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Adam Donaldson

English 1201-219

Dr. Cassel

26 November 2018

The Risk of Suicide

August 29th, 2017 was an ordinary day, much like any other. I had gotten off school and

logged onto PlayStation to enjoy some video games with my small group of childhood,

neighborhood friends. Hunter was online, so we partied up and got to playing. Shortly after we

started, I could hear his mom enter the room through his mic. She asked him if he had seen Zach,

his younger brother and big piece of our friend group. She said that they haven’t heard from him

in a couple of days and Hunter told her that he was in the same boat. We both thought this was a

little strange but neither of us thought anything of it. Hunter had gotten off for dinner as the rest

of my friends got online, so I continued playing online with all my friends. A couple hours went

by and Hunter had not logged back on yet. We were wondering what was up with him. Then, we

got a text from him in the group chat. The text read, “Guys, Zach is gone.” Followed by, “I found

him hanging in the attic.”

My heart sank. He had to be joking right? Sadly, this was not the case. Zach, the little

brother to all of us in our friend group, had committed suicide. The tears came rushing down my

face like rain escaping from a loaded cloud. This couldn’t be happening. He was only 16 years

old. How could we let this happen? So many questions and emotions arose from this one text

message. For the next few months, as we processed this terrible event that occurred, we were

filled with misery. The thing that hurt me the most was imagining the pain and suffering that
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Hunter must have been going through. To lose your only brother, the one you have known for

your entire existence, the one that has always been there, and the one that you’ve had a brotherly

bond with, must have been a pain like no other. I cannot even imagine the thoughts and feelings

of pain and self-blame that Hunter was going through. All of us were going through immense

pain, but Hunter, Hunter was going through hell. For the months following, Hunter just wasn’t

the same.

This event had a huge impact on myself and everyone who knew Zach. It made us all

aware of the impact that suicide has on friends and family of the victim. Hunter’s mental health

couldn’t have been anywhere near its usual state, and I was afraid that due to this event, Hunter

might commit suicide as well. Thank goodness he is still alive and breathing today, but that fear

made me curious about the potential risk of suicide of friends and family of a suicide victim. I

wanted to find out if family and friends of a suicide victim are at an increased risk of suicide

themselves. To understand the pain and agony of a friend or family member of a suicide victim,

Figure 1 (WYG)
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one must understand what could drive someone to commit suicide in the first place. For most

people, this is a very uncomfortable thing to talk about.

According to the Center for Disease Control and Prevention (CDC), Suicide is defined as,

“Death caused by self-directed injurious behavior with an intent to die as a result of the

behavior” (1). Nearly everyone has suicidal thoughts at some point in their lives. Everyone goes

through difficult times in their lives and people turn to suicide when they believe the situation

they find themselves in is completely hopeless and believe that it will never get better. They are

living with an excruciating pain that they cannot make go away. According to Dr. Deborah

Serani, an adjunct professor at Adelphi University, the award-winning author of "Living with

Depression," "Depression and Your Child: A Guide for Parents and Caregivers" and "Depression

in Later Life", and a licensed psychologist in practice for over twenty-five years, when someone

chooses suicide it

has been described as a “death like no other”. Death by suicide stuns with soul-

crushing surprise, leaving family and friends not only grieving the unexpected

death, but confused and lost by this haunting loss... When someone dies by suicide,

research shows that at least 6 people are intimately traumatized by the death. Those

who are directly affected include immediate family members, relatives, neighbors,

friends, fellow students and/or co-workers. And because 90% of people who die by

suicide have a psychological disorder, mental health clinicians are also included as

a survivor of suicide loss. From the nearly 800,000 suicides reported from 1986

through 2010 and using the 6 survivors per suicide estimate, it is believed that the

number of survivors of suicide loss in the U.S. reaches 5 million people. (Serani)
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Figure 2 The number of young suicide victims is staggering (WHO).

According to Mentalhealthdaily.com, there are various reasons why someone would want to kill

themselves. The author of the website goes by the name “GLOOM” and has struggled with

anxiety, crippling depression, various personality disorders, and addiction, and uses the site to

stay up to date with new insights in the mental health field and share his experiences with others.

Many, especially young people, are bullied in life. Being bullied can break a person down along

with their self-esteem. Most people who are bullied feel depressed, worthless, and hopeless in

their situation. They see suicide as the only way to escape the pain they are feeling. People

addicted to drugs or alcohol usually use them to escape whatever is going on in their current

lives (GLOOM).
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Consistent use of drugs and alcohol can bring on depression. Long term use tends to alter

their brain functioning and build-up of tolerance to a point that one needs more and more of the

drug to have the same effect. It becomes an addiction which can turn into a long battle with

depression. Some have difficulty dealing with other life occurrences such as unemployment,

relationship problems, and financial problems. When one becomes unemployed, feelings of

depression, anxiety, and lack of purpose can be felt. The lack of income brings on stress.

