Senior suicide

— The silent generation speaking up on a quiet killer

Graham and Bruce from the Ettalong men’s shed in NSW.

Over-85s have become the Australians most susceptible to suicide and a general lack of support is threatening to make the problem worse

By

The age group most at risk of suicide may not be the one you expect.

The highest rate of suicide in Australia, for both men and women, is among people over 85, at 32.7 deaths per 100,000 for men and 10.6 deaths for women, respectively.

The global picture is similar. People over the age of 70 kill themselves at nearly three times the rate of the general population. Suicide attempts are also more lethal among older people, with US data showing that about one in four suicide attempts of older people result in death, compared with one in 25 among the general population.

But even these numbers are likely to be underestimates, says Prof Diego De Leo, emeritus professor of psychiatry at Griffith University.

Unless the death of an older person is very clearly a suicide, it is not likely to be investigated, he says, and deaths relating to misuse of medication or even falls that may have been deliberate are often assumed to be the result of senility or frailty.

“It’s widely reported in literature that there’s much more interest in scrutinising the causes of death of a young body than of an old man,” he says.

Helen Bird, 73, from the inner west in Sydney, believes her grandmother’s death fits in this category.

In 1985, Bird got a call to say that her grandmother Olive, 82, had been found in her nursing home room in Hobart with a serious head injury after falling. She died in hospital shortly after. Bird is convinced her grandmother’s death was suicide, knowing that her grandmother had been depressed and had been stockpiling her medication.

Trained nurse Helen Bird
Trained nurse Helen Bird believes her grandmother suicided in a nursing home, although the death was not recorded as such.

“Nothing stacked up,” she said. “I’m a nurse. But nobody ever asked a question. It was a fall, no one questioned it. It was something that really nobody wanted to hear about.

“It’s something that’s always been with me, with great sorrow really,” Bird says. “She felt, I suspect, there was just nothing more to live for, and that’s really, really sad.”

De Leo says there are very different assumptions around suicide for younger and older people. While suicide by a young person is treated as a tragedy and a mystery, an older person’s suicide is often seen as a rational decision.

“It’s this assumption: ‘he was making a balance between pros and cons in life and he discovered the cons were more than pros and he decided then to exit life’, it’s a rational balance,” he says.

Dr Rod McKay, a psychiatrist with a clinical practice focusing on older people, says it is sometimes assumed that someone dying through suicide later in life has less impact on people.

“Someone dying through suicide later in life does have a different impact on those who know them, but it’s not lesser,” he says.

Both McKay and De Leo are keen to draw a distinction between suicide among older people who are depressed and voluntary assisted dying (VAD), which is now legal in every state in Australia under tight restrictions.

“If someone comes to me and says ‘I want to die because I’m depressed and I see no solution to my depression’, well, as a physician I have to do my maximum best to intervene and try to improve the depression of this person, and I can,” says De Leo. “But [if someone comes with] chronic pain, chronic suffering, no hopes for improvement and inevitability of a progression of the suffering … then I feel different.”

McKay says well-meaning attempts to respect individual choices in regard to VAD, may have meant that physicians have not been proactive in referring older people for treatment of depression.

“That debate and the sensitivities everyone is feeling about trying to act respectfully, risks not identifying or investigating depression or reversible factors to the degree that we might,” he says.

A lifeline for men

Men die by suicide at much higher rates than women across all age groups. Among older men, loss of purpose and identity after retirement, weaker connections to children and grandchildren and to social networks can all be factors.

“We’ve never had anyone here who has taken their own life, or entertained that, that I know of,” says Bruce McLauchlan, president of the Peninsula Community Men’s Shed in Ettalong, an hour and a half’s drive north of Sydney, knocking on a wooden work bench. “Maybe, we hope, it’s the contribution of our shed that helps.

“We look for these things: a person who was lively and talkative goes quiet, then we say: ‘Mate, everything OK with you? Anything we can help with?’. Because we are a family,” McLauchlan says.

The Ettalong group, part of the global men’s shed movement, opens its metalworking and woodworking sheds three mornings a week. On a rainy Thursday, the men are just finishing their monthly barbecue lunch, which is sponsored by a local funeral home.

“It’s publicity for them,” laughs Graham Checkley, 84, a retired Baptist minister who is the group’s welfare officer. “We go to a lot of wakes.”

The group is a lifeline for a lot of men, especially after retirement or bereavement. McLauchlan started coming 12 years ago after his wife died. “The men’s shed helps me manage my grief. Otherwise, I’d be sitting at home watching TV all day.”

Garrick Hooper, 73, started coming three years ago after he retired as a taxi driver, and is still coming, “much to my amazement”.

“I always knew about it and I thought: ‘I’ll be avoiding that like the plague, I’m meaningfully employed.’ And then there comes a time that you’re not and you become officially elderly,” Hooper says. “When you retire, you’ve got to redefine yourself, and that’s just how it is.”

