Call the clouds and listen closely, I'm lost without you
Call your name every day when I feel so helpless
I'm fallin' down but I'll rise above this, rise above this
- Quick recovery. Those who recover quickly without assistance and can return to functioning as before. Some of these people are not distressed because they had only superficial contact with the deceased, while others are often internalizing and suppressing pain, anger or guilt. In the latter case, maladaptive strategies of coping may emerge such as substance abuse or other compulsive behaviors.
- Modest support needed. Most people who were functioning well before the suicide need only a modest level of support for anywhere from a month to a couple of years. This level of support might include outpatient therapy or support groups.
- Psychiatric disability. Some people may develop a mental disorder, such as post-traumatic stress disorder or depression, in reaction to the trauma and loss and may require extended or intensive treatment.
- Suddenness or lack of anticipation. The unexpected death offers no opportunity for goodbyes, unfinished business, resolution of conflict, or answers to questions. Very often the bereaved are left with endless “whys” and “what ifs.” When loved ones die from a prolonged illness, by contrast, we have time to prepare ourselves for their absence.
- Violence, mutilation, and destruction. Deaths that involve suffering or extreme pain may cause horrifying traumatic imagery and intrusive thoughts – whether or not the bereaved actually witnessed the death or the body. If the death occurred in a familiar or personal space of the bereaved, that space will most likely continue to trigger traumatic reactions.
- Preventability or randomness of death. The randomness of such a loss can trigger a greater sense of vulnerability and anxiety. This is often the case when there were no apparent warning signs before the person died.
- Multiple deaths (bereavement overload) or multiple losses. In addition to the primary loss of the person, secondary losses may include loss of an income, loss of a home, or loss of all things familiar. The resulting disorganization can strain the family and social system.
- Contact with first responders or the media. Sometimes the reactions of first responders – who need to rule out homicide in every suicide case – can increase confusion and distress among those bereaved. If the events surrounding the death were newsworthy, the bereaved may also be dealing with the intrusion of the media.