While the death of loved one is never easy irrespective of whether it comes with or without warning, the grieving process is always difficult. However, loss by suicide is like no other and can be complicated and traumatic for anyone. In most instances, coping with this kind of loss requires more support and help than others. Survivors may also be reluctant to confide deaths that were self-inflicted. Other feel a tremendous amount of guilt when they think that they could have probably done something to help their loved ones. Death by suicide is sometimes traumatic, violent and unexpected. Coping with the loss becomes even more traumatic and disturbing on different levels depending on the individual and their personality ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019). The host of complicated emotions and disturbances can be easily triggered.
On the one hand, a person will be in shock and despair while being consumed with anger, guilt, and confusion.
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On the other hand, those left behind feel rejected and whether their presence might have affected their loved ones who are gone. In worse case scenarios, people may have Post-Traumatic Stress Disorder or depression that affects their normal daily life ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . The trauma may extend for prolonged periods and may include symptoms such as nightmares and flashbacks accompanied by social withdrawal and difficulties in concentration. Despite the devastating effects deaths by suicide has on people and the general societies, coping strategies, and mechanisms have proven to be helpful and accommodative to the majority of individuals affected.
Suicide Loss
Suicide is not only a problem in America but a global endemic that leaves many hurts and destroyed. The effect of suicide deaths to loves ones is devastating and challenging to manage and cope with the state of loss. Affected individuals are left to deal with the mounting pressures of shame and guilt. On the other hand, suicide survivors may be overwhelmed with recurring thoughts and emotions that may prompt them to try and commit suicide gain ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . In other occasions, they are left to deal with the possibilities of suffering from mental breakdowns that have more severe effects. Unless treated and victims related to loss of loved ones are helped to cope with their situations, it becomes difficult to fit in society and continue with life as before.
Suicide is a critical public health issue involving psychological, biological, and societal problems that need to be addressed. The increase According to Curtin, Warner and Hedegaard (2016), suicide rates in the United States have increased steadily from 1999 to 2014 after a progressive decline from 1986 to 1999. The numbers keep increasing with data reporting a higher annual percentage after 2006 until the present. While suicide is high in middle-aged adults, it is becoming the leading cause of death in adolescents and the youth. Irrespective of race, both female and male deaths from suicide increased in recent years and showed no sign of stopping ( Curtin, Warner, and Hedegaard, 2016). This is large because of the increased cases and prevalence of mental illnesses as well as socio-economic reasons such as poverty or bullying from others. While suicide continues to increase, little is known about how to prevent the causative factors from causing despair in living life. This means that the number of people left to deal with the loss is higher as well.
Grieving from a suicide loss feels completely different from the normal loss of loved ones. In most instances, dealing with the death of a loved one from suicide is complicated and has longer-lasting impacts. Those left behind are left to deal with various problems that are social, emotional, and cultural ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . People will also experience challenges in their relations and may tend to seclude themselves from society due to stigmatization. According to Peters, Cunningham, Murphy, and Jackson, (2016), stigmatization from society has significant effects on the relationships of those left behind. In turn, help-seeking from others becomes more difficult as people would often blame close people of victims of suicide. The stigmatization will then lead to withdrawal and deny them the opportunity to tell their story without being judged. Society will tend to shame those left behind thereby further complicating the grieving process. Affected individuals will feel guiltier and ashamed to even speak out about anything that might be bothering them. They will blame themselves for the suicide of their loved ones and may end up depressed if stigmatization is not controlled to favor their condition and state of mind.
Due to the emotional impact of the suicide of loved ones, affected people are more likely to feel intense anger to people whom one may perceive as being negligent. Survivors of suicide often feel as if they might have done something to prevent suicide. Anger may also be directed to the dead with the feeling that they have given up too easily. People may also feel that other close individuals or family members would also do the same ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . As a result, bereaved people live in constant fear of going through the same. They also often wonder why their loved ones killed themselves as they get flooded with numerous questions about death. They also find it difficult to confide in others or constantly get intense emotions that may interfere with their relationships with others. There is also a high risk of the value and meaning of life decreasing and tend to also think about taking one’s life as well ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . A person's spiritual belief may also be affected as one would question whether God would forgive suicide deaths. The discomfort may prolong for an extended period of time where others may fall deep into depression without the hope of recovery.
Things to Know About Suicide
People always tend to look for shortcuts of blaming others for certain misfortunes to relieve themselves from the emotions and frustrations they feel inside. What they fail to understand is that no single factor contributes to the death of someone. Suicide is often the final resort after a wave of constant chaos and despair in someone's life ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . Therefore, attributing one cause to a suicide case is not adequate to lay out the exact happening of a person's life before their death. Even though loved ones get closure when they can know the cause of suicide deaths in their loved ones, it may not be fulfilling and accurate.
