Monday, June 18, 2018

"Left behind": The struggle people can face after a loved one dies by suicide

SECOND OPINION

'Left behind': The struggle people can face after a loved one dies by suicide

Stigma can make it even harder for someone to cope with the aftermath of suicide, experts say

Kate Spade is pictured with her daughter, Frances Beatrix Spade, in March 2009. (Astrid Stawiarz/Getty Images)
This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. 
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It's been almost 30 years since Corinne McDermott's mother took her own life, but she still carries a copy of the suicide note inside her Kate Spade wallet.
When she learned on Tuesday that Kate Spade herself had died by suicide, McDermott said she felt like she'd been taken right back to the moment she learned her mother was dead. In a move she says is uncharacteristic of herself, she found herself sharing her feelings in a Facebook post.
"I didn't write that note as a middle-aged mother of two coming home from work," she said in an interview with CBC News. "I wrote that note as a 17-year-old whose mom died."
Right away, she thought of Spade's daughter, Frances Beatrix.
"[She] is 13," McDermott wrote in her post. "She will never be the same."  
"When your parent takes their own life, you're still here. But you are also left behind."
McDermott was fortunate, she said, to have had love and support from her aunts, grandmother and other family members to help her get through the pain of losing her mom, who had struggled with debilitating bipolar disorder for five years before her death.
"I know my mom thought that I would be better off without her. I know that's what she thought. And it is 100 per cent not true. It's never been true for one second," she said.

'It's not just grief'

Although she was ultimately able to go on to live a happy life with children of her own and a successful career as a magazine editor, McDermott said the feelings of guilt and self doubt never truly go away.
"It's not just grief," she said. "If it were a tragic accident or a horrible terminal illness, you know, there's some sense … that it's out of your hands."
But her mother's suicide left her haunted by feelings that, "I wasn't strong enough to help her. I wasn't smart enough to fix it."
Although the death of a parent or a loved one by any cause is devastating, losing someone to suicide is different because of the additional emotions that are layered on top of grief, said Sakina Rizvi, a researcher at St. Michael's Hospital's Arthur Sommer Rotenberg Suicide and Depression Studies unit.
Spade's death, followed just three days later by the news that celebrity chef Anthony Bourdain had also died by suicide, prompted an outpouring of grief on social media, along with expressions of sympathy to their families.
"I remember seeing a tweet that said, 'Suicide doesn't end pain, it just transfers it to someone else.' And that's really what it is," said Rizvi, who also volunteers as a grief counsellor for suicide loss survivors at the Toronto-based Distress Centres.
Anthony Bourdain poses with his girlfriend, actor Asia Argento, at the Creative Arts Emmy Awards in Los Angeles in September 2017. (Danny Moloshok/Reuters)
Every person's grieving process is unique, Rizvi said, but guilt is a common emotion for suicide survivors.
"There's all these questions about 'What could I have done to stop it?'" she said. "And you live with that for the rest of your life."
That guilt among survivors is something the Royal Ottawa Mental Health Centre tries to alleviate in its awareness campaigns about suicide, said Dr. Gail Beck, clinical director of the centre's youth psychiatry program.
"Whenever a person is contemplating suicide, that's a symptom of a serious psychiatric illness," Beck said. "When someone dies by suicide, it's not anyone's fault."
In addition to guilt, some people feel anger, Rizvi said.
Whatever emotions they have, it's critical they know it's OK to feel them, she said — something they often don't feel comfortable doing in their everyday lives.

Finding a space to talk

People who come to the distress centre for support after a loved one's suicide often feel relieved they can talk about those emotions in a safe space, Rizvi said. They can "feel whatever they need to feel and to actually process all of that — whether it's shock, whether it's anger, whether it's guilt, whether it's sadness."
There's still a great deal of stigma around suicide, Rizvi said, and many people don't feel comfortable being exposed to such tragedy.
Some survivors have actually lost social connections after a loved one's suicide, she said, because their friends couldn't handle talking about it or didn't know what to do.
Corinne McDermott said she found it hard to talk about her mother's suicide with her peers when she was younger  — not because she was ashamed or embarrassed, but because it would make conversations awkward.
Corinne McDermott says the news of fashion designer Kate Spade's death took her back to the moment when she learned, at age 17, that her mom had died by suicide. (Corinne McDermott)
"You know, if you tell them, it will just suck all the air out of the room," she said. "In some instances, you kind of almost need to console them, because they obviously had no idea and they don't know how to respond or react."
Adding to the grief in some cases is the "social cultural framework around death by suicide that we don't have around other kinds of equally tragic deaths," said Dr. Stan Kutcher, a professor of psychiatry at Dalhousie University in Halifax.
"We still carry around that connotation of the 'sinfulness,' even in the words that we often use [such as] 'committed' suicide," he said.
But that societal judgment and stigma is changing, Kutcher said, and he's hopeful a time will come when "we can talk about death by suicide the same way we talk about death by cancer or death by car accident."
Rizvi says it's important that people who have lost someone to suicide are able to remember the person they've lost and share good memories from their life — just like anyone else grieving a loved one's death. But they sometimes feel they can't do that.
"If someone was to die of any other cause … their death doesn't define their entire life. Whereas when someone dies by suicide, now … they're the person that died by suicide and that defines everything that came before that. And it's not fair," said Rizvi.
"The suicide is how they died. It's not who they were."
The most important thing people can do to support a friend or colleague who has lost someone to suicide is to ask them what they need, she said, because some people may be ready to talk, while others won't.
Equally important, she said, is to remember that the person's answer will change over time.
"It's a lifelong journey," she said.

Where to get help:

Canada Suicide Prevention Service: 1-833-456-4566 (Phone) | 45645 (Text) | crisisservicescanada.ca (Chat)
In Quebec (French): Association québécoise de prévention du suicide: 1-866-APPELLE (1-866-277-3553)
Kids Help Phone: 1-800-668-6868 (Phone), Live Chat counselling at www.kidshelpphone.ca
Canadian Association for Suicide Prevention: Find a 24-hour crisis centre

If you're worried someone you know may be at risk of suicide, you should talk to them about it, says the Canadian Association for Suicide Prevention. Here are some warning signs:
Suicidal thoughts.
Substance abuse.
Purposelessness.
Anxiety.
Feeling trapped.
Hopelessness and helplessness.
Withdrawal.
Anger.
Recklessness.
Mood changes.

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About the Author

Nicole Ireland
Nicole Ireland is a CBC News journalist with a special interest in health and social justice stories. Based in Toronto, she has lived and worked in Thunder Bay, Ont.; Iqaluit, Nunavut; and Beirut, Lebanon.

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