It has been said that there are two things humans are sure to do, and those are to live and die. Even though everyone will die, death is still a taboo and uncomfortable subject for many. Death of a loved one can leave family and friends grieving. However, this grief can be compounded when the death is by suicide.

The healing process is difficult enough, but suicide is exceptionally difficult in that it is shocking, unexpected and more challenging to deal with. Suicide and its emotional impact on its survivors is what will be examined in this writing. Also, specific interventions to help survivors of a suicided loved one will be discussed.

Before delving into the emotional impact of suicide, background statistics must be presented. It is estimated that approximately 30,000 American citizens die by suicide every year, and approximately one million globally. Perhaps the most telling statistic is that one in four people know someone who has died by suicide, and existing literature seems to agree that one suicide death leaves six people directly affected and/or bereaved. This makes suicide very real and prevalent.

Impact on emotional well-being:

For this writing, the term “suicide survivors” will be used strictly for family members of the suicide victim. Much of the existing literature discusses the emotional impact that suicide has on its survivors. Some common themes that have come up in research include feelings of shame and guilt as a result of the stigma surrounding suicide of a family member. Before looking into how shame and guilt is manifested in suicide survivors, one must examine the stigma that causes these feelings. Suicide is particularly difficult to deal with because society shuns and stigmatizes it. This is nothing new. There are two examples of this stigma.

In the Victorian Era of Great Britain, suicide meant social shaming and stained family reputations. The surviving family’s property values went down as well, and funerals of the deceased were hasty. Families hid suicidal deaths. Even before the Victorian Era, there were instances in the Middle Ages, where suicide survivors felt the stigma. Suicided corpses were mutilated to stop evil spirits from being unleashed. Families were often denied proper burials, and family property was seized. Today, we do not see that type of stigmatization.

However, suicide victims have been called “selfish” and “cowardly”. The stigma still exists, as evidenced by the insurance industry. Most insurance companies will not pay out on policies where the deceased has died by suicide within the first two years. Most researchers conclusively agree that this stigma causes shame, silence, and guilt about what the survivor could have done to prevent the suicide.

Manifestations of Grief:

When it comes to suicide grief, it is manifested in a variety of ways. Various mental health problems can arise as a result of grief from sudden loss (e.g. homicide, accident, suicide). These problems include post-traumatic stress disorder, or PTSD; mood depressive disorder, or MDD; and prolonged grief disorder, PGD. While PTSD and MDD (depression) are accepted as responses to sudden loss, little is known about PGD.

PGD is a relatively new psychiatric disorder and has a set of grief symptoms that includes yearning for the deceased, difficulty accepting the loss, and hardship carrying on with normal life and activities for prolonged periods of time, six months or more. Sudden loss is one of the most common occurrences that leads to post-traumatic stress disorder. It is manifested by suicide survivors’ reliving the events at the scene of death, and re-experiencing the visual images of the suicide, either real or imagined.

Additional manifestations of suicide survivors’ grief are depression (MDD), developing drug/alcohol abuse and dependency, and becoming suicidal themselves. This is evidenced by the study of “Lilly”. She reported being suicidal for 10 days after her husband’s suicide. Her own past trauma of abandonment at birth and rape as an adolescent complicated her suicidal ideation.

When examining these symptoms in children of parents who have suicided, it becomes more complex, as they can also develop a psychosomatic disorder, psychosis, and learning disabilities. When a young child loses a parent to suicide, it affects his/her identity, personality, world-view, and socialization. Grief can recur over a lifetime, and at times, be a function of cognitive and emotional maturation. As the child matures, the grief may no longer be about missing the deceased parent but can shift to grief about what the parent could have been to him/her.

While much has been written about the negative impact, conversely, suicide sometimes is seen as a positive by the survivor. Some report feeling relieved by the death of a loved one who suicided. In one noted case, the suicide sibling caused family stress and consumed a lot of time and energy. Because of this, it is important to note that the emotional impact of suicide varies across situations and relationships.

For part two, we will look at interventions that a person can utilize to cope with a loss by suicide.

By Delmar Devers, Painted Brain intern. You can visit his blog at SingingSocialWorkerBlog

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