A person who chooses to commit suicide is often withdrawn from others and may not seem happy or completely okay. However, it is not easy to distinguish whether the changes in attitude and behavior is due to suicidal ideation or whether it is normal. This means that loved ones’ need gets close to each other and question any changes and deviation of behavior. People who die from suicide may not be necessarily mentally ill, neglected, or had troubled lives before killing themselves ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . Those who die from suicide are more likely to have been perfectionists and critics of themselves. They are also likely to have low self-esteem and fear that they may not be able to cope with significant changes occurring in their lives.
Dealing with Suicide Losses
Due to the widespread stigma attached to suicide-related deaths, many people are not able to reach out for help or discuss the troubles they are going through in life. As a result, the grieving process becomes more difficult and challenging for the bereaved to handle on their own. Even though the grieving process is different to people, reaching out and talking about the difficulties one is going through is helpful and effective in reducing the intensities of negative energy ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . Reaching out to other loved ones, family, friends, and even spiritual leaders for understanding and healing is helpful. Bereaved people should surround themselves with people who are ready and willing to listen and help. Instead of being silent, talking to others lifts some of the burdens that may be disturbing them.
Nonetheless, it is important for individuals to grieve in their way. People should choose whatever works best on them ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . This is because there is no single way for people to grieve given that people have different personalities, support systems, and mindset.
According to Castelli (2016), no single intervention would help the bereaved cope with the loss of a loved one through suicide. The patterns of reconstruction and reshaping of life after suicide is different for each. This means that clinicians and social workers should provide personalized care that would meet the individual needs of a grieving person. After all, people have different characteristics, responses, and circumstances surrounding them and that may characterize their coping behavior. The unique situations and characteristics of individuals and how the situations present themselves warrant a different type of care to be given to affected individuals and their families.
A study conducted by Sanford, Cerel, McGann, and Maple 2016 reported that over two-thirds of suicide loss survivors see individualized therapy for their loss. However, little is known about whether therapy is helpful or not in individualized treatments. From their online survey, they found that affected people require therapy to help them understand their loss while reducing the negative emotions surrounding the death of their loved ones. Since care is personalized, counselling, therapy, and support groups where individuals share their grief and troubles are helpful and fulfilling the objectives of the interventions. After all, it is believed that a problem shared is half solved. Talking with others opens the minds of affected people to other possibilities on the cause of suicide. It also sheds more light to different treatment interventions that may work on different people.
On the other hand, Treml, Steinig, Nagl, and Kersting 2017 reports that the loss of a loved one due to suicide is marred with feelings of shame, guilt, confusion, and rejection alongside stigmatization from the society. Due to the nature of their situations, their grieving is complicated to avoid the risks of having another suicide or mental illness. Their literature review showed that affected individuals require intense grief interventions that would help cope with their situations. While most people might try to suppress their emotions, it is not easy to hide and deal with their situations by themselves. In most cases, staying in a safe environment and openly writing about how people are feeling helps release some of the intense emotions people have. Opening up about emotions and feelings people harbor is enough to allow them to heal and deal with the loss appropriately without affecting themselves adversely. The study reveals that suicide-specific thoughts are particularly crucial to deter similar happening from occurring.
In the same regard, Spino, Kameg, Cline, Terhorst, and Mitchell, 2016 shows that there are nearly 41,000 suicide deaths in the united states alone that accounted for 112 suicides every 12.8 minutes. Despite reports indicating the rates of suicide-related deaths in the country, little is known about those who are left behind to deal with the loss of their loved ones. Due to the feelings of isolation from society, they remain at higher risks of getting depression and other related mental illnesses. Nonetheless, the study found out that the availability of social support is very important in coping (Spino, Kameg, Cline, Terhorst, & Mitchell, 2016). Support from the society without being judged goes along for the survivors of the loss to deal with the pain and intense emotions. The complicated feelings begin to subside once they are provided with the appropriate support from society such as house visits, being allowed to participate in community projects, and club memberships. Since dealing with a loss from suicide is partly a social affair, support groups help people recover and realize that they are not alone. However, high-risk patients should be transferred to psychotherapists to help them deal with the problem from a more personalized approach.
Additionally, Doveling 2014 reports that emotional interactions should not be limited by time or space since bereavement extends to anonymity. No one can ever know the extent of how a person would recover or is feeling about not only the loss from suicide but also the difficult life experiences and other factors. The author argues that personal empowerment should be fostered to help individuals cope with grief. As social media continues to expand and become more available, certain social sites may help people share their grief while opening up about their trauma as part of the healing process. This is because emotional regulation is paramount in dealing with the issue. Given the complication and costs of engaging in personalized treatments, seeking out social empowerment from reachable sites from social media platforms may be helpful during the grieving period.