Having a laugh together is a big part of the Ettalong Men’s Shed.
Having a laugh together is a big part of the Ettalong men’s shed.

McKay says this sort of social intervention is incredibly important, and older people have far more resilience than they are often given credit for.

“The vast majority of older people don’t feel as old as other people view them as,” he says. “We look at older people, including older people with lots of problems and say ‘I couldn’t cope with that’. Whereas most older people cope well … so we project that on to them.”

Studies show psychological wellbeing actually improves into older age, though depression goes up again in the over-85 age group.

When that happens, McKay says, social interventions are not enough.

“Older people have extremely low access to psychological treatments, the lowest of any age group,” he says.

This can be as a result of unconscious ageism among medical professionals and a sort of therapeutic nihilism that sees depression as an inevitable part of old age and not something that can be treated.

When older people do receive treatment for depression, it can make a huge difference.

“We know that when you look at things clinically, if there is mental illness there, the likelihood of response to treatment is similar to younger people,” McKay says. “There are a lot of social factors that can be addressed, sometimes there are simple medical factors that can be addressed that can make a huge difference in whether someone sees suicide as an option or not.

“It continues to amaze me sometimes when I meet people and see how poor their quality of life is and then with a good review from a geriatrician or a GP who has the time to do it – and it does take time – just the improvement they can have in their quality of life.”

Complete Article HERE!

Let’s stop calling medical aid in dying ‘suicide’

By Kenneth Norton

The New Hampshire legislature is considering a bill to join our Maine and Vermont neighbors to allow New Hampshire residents with a terminal illness, in consultation with two medical providers, the option of ending their suffering and having a peaceful death. As a Licensed Independent Clinical Social Worker who has spent over four decades working to prevent suicide at the local, state, national and international level, I think it is time to look closely at the differences between the two, and stop referring to medical aid in dying as suicide.

Legally, in the 10 states and Washington D.C. where medical aid in dying is allowed, the death is not counted as a suicide death. Medical Examiners and Coroners list the underlying terminal illness, which the person was diagnosed with, as the cause of death on the death certificate of patients who utilize medical aid in dying.

People who die by suicide, for whatever reason, no longer wish to live and feel that they have no other option than death. The person who chooses medical aid in dying wants to live yet has been diagnosed with a terminal illness that will end their life, and may cause intense suffering before they die. They are fully informed of other options including palliative care, hospice, and comfort measures. This is not a decision they are allowed to take lightly or at the spur of the moment. It requires thoughtful controls and two medical opinions in support of specific terminal illness.

A high correlation exists between suicide and mental illness. The person who dies by suicide may or may not be rational, or even competent in that moment. Research shows that many suicide deaths are impulsive. Although the person may have contemplated suicide for some time, it may only be a matter of minutes between making the decision to die and then taking their life. By contrast, in medical aid in dying, people go through a formal process with two medical professionals that includes: an assessment of their mental capability, a determination about their terminal illness, an informed consent process including a review of available options, and a mandatory waiting period

People who die by suicide die alone, and often die by violent means. In New Hampshire, over 75% of suicides involve firearms or hanging. Nationally, over 75% of suicide deaths occur in a home or primary residence. These violent deaths result in trauma for their loved ones who return home to find their loved one dead. The scene, shock, and aftermath are so distressing that many people are no longer able to continue to live in their homes. Suicide deaths can also be traumatizing and contribute to PTSD in first responders who are called to the scene.

Family, friends, and loved ones of a person who dies by suicide can experience intense emotions including shock, guilt, anger, shame, regret, and despair as they try to come to terms with the suddenness of the death, and make sense of the often-unanswerable question: “why?” People who are bereaved by suicide may experience suicidal thoughts and are statistically at higher risk themselves for suicide. Suicide deaths are often devasting and life altering for family and friends resulting in a long and complicated grief process that may last years. It is said the person who dies by suicide dies a single death, but their family/friends are left to die a thousand deaths.

By contrast, the person who goes through the medical aid in dying process, frequently includes loved ones in their decision. Most die in their home, surrounded by their family and friends. The death is planned, and peaceful. Family and friends are left at peace knowing that this was their choice and their suffering is over. To be clear, this does not stop those close people from grieving the death, but it eliminates the “whys” and “what ifs” as well as the trauma from a sudden suicide.

Despite our best efforts, there is still considerable shame and stigma associated with, and experienced by family and friends after a suicide. We should be careful not to contribute to that stigma by extending it to medical aid in dying. Whether you support or are opposed to medical aid in dying, we should acknowledge there are significant differences between the two, and we should stop labeling medical aid in dying as suicide.

Complete Article HERE!

Losing a loved one to suicide can cause immense grief and anger.

