The loss of a loved one is a dreadful event that all of us experience at some point in our lives. If that death happens by suicide, it could be even harder for the grieving loved ones to process.

The bereavement process is a completely natural but very personal response to loss. How one grieves ultimately depends on a multitude of factors, such as the chain of events leading to the other person’s death, one’s personality, support and coping mechanisms and faith. But one thing remains in common, healing takes time and it happens gradually.

Bereavement after a suicide shares characteristics with other bereavements but it also has its differences. It is often complex and can last longer – in fact, some significant effects may be felt years after the death.

After a loss to suicide, it can be hard to accept what happened. Bereavement can bring about a range of complex and intense emotional and physical reactions, which can feel uncomfortable or frightening. Feeling guilty, regretful or perhaps even angry for things that were said or unsaid, as well as profound sadness and fear are not uncommon.

Additionally, the bereaved may also experience physical symptoms such as headaches, fatigue, poor concentration, nausea and stomach pains, sleep disturbances or even chest tightness.

Loved ones may be haunted by unanswered questions such as why did s/he take her/his own life and could I have prevented it in any way. It may not always be possible to find a suitable explanation and the individual may spend considerable time mulling over these questions, which is part of the grieving process.

If they had witnessed the event, they may even suffer from distressing flashbacks/nightmares, re-imaging what happened.

Eventually, s/he may choose to either accept that s/he will never know the right answer or settle for an answer s/he can live with.

Perhaps the most distressing feeling is the sense of isolation in the aftermath. Stigma generates a lot of speculation involving shame and blame. Close family and friends (or even the public) try to piece together a story that might explain what has led to the suicide death, which, often times, leads to prejudices and can also cause family tensions and conflict. Such hurtful stigmatising and judgmental comments might prevent the bereaved individual from seeking the help s/he requires.

After a loss to suicide, it can be hard to accept what happened. Photo:

What to do?

Anyone who is trying to support a person affected by a suicide death can, often times, feel lost or awkward on how to best offer help without hurting them, even if it’s a close friend or colleague. The following are some tips to help you feel more comfortable in doing so.

Don’t assume that someone is receiving the support – reach out to them and let them know you are there if they need you. You don’t have to be a close family member or friend; sometimes the most touching support comes from those least expected.

Staying silent or ignoring the bereaved with the fear of hurting them can often make them feel more hurt or isolated. Every person grieves differently and it is best to ask them how they would like to be supported or contacted during this sensitive time. Moreover, if someone is slow at returning back your calls or messages, keep trying but do not take it personal.

Give them time and space to open up if they want to and, when they do, actively listen to them, sharing their emotions. Grieving might be a long process, so be patient. However, avoid using the term ‘committed suicide’ as this is often stigmatising and denotes a criminal act. Instead, use neutral terms such as ‘died by suicide’ or ‘took their own lives’. Avoid using clichés terms, such as ‘time will heal’ or ‘they’re at peace now’ to comfort another and try not to prod for details surrounding the suicide. It might come across as morbid curiosity rather than concern, so let the bereaved person lead on to whether it is helpful for them to speak about specifics.

Apart from emotional support, you can also offer much-needed practical help. This includes taking care of their children, preparing them a hot meal, walking their dogs, paperwork or even accompanying them during appointments.

Finally, the chance to share a happy or a funny story about the deceased person can be very comforting in order to keep their memory alive.

We urge you to reach out to someone you might know who is going through a similar process of grief and be emotionally present. Encourage them to seek professional help if necessary, where they can receive all the guidance and support required.

Georgiana Farrugia Bonnici and Daniela Zammit are members of the suicide prevention sub-committee of the Maltese Association of Psychiatry.

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