International Survivors of Suicide Loss Day – November 19th

Hopefully, many of us will never know what it’s like to lose someone to suicide. However, for those who sadly are living with it, we feel compassion and acknowledge their grief and loss. On November 19th, we dedicate the day to those who have lost loved ones to suicide. International Survivors of Suicide Loss Day allows survivors to come together in a supportive place and share experiences while honoring their loved ones.

Those Left Behind

With more than 45,000 people committing suicide in the U.S. every year, at least several people per suicide are left behind, grappling with grief and trying to make sense of this trauma. The events surrounding a suicide make the grief emotionally devastating and complicated, with family members and friends often needing increased support but being afraid to speak out loud about the circumstances of the death.

Stages of Grief and Strong Emotions

There are several models of grief, including Freud’s model of Bereavement, Bowlby’s Attachment Theory, and Elisabeth Kubler-Ross's five stages of grief, as detailed in her book On Death and Dying, which will be reviewed here. For survivors of suicide, the emotions displayed through the stages can be even more intense and confusing.

1- Denial

The 1st stage of grief, aptly called “shock and disbelief” by Bowlby, dulls the intensity of the agonizing situation. It protects survivors from the extreme pain and anguish of considering the circumstances surrounding the truth of the suicide.

2- Anger

Anger is a natural response that takes place once reality sets in. Many other emotions hide in anger and manifest in various reactions, such as losing patience with others, having a short temper, and blaming others. Some of this blame is even directed toward their loved ones for committing suicide or towards family, friends, or even themselves for not picking up on the signs and getting help. Some even direct their anger towards a higher power for what they feel is an unjust situation.

3- Bargaining

Bargaining helps delay the grief that is undeniably coming. For a survivor of suicide, bargaining could include examining the many “what-ifs” or “if-only” moments of the situation, which can be excruciating and exhausting.

4- Depression

While the first three stages are an instinctive effort to protect us from emotional pain, depression inevitably arrives as the survivor faces the full recognition of their new reality. Heavy and confusing and full of uncertainty and regret, depression can weigh you down. It’s the phase that most people understand and relate to someone’s death.

5- Acceptance

Acceptance doesn’t mean that all the negative emotions are suddenly gone. The survivor has begun to accept the loss and fear and is coming to terms with it. Bowlby describes this as the rebuilding and healing stage.

Self-Help

These stages of grief are unique for everyone and may be experienced in various orders and then revisited. You may be in the acceptance stage and back in anger and denial. It could take weeks, months, or even years to go through all the stages.

The emotional lability that comes with being a survivor of suicide loss can be difficult on your health, and it’s important to practice self-care with things such as:

• Taking a short 10-minute walk outside a couple of times a day
• Taking time out during the day for deep breathing exercises
• Drink enough water
• Eating healthy meals regularly
• Monitor alcohol consumption
• Join a support group
• Talk to friends and family. They are likely going through the same emotions
• Seek out a professional therapist for talk therapy and short-term antidepressants if necessary

When to Seek out Professional Help

It’s important to recognize when self-care isn’t enough to get through the pain on your journey through grief, it may be time to seek professional help. There are several choices of professional help available to you:

• A clinical psychologist can guide you in learning to manage and express your feelings and find healthy ways to cope.
• A psychiatrist can prescribe medications to help get you through the stages of grief a bit more smoother.
• A clinical social worker can also offer individual, family, and group therapy and is found in a variety of settings.

Seeking out professional mental health help is critical and beneficial if you find yourself:

• Having suicidal thoughts
• Have a history of depression or increased depressive symptoms
• Symptoms of PTSD
• Somatic symptoms
• Increased dependence on alcohol, drugs, or tobacco
• Insomnia or hypersomnia
• Physical symptoms such as headache or unrelieved pain
• Feeling that you are not able to move forward in your own life without the deceased
• No improvement after several months

Both the holiday season and daylight savings time are upon us, which challenges our motivation and slows our physical activity whilst our anxiety and seasonal depression may increase.

With the many demands put on us this hectic time of year (I.e., shopping, cooking, entertaining) and anxieties (money, time, family dynamics), it’s important to keep self-care at the top of our to-do lists so we can also care for others who may be faring worse.

The CDC reports that increased suicide rates are often highest in the Spring and Fall and not around the holidays as commonly reported. However, with suicide remaining the 10th leading cause of death for all Americans, we must remain observant of our friends and family during this season.

The CDC offers families and communities the Suicide Prevention Resource for Action, which lists meaningful data-driven strategies with a focus on preventing the risk of suicide before it arises while also decreasing the immediate and long-term damage suicidal behavior can have.

Psychological and physical distress is a traumatic event. Trained clinical psychologists and psychiatric nurse practitioners offer the latest treatments for care in PTSD and are trained extensively to treat individuals suffering from trauma.

References/Resources

International Survivors of Suicide Loss Day

Left behind after suicide

Theories of Loss and Grief

Kubler-Ross Stages of Dying and Subsequent Models of Grief

What to Know About Being Unable to Control Emotions

Coping after suicide loss

I've lost someone

Post-traumatic stress disorder (PTSD)

Holiday Suicides: Fact or Myth?

Suicide Prevention Resource for Action