Coping with suicide of a loved one — (The Toronto Star)

SSRI Ed note: Successful executive feels depressed, takes antidepressants, kills himself. Wife struggles with "why" not understanding how the meds work.

Original article no longer available

The Toronto Star

Sep. 29, 2006. 06:55 AM


The day Mrs. G came home and found her husband’s body in their garage ­ the car still running ­ she underwent one of life’s most painful experiences.

She described it graphically and became inconsolable, guilt-ridden and emotionally paralyzed. “Doctor,” she sobbed to me, “my life is over.”

Her husband had been depressed for six months. The successful executive had been in therapy and on antidepressants.

But before that fateful day he had recently returned to work and appeared stable. In fact, in the last few days before his death, he seemed in good spirits.

He was calling old friends, socializing, seemingly back “on his game.”

But it was an illusion.

He left a note saying, “I tried, I really tried, but in the end it was too much. I love you. Don’t blame yourself.”

Every year there are about 4,000 suicides in Canada. Suicide accounts for 24 per cent of all deaths among Canadians 15 to 24 and 16 per cent of all deaths for those 25 to 44.

Depression and profound personal turmoil are the major reasons people turn to self-destructive behaviour.

During our lifetime, up to 15 per cent of us will suffer serious clinical depression ­ losing interest in life, withdrawing, feeling varying degrees of hopelessness, negativity, helplessness with suicidal ruminations.

Yet a recent study in the Canadian Psychiatric Journal indicated approximately one out of three individuals who are suicidal will not consult with a mental health professional.

But suicide is not a private event; there are survivors. The impact on those who survive ­ the families, the friends and the community ­ is often catastrophic.

Guilt, guilt and more guilt becomes the obsessive theme, at least in the beginning. While those who end their life may find relief from the pain of their existence, their families experience a collective, profound psychological wound.

Inevitably their introspection leads to self-denigration. They are convinced more could have been done, that they should have paid more attention or seen cries for help.

The emotional aftermath can be crippling and long-term, says Dr. Thor Choptiany, an expert in child and adolescent psychiatry at the University of Manitoba.

Survivors go through a serious form of bereavement. In extreme cases, people may try suicide themselves. Help from mental health professionals as well as the love of family and friends becomes a mainstay.

Mrs. G was searching for answers; a map for survival, a port in the storm. The challenge would be daunting, the journey arduous. She worked with me for several years. At times she’d struggle with her own suicidal impulses.

In therapy she tackled her guilt, her regret over not being able to save her husband and her belief that she was worthless and nothing was left for her. All this, in spite of her children, a company she ran and her wide circle of friends.

Eventually it became important that she recognize her rage at her husband’s abandoning her. She also had to realize that for a variety of reasons her husband had chosen his solution, and that she, like her therapist was only human with limitations. And in spite of her love, her husband had been driven by his own pain.

Ultimately she was able to reinvest in the value of life, to tolerate her memories and forgive herself and her husband for the tragedy that had scarred her life. Today she is remarried and living a rich life and accepting the past as part of her karma.

In a recent soul-searching book, Finding Lily, author Richard Clewes struggles to find meaning in his wife’s suicide. His journey is a chronicle of introspection, questioning his role in her demise. Finally, he achieves some degree of inner peace.

He lets go as much as possible and comes to terms with the choices she made to end her life. He absolves himself of any responsibility for her final act.

He learns that for whatever reason someone chooses suicide, the choice is an individual one and recognizes for the profoundly mentally ill, these choices may be significantly influenced by the victim’s inner struggles.

For those with psychosis and bipolar mood disorders up to 50 per cent will attempt suicide.

At least 15 per cent of the severely mentally ill, especially those with psychosis and significant depressions, will be successful.

In Man’s Search For Meaning, the late psychiatrist and Auschwitz survivor Victor Frankl talks about how it is important to be able to turn to one’s own inner life and spirituality to survive and tolerate suffering. He emphasizes the importance of having a vision of the future to avoid hopelessness.

Without hope, he says, life has no authentic context. Perhaps this is the core ingredient that separates those who choose suicide from those who choose to continue to struggle with the vicissitudes of life.

Dr. Fred Shane is an Associate Professor of Psychiatry in Winnipeg, Man. He treats severely depressed individuals and survivors of suicide.