Peer support can be healing for survivors because it helps normalize both emotions and life changes.
Experiencing the death of a loved one is always tragic. But when someone you're close to , the aftermath can be particularly complex.
Suicide adds "multiple layers" to the grieving process, say David and Norma Walker of Garland, Texas, whose 15-year-old daughter, Sadie, died from suicide last December. "Any death is going to be hard," David Walker says. "But with suicide, you're dealing with many different emotions and experiences."
While there's no single way to recover from this kind of loss, experts and survivors offer the following coping strategies:
Educate yourself – and others. According to the American Foundation for Suicide Prevention, a New York City-based nonprofit that aims to understand and prevent suicide through research, education and advocacy, more than 40,000 Americans die by suicide every year. Suicide is the second leading cause of death for individuals ages 10 to 24, and the 10th leading cause of death in the U.S. Yet due to stigma and a lack of dialogue, few people – or believe it can happen to someone close to them.
"People walk around thinking they're immune to certain things," says Michelle Cornette, executive director of the American Association of Suicidology, a District of Columbia-based group that strives to understand and prevent suicide. "Only certain types of family members or people take their own lives. And then someone in their immediate network dies of suicide, and it shakes up their world view."
Experts don't know what drives people to take their own life. According to Dr. Christine Moutier, AFSP's chief medical officer, suicide "is typically the result of biological, psychological, social and environmental factors that converge, often as the result of stressful triggers and in the context of lethal means." Research suggests 90 percent of those who die by suicide had a diagnosable psychiatric disorder.
Understanding suicide – and talking about it – can help reduce stigma and save lives, says David Walker, whose family now engages in public awareness and outreach efforts.
Seek support. The sooner you seek help from a professional after a suicide, the better, says Eric Marcus, senior director for loss and bereavement programs at AFSP. He has seen families and relationships torn apart by a lack of communication or support.
Peer support can be very healing for some survivors because it helps normalize both emotions and life changes they're dealing with. And – such as cognitive behavioral therapy and group family therapy – can also be helpful for survivors. Others might benefit from talking to a counselor, a licensed social worker or a spiritual leader in their community.
However, someone doesn't necessarily need a degree to be of service – or of comfort. Reach out to friends, relatives, neighbors or peers who can help you with everything from everyday tasks such as cooking and running errands to simply providing you with conversation, company or a hug, Norma Walker says.
Avoid lingering 'whys' and 'what ifs.' Suicide can often be accompanied by whirlwind of speculation: Didn't we love them enough? Didn't they love us enough? Could we have done anything to prevent this? Were there signs we should have noticed before it was too late?
"Since hindsight is 20-20, often-missed clues become available that were understandably not seen or identified. These circumstances can lead to conflicted – and more prolonged – grief," Moutier says.
While it's easy to imagine where things went wrong, it's impossible to pinpoint one reason or factor that led to suicide. Often, the person was mentally ill and had been sick for some time before taking his or her own life.
Take care of yourself. Marcus recommends basic self-care after the suicide of a loved one. "Everything from exercising to breathing to eating well – these are all the personal-care issues you have to pay attention to in the aftermath of a traumatic death," he says.
Since mental illness often , it's important to have an open conversation with surviving relatives about suicide, says Kim Ruocco, manager for suicide outreach and education programs at The Tragedy Assistance Program for Survivors, a nonprofit based in Arlington, Virginia, that provides care and support to families and friends who've lost someone in the armed forces. Ruocco lost her husband, a veteran, to suicide. Define the difference between mental heath and physical health, and be prepared to discuss topics such as depression and other mental health conditions.
Stay mindful of language. Experts and survivors say it's important to adhere to the family's preferred terminology surrounding a loved one's death.
"You want to ask the family what their perception is of how [the person] died," Ruocco says. "You want to adopt the language they use. They may call it an accident – an 'accidental death.' On the news it may be, and the coroner's report might say, it's a suicide. But if the family believes it's something else, don't assume otherwise based on public knowledge."
Experts discourage the term "commit suicide" because it sounds similar to disparaging phrases such as "committed a crime" or "committed a sin." They also suggest avoiding "successful suicide," which suggests suicide is something one can "achieve." Instead, they recommend sticking to phrases such as "died from suicide," "took her own life" or "ended their life."
If you're a family member or relative, language and terminology can become particularly important when informing the community of a death. Whether it's an obituary or memorial website, it's normal for survivors to become stymied on what to say. Should they err on the side of privacy, or attempt to combat stigma by remaining open about the cause of death? Should they worry about suicide contagion?
The wording in the obituary "is really up to [you]," Ruocco says. "Most people are not comfortable saying 'died from suicide' in an obituary" because they're still in shock. Plus, family members might disagree about how to address the death – a conflict that could add to an already stressful situation. Ruocco recommends keeping the obituary as simple as possible: honoring the person's life, love and achievements, and focusing on the life lived instead of the death.