— But the truth can set you free

‘Love is never wasted, it bears all things; even a terrible death and deep grief,’ the Rev Sharon Hollis writes.

When my husband died I questioned my purpose in life. But my faith offered me tools to help navigate the worst days

By Sharon Hollis

When a loved family member dies unexpectedly we experience immense grief and sadness. It can cause us to ask questions about our meaning and purpose in life. This is even more so when the death is sudden or traumatic.

I found myself asking these questions when my husband Michael died suddenly by suicide 10 years ago. As a minister in the Uniting church, I turned to my faith to give me some guidance. What I discovered was that Christianity offered many tools to help me navigate the worst days of grief (along with good counselling and fabulous friends). And they can be used by anyone, regardless of faith.

Be compassionate

For much of the history of the Christian church, suicide has been considered a sin so grievous that a Christian funeral couldn’t be offered and a burial couldn’t take place in church graveyards. This represented a failure to understand mental illness as an illness that deserves our compassion in the same way any other illness does. There is no love in the historic position of the church. It is not a “love that bears all things”, including death by suicide.

Michael battled deep depression, spent time in a psychiatric ward and clung to life for as long as he could. I choose to continue to love Michael, notwithstanding what he did. One of the things my counsellor said many times was that none of us wants to be judged by our worst moment. I choose not to judge Michael by his worst decision, as I believe God chooses not to judge us by our worst moments.

Choose love

I loved Michael in life, and my love for him endures. Love is never wasted, it bears all things; even a terrible death and deep grief. Not everyone understood my capacity to keep loving Michael. Yes, I’ve had times when I’ve been furious with him. I’ve been sad for him and what he is missing, and so sad for the loss of his presence in my life and the life our daughters. But I continue to love him. I know not everyone can do this but I find strength in the enduring nature of our love. It is one of the ways Michael continues to be present in our lives, even in his absence.

The Christian story is not one of a God who doesn’t know or experience suffering. I take great comfort from this. Some time after Michael died, I wondered: where was God when Michael made his decision to die? Where was God when Michael died? An image came to me of Jesus holding Michael in that moment, catching him and holding him.

Speak the truth

One of the things I was most clear about almost as soon as I knew Michael had died was that I would be honest about how he died. I never wanted to feel ashamed of him. I never wanted to feel ashamed of our relationship. I never wanted my children to feel they couldn’t talk about their father or feel ashamed of him. I didn’t want to use what precious energy I had in the depth of my grief worrying about who knew what.

I told the truth about his death to our daughters, to our family and friends. We told the truth at his funeral. I have continued to tell the truth. Speaking the truth of Michael’s death has been a gift in so many ways. I have had wonderful conversations with people who have found it hard to speak about mental illness or the death by suicide of a family member or friend. Jesus said the truth will set you free and I have found this to be so.

The Christian story teaches us that death does not have the last word, and that we can find new life and new hope even where there has been great sadness. I have found it to be true. In the wake of Michael’s death I have found the courage to live again; to notice joy, small moments at first, now days, weeks months of joy; a new life of love and family and friends. This has brought me back to a fullness of life.

If you have lost someone close to you, particularly by suicide, I hope these tools can help you navigate the next stage of your life, and bring you back to a fullness of life.

Complete Article HERE!

What Are Suicidal Thoughts, and How Do I Cope With Them?

— Suicidal thoughts can feel scary and isolating, but you don’t have to cope with them alone. Here’s how to get the help you need.

Feeling hopeless, trapped, or lonely, or having a mental health condition like depression, are all potential risk factors for suicidal thoughts.

by Shelby House, BSN-RN

Suicidal thoughts — also called suicidal ideation — include wishes, thoughts, and preoccupations with death and suicide, according to StatPearls.

Suicidal thoughts can fluctuate in intensity and duration. They tend to follow a “waxing and waning” pattern, where they’re more intense at certain times and level out — or possibly subside altogether — during others, the authors of the report noted. Sometimes they’re fleeting, passive wishes to simply cease to exist, and sometimes they’re persistent and overwhelming thoughts of harming oneself.

“When such thoughts first occur, they often feel intrusive and frightening,” says Amy Mezulis, PhD, a licensed clinical psychologist and co-founder and chief clinical officer at Joon Care, a mental health care platform for teens and young adults. “For some individuals who struggle with depression or suicidal thoughts for a long time, they can start to feel almost normal,” she says.

The types of suicidal thoughts one experiences can vary from person to person and are considered either passive or active in nature, per the aforementioned report.

Passive Suicidal Thoughts

Passive suicidal thoughts are when someone loses the motivation to live, but they do not have a plan in place to end their life, according to Salt Lake Behavioral Health in Salt Lake City, Utah. “These can be thoughts such as wondering what it would be like to be dead or to not wake up in the morning,” says Dr. Mezulis.

