The Pain of Suicide: Preventing and Coping With Tragedy

More than 40,000 Americans commit suicide each year, according to the Centers for Disease Control and Prevention and the American Foundation for Suicide Prevention. Thatís approximately 110 people every day. In this country, suicide is the tenth leading cause of death overall, but the second leading cause for young people between the ages of 10 and 25. Although women are more likely to attempt suicide, four times as many men actually succeed. More than 20 percent of all suicides are committed by veterans. Suicide, and its aftermath, can affect anyone.

Who Is at Risk?

Certain risk factors increase a personís risk of suicide. Chronic physical and mental health conditions and substance abuse are behind most suicide attempts, and environmental or circumstantial factors also play a role. Specific risk factors include:

  • Depression.
  • Anxiety.
  • Schizophrenia (a severe and disabling mental disorder that affects about one percent of Americans).
  • Emotional stress (for example, from bullying).
  • Acute loss, such as that of a loved one or a job.
  • Chronic pain.
  • Debilitating or terminal health conditions.
  • Alcohol or drug addiction.
  • Isolation from family and friends.
  • Access to drugs, firearms, or other lethal tools.
  • Personal or family history of suicide attempts.

"People who are considering suicide often show warning signs, such as giving away their belongings, isolating themselves from loved ones, withdrawing from normal activities, and even talking about suicide, or claiming to have no reason to live," says psychologist Adele Ryan McDowell, PhD, author of Making Peace with Suicide (White Flowers Press, 2014). The more warning signs, the higher the odds a suicide will actually occur.

How You Can Help

If you are with someone who is threatening to commit suicide, there are several steps you can take.

  1. First, make sure the person is safe. That is, confirm that there is no weapon available.
  2. Tell the person you want to help them feel safe and sane, that there are options such as medical evaluation, medication or, more immediately, calling a hotline. Remember, in this moment, it is like they are locked in a tight box and they cannot think outside of that box. Rather than tell them what you think they should do, McDowell advises asking them if they will consider outside help.

    "Itís important to 'insert a pause' into the conversation," McDowell explains. "Rather than just rush in and try to manage the situation, listen to the personís anger and pain; they may not want help at that moment." This pause gives suffering people a window of opportunity to calm down, regain footing, and understand that they can get help rebuilding their lives. By inserting this pause, you are, in effect, expanding their support system by letting them know there are other options.
  3. Itís also important to be honest, and say something to the effect of "I donít know what to do but Iím here for you and there are people we can call for help." In an immediate crisis, however, it may be necessary to skip prolonged conversation and get the person to an emergency room as soon as possible.

Picking Up the Pieces

If someone you care about succeeds in committing suicide, you are left with what McDowell calls "a complicated loss." Itís often a sudden and unexpected death, and you are left behind to "clean up the mess" if not physically, then certainly emotionally. There is trauma, perhaps a feeling of anger, and then guilt about the anger. In addition, there is often the added burden of a broken taboo. Trauma triggers memories of other traumas, just as loss triggers thoughts of other losses. The result is a whole cavalcade of emotions added to your grief.

Like all healing, recovery from a suicide happens in stages. Your goal, McDowell stresses, is to create peace in your life as a pathway to healing. Along the way, you may find it helpful to engage in creative, physical, volunteer, faith-related or other activities, as well as the help of a counselor or support group, to move you through this tough time and help you heal.

"You must take however long it takes you to move from anger, guilt and grief to acceptance of the reality of this loss, forgiveness (which doesnít necessarily mean you condone the action), and compassion for both the person who took their life and for yourself," McDowell adds. "Always remember: They didnít do this to hurt you; they did this to release themselves from unbearable pain."

Adele Ryan McDowell, PhD, reviewed this article.


McDowell, Adele Ryan, PhD. Phone interview with author May 11, 2015.

"Understanding Suicide." American Foundation for Suicide Prevention. Accessed May 4, 2015.

"NCHS Brief No. 168: Mortality in the United States, 2012." Centers for Disease Control and Prevention. October 2014.

"Schizophrenia." National Institute of Mental Health. Page accessed May 13, 2015.