As the world is becoming more intelligent and smart, more interventions for dealing with emotional issues are increasing. Given the influence of social factors such as stigmatization to survivors of suicide loss, support groups are becoming more prevalent and helpful in reducing loneliness and worries. Support groups are empowering and increase the value of life while showing the importance of caring for each other. People who are supported feel loved and cared as well as strengthened to deal with everyday issues of life including the loss of a loved one from suicide ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . Support groups also foster togetherness and teamwork, particularly when dealing with people who have almost similar experiences and losses. Eventually, the raw intensity of a person’s grief will fade since tragedy is temporal and not always a dominant thing.
Support from other survivors is helpful if individual counseling is either not available or is not working for them. It is helpful to engage with people who have similar problems and who can openly share their success stories and interventions in coping with the loss. It is helpful for affected individuals to know that they are not alone and that they can get better and deal with the situation in a more appropriate way. Support groups have been designed to create a safe and warm feeling for people dealing with various issues ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . Irrespective of whether they are facilitated by a layman or a mental health expert, they are aimed at ensuring that their members get the required support needed to recover from their period of intense grief fully. Support groups provide extra comfort where people can comfortably open up about their issues without having a fear of being judged. Support and care provided range from frequent meetings to home visits of the bereaved to extend a sense of hope that everything will be restored as it was before.
Knowing what to say or how to help someone cope with death is difficult particularly when choosing the exact words to say to make affected people feel better. Even though members in support groups have the same experience of loss, no one should assume that a person’s grief and needs are the same as theirs. Due to the sensitivity of the issue, asking someone if they are free to open up about their problems is reasonable and warm ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . For instance, if one asks whether one is okay to open up and what they need to be provided with to feel better should be the first step in making them feel appreciated and belonging to a community that understands and cares. Patience is also helpful in allowing people to deal with their issues at their own pace.
Individuals first need to accept their emotions since some emotions are unexpected and confusing to deal with them all at once. Understanding that healing takes time will enable people not to be overly anxious or expect a lot from the process. Since there is no standard time for grieving, individuals should not worry about what they are required to do or how they are supposed to react. The first step is to take care of themselves by practicing safe and healthy lifestyles such as getting enough sleep and eating regular meals. Taking care of the physical body is critical in creating a balance in the emotional cycle in an individual. It encourages people to improve their mood and get enough strength to cope with their situation ( Bottomley, Smigelsky, Bellet, Flynn, Price, & Neimeyer, 2019) . Even though support groups cannot eliminate all the negative emotions in a person, they help encourage and cope with the situation. It is therapeutic and effective in helping loved ones understand the dynamics of suicide and how one can manage their emotions and appear stronger than before. Alternatively, social support could be used alongside other treatment interventions such as risk screening, medications in the event of a person developing depression, as well as personalized therapy. In its many forms, support groups have proven to be highly effective and beneficial in not only dealing with suicidal loss but also when dealing with mental health problems.
References
Bottomley, J. S., Smigelsky, M. A., Bellet, B. W., Flynn, L., Price, J., & Neimeyer, R. A. (2019). Distinguishing the meaning-making processes of survivors of suicide loss: An expansion of the meaning of loss codebook. Death Studies , 43 (2), 92-102.
Castelli Dransart, D. A. (2017). Reclaiming and reshaping life: Patterns of reconstruction after the suicide of a loved one. Qualitative health research , 27 (7), 994-1005.
Curtin, S. C., Warner, M., & Hedegaard, H. (2016). Increase in suicide in the United States, 1999–2014.
Döveling, K. (2015). Emotion regulation in bereavement: searching for and finding emotional support in social network sites. New Review of Hypermedia and Multimedia , 21 (1-2), 106-122.
Linde, K., Treml, J., Steinig, J., Nagl, M., & Kersting, A. (2017). Brief interventions for people bereaved by suicide: A systematic review. PloS one , 12 (6), e0179496.
Peters, K., Cunningham, C., Murphy, G., & Jackson, D. (2016). ‘People look down on you when you tell them how he died’: Qualitative insights into stigma as experienced by suicide survivors. International journal of mental health nursing , 25 (3), 251-257.
Sanford, R., Cerel, J., McGann, V., & Maple, M. (2016). Suicide loss survivors′ experiences with therapy: Implications for clinical practice. Community mental health journal , 52 (5), 551-558.
Spino, E., Kameg, K. M., Cline, T. W., Terhorst, L., & Mitchell, A. M. (2016). Impact of social support on symptoms of depression and loneliness in survivors bereaved by suicide. Archives of psychiatric nursing , 30 (5), 602-606.