Even though someone with passive suicidal thoughts doesn’t have a plan in place to end their life, these thoughts could eventually progress into active suicidal thoughts and lead to a suicide attempt, per the aforementioned StatPearls report. Passive suicidal thoughts should be taken very seriously.

Active Suicidal Thoughts

Suicidal thoughts are considered active when someone loses the will to live and has a plan in place to end their life, per Salt Lake Behavioral Health.

“Active suicidal thoughts refer to thoughts that focus on methods and plans for dying by suicide,” says Mezulis. “These can be thoughts such as considering different suicide means or making a mental plan for dying by suicide.”

Causes and Risk Factors for Suicidal Thoughts

“Suicide is complex and there is never a single cause,” says Jill Harkavy-Friedman, PhD, the senior vice president of research for the American Foundation for Suicide Prevention. “There are many potential contributors that may combine to create or increase risk.”

Factors that could raise your risk for suicidal thoughts, per Mayo Clinic, include:

  • Feeling hopeless, worthless, lonely, or socially isolated
  • Experiencing a stressful life event, such as the loss of a loved one or financial problems
  • Having a mental health condition like depression
  • Having a substance use disorder
  • Having a chronic disease, chronic pain, or terminal illness
  • Having a history of physical or sexual abuse
  • Family history of suicide
  • Having a family history of mental health conditions
  • Being lesbian, gay, bisexual, or transgender without a supportive family or living in hostile surroundings
  • Having prior suicide attempts

Signs and Symptoms of Suicidal Thoughts

The warning signs that someone may be having suicidal thoughts, per Mayo Clinic, include:

  • Talking about suicide and openly wishing to die or be dead
  • Obtaining the means to end one’s life, such as stockpiling pills or purchasing a gun
  • Withdrawing socially and expressing a strong desire to be alone
  • Having mood swings, such as feeling emotionally high one day but down and discouraged the next day
  • Fixating on death, dying, or violence
  • Feeling hopeless or trapped in a situation
  • Increased drug or alcohol use
  • Changing their usual routine, including sleeping and eating habits
  • Experiencing severe anxiety or personality changes
  • Engaging in risky behavior, such as reckless driving or substance use
  • Giving away personal belongings, drafting a will, or getting their affairs in order when there’s seemingly no logical reason for doing so
  • Saying goodbye to friends and family as if they will never be seen again

How Suicidal Thoughts Affect Your Health and Well-Being

Suicidal thoughts can take a serious toll on your emotional and physical well-being, in addition to heightening your risk of dying by suicide or injuring yourself in a suicide attempt, according to the CDC.

The human brain can only process so much information at a time, says Mezulis. So when a person is experiencing constant suicidal thoughts, much of their cognitive and emotional energy is consumed by them, she says.

“That can be exhausting, both psychologically and physically,” Mazulis explains. “Persistent suicidal thoughts can impact mood and health, contributing to a cycle of negative mood and suicidal thoughts that can be difficult to interrupt.”

The most serious consequences of suicidal thoughts are attempted suicide or death by suicide. People who survive a suicide attempt can be left with serious physical damage to their bodies that can be debilitating or even permanent, according to Cross Creek Hospital in Austin, Texas. The effects can include:

  • Scars
  • Broken bones
  • Hemorrhage, or heavy bleeding
  • Organ failure
  • Brain damage
  • Paralysis
  • Coma

Prevention of Suicidal Thoughts

Suicidal thoughts are often part of a larger issue, such as an underlying mental health condition like depression, substance use disorders, or schizophrenia, according to research. “Treating these underlying mood conditions [or other mental health conditions] can help prevent and reduce suicidal thoughts,” says Mazulis.

But not all people who experience suicidal thoughts have a mental health condition — stressful life events such as relationship problems, the death of a loved one, or eviction can lead to suicidal thoughts, too, according to the National Alliance on Mental Illness. Similarly, addressing those contributing factors (through strategies like talking to a mental health professional about those stressors and finding ways to manage the resulting feelings of distress, for instance) can help lessen suicidal thoughts, too.

Other factors that can protect against suicide and suicidal thoughts, per the CDC, include:

  • Having access to high-quality, consistent healthcare for mental and physical health conditions
  • Developing effective coping and problem-solving skills
  • Focusing on your reasons for living, such as family, friends, or pets
  • Having or developing meaningful connections with others
  • Having a strong sense of cultural identity
  • Getting support from friends and family

How to Cope With Suicidal Thoughts

Suicidal thoughts should always be taken very seriously. Don’t wait to get help for yourself or a loved one who’s considering suicide.

“If you feel like life is not worth living, notice changes in your thoughts and behaviors that make it hard to keep going, or you feel depressed or hopeless, it is important to trust your gut and take action,” says Dr. Harkavy-Friedman.