Relationship problems, possible divorce, abuse, loneliness can trigger feelings of depression,

anxiety, guilt and panic (GLOOM).

Those living with chronic pain or a terminal illness are candidates for suicide as well.

Chronic pain impairs your ability to function and perform daily tasks. Terminal illnesses leave

those unable to do anything to get better. In these cases, they only see one way to take away the

pain or relieve their families from watching them die. A very common cause of suicide is mental

illness. Anxiety, being one large form of mental illness, can make it difficult to have friends, do

daily tasks like go to school, and even hold a job and show up for work. The loneliness and fear

can be overwhelming (GLOOM).

Having types of Bipolar disorder and schizophrenia makes it hard to maintain

relationships because of the mood swings, depression, hallucinations and other impairments that

go along with these diseases. Feeling trapped and unable to cope with life leads people to

suicide. The pain and continuous suffering becomes overwhelming and leads to feeling hopeless

and wanting to die. Everyone deals with pain differently and when one can’t find a way to cope,

they need to ask for help from professional sources, the problem is, most don’t (GLOOM). The

affects suicide has on the victim’s friends and family puts them at an increased risk of suicide
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themselves due to a wide range of self-blame, the constant struggle with psychache, and the

isolation that comes with public stigma.

Self-Blame seems to be the immediate first thoughts that run through the heads of the

family and friends of a suicide victim. It is the most obvious of the symptoms identified by

outsiders. It has to do with the belief that in some way, somehow, they are at fault for this

traumatic situation. Stacey Freedenthal, PhD, LCSW, is the author of the book “Helping the

Suicidal Person: Tips and Techniques for Professionals.” Dr. Freedenthal also is an associate

professor at the University of Denver Graduate School of Social Work, and a psychotherapist

and consultant in private practice. Freedenthal argues that Self-Blame is said to be correlated

with hindsight bias. Hindsight bias happens when the individual's affected understand the

outcome of their specific traumatic event and wrongly think that they possess the power to

predict or even change its outcome. They believe deeply that their past actions lead to the loss of

their loved one, something that is very tough to get past. In reality, they are blaming themselves

for something that they couldn’t have seen coming. It may take years for them to forgive

themselves for something they never controlled and could ultimately lead them down a dark and

unforgiving path. The guilt that comes with taking some responsibility in the death of another is

hard to get over and in some cases, there are people who never do. It becomes an everyday battle

and the longer the battle lasts, the tougher it is to let go. When one self-blames, they have higher

chances of breaking themselves down in relations to self-esteem, creating a perfect environment

for mental illness’s of their own to grow and takeover (Freedenthal).

The second factor that goes into an increased risk of committing suicide for friends and

family members of a suicide victim is the constant struggle with psychache. Psychache is a term

coined by suicidologist Edwin Shneidman. It refers to psychological pain that has become
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constant and unbearable. When a traumatic event occurs, the thoughts and emotions associated

with it manifest into this very intense, constant mental pain. Self-blame, depression, physical

aches and sores, all contribute to this psychache. This consistent agony and sorrow of all of these

factors together (self-blame, etc.) “becomes a circle of never ending bewilderment, pain,

flashbacks and a need to numb the anguish.” (Freedenthal) An “endless” cycle filled with these

intense emotions can become overwhelming to the thinker of these thoughts and make the victim

prone to committing suicide themselves to escape the constant intense distress. According to the

American Foundation for Suicide prevention, 44,965 Americans take their own lives each year,

and for every one successful suicide, there are about 20-25 failed attempts (WHO, AFSP). That’s

just about 1.1 million people that are having suicidal thoughts and doing something about it,

most likely dealing with psychache. With 325.7 million people living in the US, if you add it all

up, 0.345% of Americans are dealing with psychache on a daily basis. There are about 18,647

students enrolled at the Sinclair campus in Dayton. Using this 0.345%, 62 students enrolled are

dealing with psychache, just to put it in perspective (Sinclair).

Rui C. Campos from the University of Évora, Portugal, Ronald R. Holden from Queen’s

University, Canada, and Sara Santos from the Portuguese Red Cross, all teamed up to conduct a

study about psychache and its relation to suicide. The purpose of the study was to compare a

sample of people exposed to suicide in their families with a control group, for “lifetime

suicidality” (their risk of committing suicide over their lifetime). This study also evaluated the

level of “psychache” to see how that factor plays a role as well. The study consisted of a control

group of 172 individuals, and an experimental group composed of 53 individuals exposed to

suicides within their families. The three self-tests that the study gave to its participants were the

SBQ-R (Suicide behaviors questionnaire – revised), BSI (The brief symptom inventory, which
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measures symptoms of general distress), and the psychache scale (which measures the scale of

psychological pain). As for the results, The two groups’ results did differ significantly on the

SBQ-R test and the psychache scale, but without much differentiation on the BSI test. The

exposed group had significantly higher average values on the SBQ-R test and psychache test

with a strong correlation between the two tests. The study concluded that “suicide-exposed

persons manifesting high levels of psychache should be especially considered for therapeutic

intervention” (Campos, Holden, Santos).

