldn’t ask if someone has thoughts of killing themselves, that the question will somehow plant the idea where it doesn’t exist.  This is highly unlikely.  We certainly do not have the power to prevent all suicides but paying attention to evidence of severe depression in a loved one can help. 

Suicidal thoughts are NOT normal.  They are always cause for alarm and should always receive professional treatment.

The American Foundation for Suicide Prevention says that 90% of all people who die by suicide have a diagnosable (and therefore treatable!) psychiatric disorder. I have visited many a teenager in the emergency room when I was on staff at a hospital.  Suicide is the third leading cause of death for people 15 to 24 and estimates are that there are about 8 suicide attempts for every completed suicide.  Luckily, teenagers are less competent and sophisticated in completing their plans but I have heard from families way too often, “oh they were just trying to get attention” in response to a suicide attempt that was unlikely to cause death.  I do not think these are uncaring parents.  I think it is just easier to hope it is a defiant or difficult child, rather than one who is at serious risk of dying.  The risk is very real when there is an attempt.  The highest predictor of suicide is previous attempts.

Suicide can be very isolating for families, difficult to share with friends.  Many people are unsure how to approach a bereaved family when suicide is the source of the loss.  These families need our support and compassion as they deal with this terrible loss. The best way to find out how to support someone you know dealing with a suicide is simply to ask.  How can I help?  Would you like to talk about it?  I care about you and I am so very sorry for your loss. These are simple strategies but powerful in their ability to help those dealing with the suicide of a loved one.

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4 Responses

  1. An insightful and beautifully written article that I will use and refer to in my daily practice as a psychiatrist in the Jacksonville,FL area. Great job, Dr. Goldstein.

  2. Bernard Jackson says:

    Dr. Goldstein, I am a regular reader of your posts during the last year or so. They are so poignant, throught-provoking and well-reasoned. You are helping many people, I’m sure, and trust that you will continue in this meaningful work.

  3. Joe Wasch says:

    So sad.

  4. Vicky Miller says:

    Absolutely wonderful website……a great great job!!! Well done Robin!

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