Understanding Grief

The Intensity of Grief After Suicide Loss

One of the questions we regularly hear from new members of the support group is “when will I feel better?”.  Grief from a suicide loss is often the most intense feeling that a survivor has ever felt in their lives.  Most of us are not prepared for how intense the feelings are and how disruptive it is to our lives.  There has been debate among the psychiatry community about when grief is too long.  The most recent DSM 5, the “psychiatry bible” of diagnosing mental health issues finally acknowledged that there is such a thing as “prolonged grief disorder” https://www.nytimes.com/2022/03/18/health/prolonged-grief-disorder.html  This is often called complicated grief, and I discuss it below.  But generally they believe that grief that profoundly disrupts your life for more than one year may qualify as prolonged grief disorder.  In the case of a suicide loss, I think the intensity of grief is fairly profound for the better part of one year for many people.  But I also believe that the intensity does fade somewhat for many people after the first six months.  Everyone is different and the circumstances surrounding your loved one suicide death may add additional complexity.  Many will struggle with PTSD or PTSD like symptoms following the death of their loved one.  

No Set Timeline for Healing

There is no timeline for you to heal.  We each heal differently and at different rates.  This often causes stress among surviving families as each member processes the loss their own way. 

Phases of Grief

I generally think that healing occurs in several phases.  

• I believe the first phase is “complete shock” and a “search for the truth”.  Many people take 3-6 months to process what has happened and their grief starts to slowly evolve.  They have come to accept the physical loss, but still struggle with the emotional loss.  The head and the heart heal at different rates.  This is often referred to as “acute grief”.
• I think the next phase ranges from 3-12 months when we go through each of the holidays, birthdays and other events without our loved one.  The world goes on while we tend to grieve in private during this phase.  Your friends and coworkers stop asking you how you are doing and they don’t understand how intense your loss still is.  I truly believe that unless you have been through a suicide loss, it is impossible to understand how powerful this loss is.  This is the beginning of the acceptance of the loss and the beginning of the “integrated grief” phase.
• I also believe that the final phase for many people is after the first year anniversary.   Many people emotionally stumble in the second year by assuming that the second year has to be easier than the first.  The second year is different.  It is when you truly start to integrate the loss into your life and continue on your new path of healing.  Our new lives without our loved ones are waiting for us to discover.  We don’t want to be on this path, but that is the road we are now on.  This can be referred to as the “integrated grief” phase.

Understanding Prolonged Grief Disorder

Unfortunately about 10-20% of grievers get stuck along the way in a much more intense phase referred to as Prolonged Grief Disorder, formerly known as complicated grief.  The Center for Prolonged Grief at Columbia University describes the stages of grief as follows:

• Grief is a person’s response to loss, entailing emotions, thoughts and behaviors as well as physiological changes. Grief is permanent after we lose someone close though it’s manifestations are variable both within and between people. Still, there are some commonalities that can help you recognize complicated grief.
• Acute grief occurs in the initial period after a loss. It almost always includes strong feelings of yearning, longing and sadness along with anxiety, bitterness, anger, remorse, guilt and/or shame. Thoughts are mostly focused on the person who died and it can be difficult to concentrate on anything else. Acute grief dominates a person’s life.
• Integrated grief is the result of adaptation to the loss. When a person adapts to a loss, grief is not over. Instead, thoughts, feelings and behaviors related to their loss are integrated in ways that allow them to remember and honor the person who died. Grief finds a place in their life.
• Complicated grief occurs when something interferes with adaptation. When this happens acute grief can persist for very long periods of time. A person with complicated grief feels intense emotional pain. They can’t stop feeling like their loved one might somehow reappear and they don’t see a pathway forward.  A future without their loved one seems forever dismal and unappealing.

“Are strong feelings of yearning or longing for your loved one and/or thoughts and memories of them so persistent and intense that it stops you from being able to live your life in a meaningful way?”  Answering yes to this question several months after a loss may indicate you should be talking to a specialist.  Those that truly get stuck in complicated grief can also find great relief from dealing specifically with a trained prolonged grief specialist.   

Seeking Support and Moving Forward

Most survivors of suicide loss eventually seek out support from a professional grief counselor to help them process their grief in the first two years.

You can often feel like you are alone and are going crazy.  That is typical and not necessarily complicated grief.    Support groups like ours help to discuss the general issues, but a professional grief counselor can help you work on the specifics of your loss.  

Grieving the loss of a loved one to suicide is an intensely personal process and it can be overwhelming if you don’t have someone to talk to.  We can share with you lists of counselors we  have heard about for folks at any stage of their grief.  It is never too late to start to get help and to jump start your journey of healing towards integrated grief.  There is hope and you will heal.

Navigating Thanksgiving After Suicide Loss: When Gratitude Feels Impossible – Offers guidance on coping with grief during emotionally challenging holidays.

Time After Loss: Finding Your Way Forward – Explores ways to navigate grief over time, complementing the phases discussed here.

Facing the Summer with Patience – Discusses handling seasonal triggers and maintaining emotional resilience after loss.

Navigating Holiday Greetings – Provides tips for social situations that can be difficult during early grief.

International Survivors of Suicide Loss Day: Finding Connection and Hope – Encourages connecting with others who understand the journey of grief.