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Providing grief education and support

Most people will not have experienced suicide bereavement previously. Educating them on what to expect may help them to manage the intense, distressing, and even shameful and frightening, emotions. Additionally, it is important to be able to judge whether a patient’s grief is progressing adaptively in order to make decisions about whether to intervene or not.34 Therefore, you need a good understanding of the range of grief experiences different people can have.34

Grief is different for each person and for each loss. For some, grief reactions will appear barely noticeable, while others will experience profound anguish and dysfunction on multiple levels (eg emotional, cognitive, physical, functional). The intensity and duration of grief is determined by multiple factors such as the nature of the relationship, personality, age, health, spirituality and cultural identity, supports and resources, and the type of loss (sudden and unanticipated versus gradual and anticipated).34

People experiencing suicide bereavement describe:

  • shock
  • anger
  • guilt and regret (eg ‘Why didn’t I notice something?’, ‘Why didn’t I do something?’, ‘I did do something but it didn’t work, why?’)>
  • loss and loneliness
  • fear
  • anxiety and depression
  • intrusive images
  • depersonalisation
  • feeling overwhelmed.34

These feelings may intermingle with relief, joy, peace and happiness – these ‘positive’ emotions too can cause distress and guilt.34 The grieving process may feel like a roller-coaster.

It is not uncommon for people to dream of the deceased, half look for them in crowds, sense their presence, or feel them watching out for them.34

After acute grief (when feelings may be present constantly) comes integrated grief, where the deceased no longer preoccupies thoughts, but is easily called to mind, and feelings of sadness and longing predominate.34 This transition usually begins within a few months after the death. Even when the grief is fully integrated, people do not forget the person they lost or stop feeling sadness or stop missing them.34


  1. Zisook S, Shear K. Grief and bereavement: What psychiatrists need to know. World Psychiatry 2009;8(2):67–74.


After suicide: A resource for GPs