If you feel like you or a loved one are in imminent danger of suicide, call 911 for emergency help. For immediate crisis assistance from a trained counselor, you can reach the free, 24/7 988 Suicide and Crisis Lifeline by calling or texting 988, or the free, 24/7 Crisis Text Line by texting HOME to 741741.

If you feel you’re not in immediate danger, you should schedule an appointment to see your doctor or therapist to talk about what you’re going through, according to Mayo Clinic. They can help you determine the severity of your suicidal thoughts and come up with a treatment plan to manage them.

Treatment options for people experiencing suicidal thoughts, per Mayo Clinic, may include:

  • Psychotherapy Also called “talk therapy,” psychotherapy involves working with a licensed therapist to explore the root causes of your suicidal thoughts and learn skills to help you manage your emotions.
  • Medications These could include antidepressants, antipsychotics, or anti-anxiety medication if you have a mental health condition. Managing the symptoms of a condition can in turn lessen suicidal thoughts.
  • Addiction Treatment If you have a substance use disorder, getting treatment for it can reduce suicidal thoughts. This could include detox, addiction treatment programs, or self-help group meetings.

Along with professional treatment, practicing self-care can help you feel better and can reduce thoughts of suicide over time, says Harkavy-Friedman. Some self-care strategies that can help are getting regular sleep, exercising, eating a nutritious diet, spending time with friends and family, and making time for things that bring you joy, she says.

You could also reach out to family members, friends, or members of a faith community, for instance, when you feel like you need support. Having a strong support system can help lower your risk for suicide, according to Mayo Clinic.

In addition, it could help to reach out to one of the suicide hotlines described above, even if you don’t feel like you’re in immediate danger. A trained crisis counselor can offer free and confidential emotional support and connect you to resources that could help.

Resources We Love

American Foundation for Suicide Prevention (AFSP)

The AFSP is committed to raising awareness about mental health and suicide, and funding research related to suicide and suicide prevention. They offer specific resources for anyone who is experiencing thoughts of suicide, has survived suicide attempts, has lost a loved one to suicide, or is worried about someone else with suicidal thoughts.

988 Suicide and Crisis Lifeline

The 988 Suicide and Crisis Lifeline provides 24/7, free, and confidential support for people in distress, suicide prevention and mental health crisis resources, and best practices for health professionals in the United States. Dial 988 to speak with a trained crisis counselor who can help you if you or a loved one is experiencing thoughts of suicide. They also have a chat tool for those who are deaf or hard of hearing or who may otherwise prefer a chat option.

National Institute of Mental Health (NIMH)

The NIMH is the lead government agency for research on mental health conditions. It provides a “Suicide Prevention” resource for people experiencing thoughts of suicide or for their loved ones.

Complete Article HERE!

More obituaries acknowledge suicide as openness on mental health grows

Deborah Blum holds a photo of her child, Esther Iris, who died by suicide in 2021. When it came time to write the death notice, Blum was open and specific about the mental health struggles that led to her child’s death.

By Debby Waldman

When Deborah and Warren Blum’s 16-year-old died by suicide in November 2021, they went into shock. For two days, the grief-stricken Los Angeles couple didn’t sleep.

But when it came time to write a death notice, Deborah Blum was clearheaded: In a heartfelt tribute to her smart, funny, popular child, who had recently come out as nonbinary, she was open and specific about the mental health struggles that led to Esther Iris’s death.

“Esther’s whole thing was that people should know and talk about mental health and it shouldn’t be a secret,” Deborah Blum told KFF Health News. “The least I could do was to be honest and tell people. I think being embarrassed just makes it worse.”

Deborah Blum in the bedroom of her teen child, Esther Iris.

While it was once unheard-of to mention suicide as a cause of death in news obituaries and paid death notices, that has been changing, especially in the past 10 years, said Dan Reidenberg, a psychologist and managing director of the National Council for Suicide Prevention.

High-profile suicides — such as those of comic actor Robin Williams in 2014, fashion designer Kate Spade in 2018 and dancer Stephen “tWitch” Boss in 2022 — have helped reduce the stigma surrounding suicide loss. So has advertising for depression and anxiety medications, which has helped normalize that mental illnesses are health conditions.

The covid-19 pandemic also drew attention to the prevalence of mental health challenges.

“The stigma is changing,” Reidenberg said. “There is still some, but it’s less than it used to be, and that’s increasing people’s willingness to include it in an obituary.”

The teen’s drawings.
A card Esther Iris made for their dad, Warren Blum.

While there’s no right or wrong way to write death announcements, mental health and grief experts said the reluctance to acknowledge suicide has implications beyond the confines of a public notice. The stigma attached to the word affects everything from how people grieve to how people help prevent others from ending their own lives.

Research shows that talking about suicide can help reduce suicidal thoughts, but studies have also found that spikes in suicide rates can follow news reports about someone dying that way — a phenomenon known as “suicide contagion.” The latter is an argument people make for not acknowledging suicide in obituaries and death notices.

