According to the Centers for Disease control, more than 40,000 people completed suicide in 2013 making suicide the 10th leading cause of death in the United States. Statistics also suggest that nearly 1 million people complete suicide each year (DeLeo, Bertolote, Lester, 2002). For those who are grieving the loss of someone they love due to suicide, the process of healing is often very difficult.
The loss of a loved one to suicide is extremely painful not only because loved ones are grieving the loss of that person, but also because the circumstances of that loss can often intensify the difficulty of the grieving process. In addition to feeling sadness and loss, the bereaved often face some unique challenges associated with the loss of someone by suicide.
There are three types of grief that are often referred to in the literature. Understanding the type of grief you are experiencing can help you to understand the typical process of grieving and to determine whether you may need assistance in the grief process. The three types are (adapted from Young, Iglewicz, Glorioso, Lanouette, Seay, Ilapakurti, & Zissok, 2012):
- Acute grief – This type of grief describes the experience immediately after the loss of someone you care about. Common feelings associated with this type of grieving are denial, numbness, and shock. The sense of emotional numbness or the denial of the loss often aides the bereaved in attending to the tasks associated with the loss such as planning a memorial service or funeral. In the days, weeks and possibly months following the death, the bereaved will begin to understand the loss more completely and will start to work through the emotions associated with the death. At this time, many feelings may arise including anger, guilt, anxiety, fear, sadness, loneliness, and shock. These feelings often come in waves brought on by reminders of the lost loved one such as an anniversary, a memory or an event. As time passes, the frequency and duration of these waves begin to subside. During the phase of acute grief, the bereaved begin to accept the loss and begin to feel more emotionally balanced and able to attend to life tasks.
- Integrated grief – This period of grief is described as the time when a person has begun to heal from the loss. The bereaved are able to get back to daily routines and responsibilities and can think of their loved one without the same level of hurt that was experienced in the acute phase. People are also able to become more engaged in their relationships with others and are likely to have found a new sense of strength and meaning in their own lives and experiences.
- Complicated grief – When the acute grief continues to be distressing for an extended period and begins to interfere with a person’s ability to function in their daily lives, then the person is likely experiencing complicated grief. This type of grief is typically characterized by the inability to reintegrate into one’s life after a loss and a prolonged period of yearning and longing that goes beyond what is experienced by others who have experienced this same loss. There is a sense that no healing has occurred and instead the bereaved continues to experience intense feelings of loss and sadness and may become very focused on their lost loved one while at the same time avoiding places, thoughts or feelings that they believe may bring up increased feelings of loss. People experiencing complicated grief are also at increased risk for experiencing suicidal thoughts, which may be due to a belief that the intense feelings of loss will only subside if they are able to join their loved one. Those who have lost someone to suicide are more likely to experience complicated grief due to the intense nature and possible trauma associated with this type of loss.
If you believe that you are experiencing complicated grief then it may be time to get some help. Meeting with a therapist or joining a support group can be important ways to begin to move toward healing. Below, you will find some resources for finding support groups and further information related to grief following suicide.
Dr. Stephanie Davidson is a licensed, clinical health psychologist and co-founder of the Rowan Center for Behavioral Medicine specializing in the use of cognitive-behavioral, humanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.
Please feel free to call the Rowan Center for Behavioral Medicine for further information 818-446-2522 or email
American Foundation for Suicide Prevention (AFSP) http://www.afsp.org
American Association for Suicidology (AAS) http://www.suicidology.org/
International Association for Suicide Prevention (IASP) https://www.iasp.info
DeLeo, D., Bertolote, J., & Lester, D. (2002). Self-directed violence. Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B. & Lozano, R. (Eds.) World Report on Violence and Health, Geneva Switzerland: World Health Organization; 185-212.
Young, I. T., Iglewicz, A., Glorioso, D., Lanotte, N., Seay, K., Ilapakurti, M., & Zisook, S. (2012). Suicide bereavement and complicated grief. Dialogues in Clinical Neuroscience. 14(2), 177-186.