If a relative died by suicide, accident, or homicide, do not try to tough it out; go and ask for professional help

People whose spouse died by suicide have a higher chance of being diagnosed with a mental disorder within 5 years than other people do: about 80% higher for men, about 70% higher for women. Compared with people whose spouse died of another cause, the chance is also 70% higher up to twice as high. People bereaved this way are more likely to feel kept at a distance, and to feel shame. That is the reason to go and ask, rather than waiting to feel better on your own.

Cost

Calling 12356 costs nothing. If you need to see a doctor, a psychology clinic is the price of an ordinary outpatient visit. The hard part is opening your mouth and asking.

Benefit

A national registry in Denmark followed 6700000 adults, from 1980 to 2014, more than 136000000 person-years in all (the years each person was followed, added up). For people widowed because a spouse died by suicide, the risk of a newly diagnosed mental disorder within 5 years, compared with other people, was an IRR of 1.8 for men (95% CI 1.6–2.0), that is, about 80% higher. For women it was 1.7 (1.6–1.8), that is, about 70% higher. Compared with people widowed by other causes of death, the IRR was 1.7 for men (1.5–1.9) and 2.0 for women (1.9–2.2), that is, 70% higher up to double. In this group, suicidal behavior, mortality, and the share who needed municipal assistance were also higher. Physical illnesses such as cirrhosis and sleep disorders were higher as well. Another 57 studies were summarized separately, without pooling the arithmetic. Bereavement by suicide is linked to the following. A partner's risk of suicide is higher. After a child dies by suicide, the parents' risk of admission to a psychiatric ward is higher. After an adult child dies by suicide, the mother's risk of suicide is higher. After a parent dies by suicide, the child's risk of depression is higher. Compared with people bereaved by other violent deaths, people bereaved by suicide more often say they are kept at a distance and feel shame.

Notes

A sudden, violent death means an accident, a homicide, or a disaster. After this kind of death, the share with post-traumatic stress disorder, depression, and grief that stays stuck is higher than after a death from illness. Recovery is also slower. If a month has passed and you are still having nightmares, flashbacks, or avoiding what you dare not touch, see item 14 of this section (trauma-focused psychological treatment). What to do when you yourself have suicidal thoughts is in section 1, item 25.

Sources · 3

1. Erlangsen A, et al. (2017). Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes: A Longitudinal and Nationwide Register-Based Study. JAMA Psychiatry. doi.org/10.1001/jamapsychiatry.2017.0226
2. Pitman A, et al. (2014). Effects of suicide bereavement on mental health and suicide risk. The Lancet Psychiatry. doi.org/10.1016/S2215-0366(14)70224-X
3. Kristensen P 等 (2012). Bereavement and mental health after sudden and violent losses: a review. Psychiatry. doi.org/10.1521/psyc.2012.75.1.76（备注里那份综述）