Reidenberg said, however, the subject can be addressed responsibly.

That includes telling a balanced story, similar to what Deborah Blum did, acknowledging Esther Iris’s accomplishments as well as their struggles. It means leaving out details about the method or location of the death, and not glorifying the deceased in a way that might encourage vulnerable readers to think dying by suicide is a good way to get attention.

A surfboard in memory of Esther Iris, with notes from their community written on it, is outside the Blum home in Los Angeles.

“We don’t ever want to normalize suicide, but we don’t want to normalize that people can’t have a conversation about suicide,” Reidenberg said.

Having that conversation is an important part of the grieving process, said Holly Prigerson, a professor of sociology in medicine at Weill Cornell Medical College in New York and an expert on prolonged grief disorder.

“Part of adjusting to the loss of someone is coming up with a story of what happened and why,” she said. “To the extent that you can’t be honest and acknowledge what happened if it’s a death due to suicide, that will complicate, if not impede, your ability to fully and accurately process your loss.”

People close to the deceased often know when a death was by suicide, Reidenberg said, particularly in the case of young people.

“Being honest can lead to information and awareness, whereas if we keep it shrouded in this big mystery it doesn’t help,” he added.

A study about caregiver depression that Prigerson recently conducted identified avoidance as an impediment to healing from grief.

“Not acknowledging how someone died, denying the cause of death, avoiding the reality of what happened is a significant barrier to being able to adjust to what happened and to move forward,” she said.

Researchers are increasingly seeing bereavement as a social process, Prigerson said, and as social beings, people look to others for comfort and solace. That’s another reason the stigma attached to suicide is harmful: It keeps people from opening up.

“The stigma is based on the perception that others will judge you as being an inadequate parent, or not having done enough,” Prigerson said. “This whole thing with obituaries is all about others — it’s about how people are going to read what happened and think less of you.”

Stigma, shame and embarrassment are among the reasons grieving family members have traditionally avoided acknowledging suicide in obituaries and death notices. It’s also why, if they do, they may be more likely to address it indirectly, either by describing the death as “sudden and unexpected” or by soliciting donations for mental health programs.

Economics can factor in — sometimes people are secretive because of life insurance plans that exclude payouts for suicides. Sometimes they’re trying to protect reputations, theirs as well as those of the deceased, particularly in religious communities where suicide is considered a sin.

Avoiding the word suicide doesn’t necessarily mean someone is in denial. In the days after a loss, which is when most obituaries and death announcements are written, it’s often profoundly difficult to face the truth, especially in the case of suicide, said Doreen Marshall, a psychologist and former vice president at the American Foundation for Suicide Prevention.

Even when people can admit the truth to themselves, they might have trouble expressing it to others, said Joanne Harpel, a suicide bereavement expert in New York who works with mourners through her business, Coping After Suicide.

In the support groups she runs, she said, people vary in how open they are willing to be. For example, in the group for mothers who have lost a child to suicide, everyone acknowledges that reality — after all, that’s why they’re there — but they don’t all do so the same way.

“Some of them will refer to ‘when this happened’ or ‘before all this,’” Harpel said, cautioning against holding all mourners to the same standard. “They’re not pretending it was something else, but using the word ‘suicide’ is so confronting and so painful that even in the safest context it’s very, very hard for them to say it out loud.”

If you or someone you know needs help, visit 988lifeline.org or call or text the Suicide & Crisis Lifeline at 988.<

Complete Article HERE!

Dinner parties and vulnerability

— How a new generation has changed grief

By Rachel Zimmerman

When my husband died by suicide in 2014, leaving me alone to raise our two young daughters, I yearned to do grief in five tidy stages.

But my “stages” didn’t resemble stages at all, and nothing about my emotional lurching — from feeling physically battered by loss to compulsively digging for answers — was tidy. Clearly, I thought, I was grieving all wrong.

hese days, it’s widely acknowledged that the five stages of grief described by Elisabeth Kübler-Ross in 1969 — denial, anger, bargaining, depression and acceptance — were overhyped and misconstrued. They were based on interviews with people dying from terminal illness (not those grieving the death of a loved one), packaged into a theory that got refashioned in the public imagination.

“The trouble is, what was a description of grief became a prescription for grieving,” said Mary-Frances O’Connor, an associate professor of psychology at the University of Arizona and author of “The Grieving Brain: The Surprising Science of How We Learn from Love and Loss.”

The new grief

The grieving process is undergoing its own transformation, becoming a more public and shared experience. The shift is fueled in part by the pandemic, which forced a global reckoning with grief, and a generation of digital natives, who are at ease using social media to share virtually all aspects of their lives, including grief.