The last factor that goes into suicide risk for family and friends of a suicide victim is the

public stigma of suicide. Since suicide is such an intense and uncomfortable topic to talk about,

most people avoid discussions on it stay bottled up to prevent discomfort from it. This leads to

ignorance and misconception about what mental illness and suicide really is. According to an

explanation by whatsyourgrief.com, a blog where grievers can post their stories and look for

commonalities among others, it is hard for outsiders to imagine the emotional and mental pain

that a suicide loss survivor is going through since they have not gone through it themselves. This

leads to assumptions and judgements about the suicide victims actions that are not at all true,

calling them weak and cowardly for “taking the easy way out”. “This being the case, it’s no

wonder that many people choose not to open up about their loved one’s death. Isolation and

shame may result from a lack of social support or because others don’t acknowledge the death.

Shame, isolation and stigma may be felt in response to messages from media and broader society

about suicide (WYG).” This quote summarizes this stigma perfectly. If no one is willing to listen

to a suicide loss survivor due to their own uneducated beliefs, why would the survivor trust them

to help in the vulnerable state that they are in? This leads to bottled up emotions and psychache

that family and friends of a suicide victim think they have to deal with themselves.
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When it comes to exploring this argument that family and friends of a suicide victim are

at an increased risk of suicide themselves, thoughts of self-blame lead to a decrease in self-worth

and aid to manifest into the depression and pain that contributes to psychache. The deep, intense

psychological pain that is psychache makes suicide loss survivors screaming for help, but that is

quickly shot down by ignorance and public stigma of suicide that our society has.

Sadly, family members and close friends are severely affected by the loss of a loved one

by suicide. They have a definite increase in committing suicide themselves and because of this

we need to, as a nation, pay close attention to how we interact with survivors and those affected

by suicide. We must continue to be passionate through thoughtfulness and have the open mind to

accept mental health as a serious problem to make the correct steps in the help of prevention and

healing.

In my situation with losing a close childhood friend to suicide, I personally have

experienced self-blame, psychache, and put up with the public stigma surrounding suicide. It was

the lowest point in my life so far. Dealing with the constant pain brought on by all of the

unanswered questions and self-blame, and the pounding psychache that will not stop, that’s

enough to make you want to die by itself. Thankfully I had friends who I knew were going

through the same thing as me. We could talk about it and understand each other’s troubles

because we were all dealing with the pain of losing of a childhood friend. If it wasn’t for the

luxury of people truly understanding what you are going through, and the mutual support from

those friends, the outcome might have been different.

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Works Cited

Campos, Rui C., et al. “Exposure to Suicide in the Family: Suicide Risk and Psychache in

Individuals Who Have Lost a Family Member by Suicide.” Journal of Clinical

Psychology, vol. 74, no. 3, Mar. 2018, pp. 407–417. EBSCOhost, doi:10.1002/jclp.22518.

Freedenthal, Stacey. “‘If Only’: Self-Blame After a Loved One's Suicide.” Speaking of Suicide, 5

Oct. 2017, www.speakingofsuicide.com/2014/05/07/if-only/.

GLOOM. “15 Common Causes Of Suicide: Why Do People Kill Themselves?” Mental Health

Daily, 23 July 2014, mentalhealthdaily.com/2014/07/23/15-common-causes-of-suicide-

why-do-people-kill-themselves/.

"Grieving a Suicide Death." WhatsYourGrief, 17 May 2016, www.whatsyourgrief.com/grieving-

suicide-death/. 7 Nov. 2018.

Serani, Deborah. “Understanding Survivors of Suicide Loss.” Psychology Today, Sussex

Publishers, 25 Nov. 2013, www.psychologytoday.com/us/blog/two-takes-

depression/201311/understanding-survivors-suicide-loss.

“Sinclair Community College.” Sinclair College, www.sinclair.edu/.

“Suicide Data.” World Health Organization, World Health Organization, 5 Nov. 2018,

www.who.int/mental_health/prevention/suicide/suicideprevent/en/.

“Suicide Statistics.” AFSP, 2016, afsp.org/about-suicide/suicide-statistics/.

“Violence Prevention.” Centers for Disease Control and Prevention, Centers for Disease Control

and Prevention, 6 Sept. 2018, www.cdc.gov/violenceprevention/suicide/definitions.html.