“We are becoming vastly more comfortable sharing our own stories, truth-telling through innumerable new platforms,” said Lennon Flowers, founder of the Dinner Party, a platform for people in their 20s, 30s and early 40s grieving the death of a loved one and seeking peers, community and a meal.

“Increasingly, vulnerability is in vogue,” she said. “There’s an emerging cultural currency for being able to say out loud the experiences that, in previous generations, we were asked to keep under lock and key.”

How your brain processes grief

O’Connor describes grieving as “a type of learning” that, over time, evolves into a newly integrated aspect of an individual’s identity. After years of living alongside a loved one, your brain needs time to adjust, to learn and relearn that the person is truly gone.

Evidence of grief can be seen on brain scans. In one study, brain imaging revealed that the greater symptoms of yearning for a loved one predicted greater activation in the nucleus accumbens, a part of the brain associated with the rewarding aspect of close relationships.

This preliminary finding emphasizes the neurobiological basis of prolonged grief disorder — intense, persistent grief that interferes with daily life — and the importance of targeted psychotherapy to address it.

The lifelong trajectory of grieving requires “throwing out the map we have used to navigate our lives together with our loved one and transforming our relationship with this person who has died,” O’Connor said.

DIY grief

Younger generations have pushed back on “stages-of-grief-thinking,” said Flowers, because it implies that there is a right or wrong way to mourn loss.

Flowers, who was 21 when her mother died of lung cancer, said many dinner party attendees find they’re the first in their social circle to experience a death up close. And they’re often unable to find adequate support systems that match their need to share the intimacies of grief, such as the strangeness and loneliness of it, dating difficulties and reassessing career priorities.

Covid forced grief dinner parties to go virtual, Flowers said, but the upshot was that tables were no longer geographically constrained, which allowed more people to connect. Now, Flowers said, there are virtual tables for BIPOC grievers, those who have lost someone to suicide or experienced a pregnancy loss.

A survey of more than 350 dinner party participants found that the stronger the rapport at a table, the more likely people were to experience a “normalization” of their grief experience, Flowers said. This, in turn, predicted a cascade of other positive benefits, including personal growth, empathy for one’s self and others, and a sense of meaning and purpose in life.

“We’ve taken that to mean: Design for community, and healing will follow,” Flowers said.

Coping ‘ugly’

And, more often than not, healing does follow, said George A. Bonanno, a professor of clinical psychology at Columbia University and author of “The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss.”

Bonanno has found that the large majority of people exposed to loss “show a trajectory of resilience,” meaning they will experience sadness and pain but over time will be able to love, work and experience joy once again.

The key to resilience, Bonanno said, is cognitive and emotional flexibility. Rather than trying to manage grief or loss all at once, start by identifying the most pressing problem and asking, “What can I do to feel better right now?”

A short-term fix might be something he describes as “coping ugly.” It could be binge-watching “Grey’s Anatomy” with a pint of Cherry Garcia, or going out one night with a friend to drink.

Most people learn to cope with grief over time. Less than 10 percent of those suffering from the loss of a loved one follow a more “chronic trajectory,” he said, or become afflicted with “prolonged grief disorder” — when, even after many years, the bereaved person remains stuck, as if in the acute phase of grief, and appears unable to change. For this group, targeted psychotherapy and forms of cognitive behavioral therapy can offer relief.

How a new generation copes with grief

The wallop of grief can be particularly difficult for young adults, said Ann Faison, a Los Angeles-based grief educator, author and creator of the podcast “Are We There Yet: Understanding Adolescent Grief.”

“They are old enough, developmentally, to really feel the weight of those emotions, but they still don’t have a lot of life experience,” said Faison, who was 14 when her own mother died. “For many, it’s their first encounter with serious grief, and it’s a real shock to their system.

Olivia Bean was 22 when her brother, Nick, just two years younger, died of a heroin and fentanyl overdose. She sought solace through the Opioid Project: Changing Perceptions through Art and Storytelling, which uses personal narrative and art-making to reframe grief. The project is a collaboration between artist Nancy Marks and Annie Brewster, a physician and assistant professor of medicine at Harvard Medical School. (I co-wrote a book with Brewster, called “The Healing Power of Storytelling.”)

For Bean, now 30 and a graphic designer in Plymouth, Mass., engaging in the painting project, and telling the story of her brother out loud, she said, was healing.

“I ended up loving it so much,” she said, partly because there were others her age in the group and also through the freedom art can bring. “My painting was more abstract, flowing, with lots of swirling lines, intertwined, like my relationship with my brother.”

Coping with grief can take many forms: Creating or sharing music, physical pursuits such as hiking, yoga or exploring nature, volunteering or spending time with peers “who get it” can all be therapeutic.

“Whether you want it to or not, life goes on,” said Nancy Frumer Styron, a psychologist and clinical director at the Children’s Room, a bereavement center in Arlington, Mass. “So the question becomes, how do I take this piece that has happened and integrate it into my life in a way that is part of me but doesn’t define me.”

Complete Article HERE!

When There’s No Word Like ‘Widow’

— After my sister died, I yearned for a word like “orphan” to name my new identity.

By Kyleigh Leddy

The first time I lied about my sister, I was sitting in a semicircle in my high school homeroom study hall. Our teacher asked us to describe one of our siblings as a class bonding exercise. Numb with grief, I almost laughed at the cruel timing.

I was 17 and my sister, Kait, had been missing, presumed deceased, for only a few days.

One by one, my classmates shared anecdotes about their brothers and sisters. When it came to my turn, I panicked and said, “I’m an only child.” The words tasted sour in my mouth.

On Jan. 8, 2014, security cameras captured footage of my sister walking to the peak of Philadelphia’s Benjamin Franklin Bridge and not returning. She was 22 years old and had been struggling with her mental health and the effects of a traumatic brain injury for several years.

It might have been easy to deduce what had happened, but grief defies reason. My family never found Kait’s body. It took us years to accept that she had taken her life, and even longer to put the experience into words.

In the months after my sister’s suicide, every time someone casually asked me if I had siblings — on first dates; during college admission interviews; in the grocery store in the middle of an otherwise average day — I would wince. It was such an innocuous question for some, but so loaded for me. It made my chest ache each time.

Later, in college, where no one knew me or what had happened, I found it easier to lie about being an only child than to communicate the clunky but simple truth: I once had a sister but now I don’t.

In those early weeks of college orientation, full of repetitive conversations about our hometowns and prospective majors, I remember feeling surprised, guilty and sometimes even angry when people believed me. How could they not see all the ways my sister has shaped me?

I think of her when I do my makeup in the morning. I use her unique turns of phrase. I imagine her advice before I make a major decision. I don’t do this consciously. I do it because I was born a sister. When I entered the world, Kait was already in it. There is no version of me that exists without her imprint. And the qualities I like most about myself — my sense of humor, my desire for adventure — are hand-me-downs from her.

I wished there was a word to identify myself in relation to my loss. I longed for a label that would be instantly understood by others, one that would communicate both Kait’s presence and absence in my life. I wanted a word like orphan or widow — a term that says, “I once had a sibling, but I lost her.”

“There are no words,” was a phrase I heard often when I was grieving, and on some level, it is true. Death is mute. Loss steals our language. There aren’t sufficient words to convey what it feels like to lose someone you love — and even fewer to comfort those of us who know the feeling too well.

But does the inadequacy of language in the face of death mean we should silence ourselves? Grief is isolating enough. Shouldn’t we try to name what we can?

Some people may bristle at the titles of orphan, widow and widower, as they each come with their own stereotypes and limitations. But, after losing my sister, I yearned for a similar title to locate and lend legibility to my experience.

If I had a word to describe myself, perhaps I would have been more likely to mention my sister to my college classmates, rather than entirely omitting her existence. If I had a word to describe myself, perhaps I would have been more likely to meet and connect with other people who struggle to speak when asked if they have any brothers or sisters.

At the very least, I wanted a term that could serve as a metaphorical stop sign in conversation: a warning to tread carefully, a succinct and sufficient answer in its own right.

But I didn’t have that word. So I resorted to lying until, only a few weeks into college, I was caught.

A group of us were sitting on a friend’s dorm bed when a boy confronted me. I was telling a story about my sister’s brief flirtation with a famous actor.

I was bragging like a little sister, but I had previously told everyone that I wasn’t a little sister. The boy pointed out the discrepancy. “Who lies about something like that?” he asked.

As everyone turned to look at me, my cheeks burned and my heart caught in my throat. My voice wavered, but I didn’t cry. For the first time in a public setting of more than one or two people, I answered the question honestly.

That was seven years ago. Back then, there was more urgency and confusion for me about how to approach my loss. Now there is some clarity. The more I’ve written and talked about my sister’s life publicly, the more confident I feel in telling the hard, full truth.

If someone asks me if I have siblings now, I tell them that I have a sister who passed away. I tell them that Kaitlyn was rebellious, smart, beautiful, outrageously funny and sometimes outrageously defiant too. If they ask further questions, I tell them what she went through and how she died.

And yet, I still wonder if I and others whose siblings have died would benefit from having a word that names our pain — especially in the early days of mourning when telling the complete story may feel impossible.

For now, there is a word for longing, and there is a word for grief, but there are no words to describe how it feels to pull your phone out to text your sister and know that she won’t answer. There is no term for being the remaining half of a shared tradition, no label that captures a relationship that ends, but also doesn’t, like a phantom limb that still aches when it rains.

Hopefully, someday, someone will find or create an adequate term for people like me. But in the meantime, what I am, and what I will always be, is a little sister.

Complete Article HERE!