Dr. Suzanne B. Phillips

Licensed Psychologist, Psychoanalyst, Diplomate in Group Psychology, Certified Group Therapist, Author, Radio Host and Media Consultant Covering a Wide Range of Psychological Topics

Post: In The Aftermath of Suicide: The Question WHY?

Suicide is tragic and complicated loss that takes the lives of too many.

Suicide is dangerously high in this country . In 2018 there were 48,344 recorded suicides, up from 42,773 in 2014, according to the CDC’s National Center for Health Statistics. The annual U.S. suicide rate increased 24% between 1999 and 2014, from 10.5 to 13.0 suicides per 100,000 people, the highest rate recorded in 28 years.

For every suicide, people are left behind trying to cope with traumatic loss. They include spouses, parents, children, siblings, friends and relatives.

When the person is a celebrity or a known person in the media, as in the case of Robin Williams, Kate Spade or Anthony Bourdain the tragedy is shared by many more.

Social psychologist, Frank McAndrew reports that given the use of media, we see celebrities often and they become part of our life. We not only look toward them as models, they become personally important to us. Their death by suicide equates to tragic, untimely and inconceivable loss.

The Question WHY?

One of the haunting thoughts that most survivors carry in the aftermath of suicide is “ WHY DID THIS HAPPEN?”

As Bev Feigelman, one of the authors of Devastating Losses, and the mother of a young, newly engaged, filmmaker who died by suicide says, “ The question mark stays in the forefront of your mind haunting you and only with time starts to slowly move toward the back.”

Possible Reasons

Suicide is a complex behavior with a wide range of underlying causes, including a variety of risk factors which are related to mental illness as well as societal, cultural and gender factors.


Depression that is unrecognized and untreated is considered a major cause of suicide. The Diagnostic Criteria for Major Depressive Disorder (MDD) includes Depression or irritable mood for more than two weeks, and five of the following factors- decreased interest or pleasure, significant weight change, change in sleep, change in activity, fatigue or activity, fatigue or loss of energy, guilt or worthlessness, concentration, and suicidality. Such symptoms cause significant distress and loss of functionality and can not be explained by a medical condition.

Depression can be exacerbated by  fear or shame that precludes seeking treatment, or the belief that nothing can or will dissipate the pain.

Masked Depression in Men

Masked Depression in men is a dangerous reality as men are four times more likely to commit suicide than women. Compared to women, men don’t manifest depression in the terms associated with clinical diagnosis of depression.

  • Rather than seek help, men have a tendency to self-medicate or avoid the anguish, sadness, guilt or self-doubt associated with depression with anger and or acting out. They may engage in sexual acting out, alcohol or substance abuse, risky behaviors like reckless driving, escapist behaviors as internet addiction, porn or compulsive involvement in work or sports.
  • As their hopelessness and despair inevitably escalates they choose more lethal methods to escape the pain.

Cultural and Gender Factors

As reported by Rebecca Clay in the Monitor of Psychology, there can be cultural and gender factors that result in the shame, hopelessness, isolation and fear associated with suicide.

  • In a screening tool developed for Cultural Assessment Risk for Suicide, Dr. Chu and co-authors identify four broad suicide risk categories: A country’s language of distress, the stress of being a minority, family conflict and cultural beliefs that add to suicide stressors and the acceptability of suicide or not.
  • Often overlooked, sexual and gender minorities are at higher risk for suicide. Key risk factors include rejection by family members, harassment for sexual orientation or gender identity and being threatened or injured with a weapon.

Risk Factors

The American Psychological Association lists the following as risk factors for suicide that warrant seeking help.

  • Talks about committing suicide
  • Has trouble eating or sleeping
  • Exhibits drastic changes in behavior
  • Withdraws from friends or social activities
  • Loses interest in school, work or hobbies
  • Prepares for death by writing a will and making final arrangements
  • Gives away prized possessions
  • Has attempted suicide before
  • Takes unnecessary risks


Adding to these factors is lethality – when there is the presence of drugs, alcohol, or the availability of a gun, professional help is warranted.

Suicide As A Desperate Attempt to End Pain

With or without diagnosed mental health conditions, suicide is often an act of desperation, brought on by an inability to cope with pain.

In many cases, suicide involves a misguided solution to unbearable psychic pain. Edwin Shneidman defined it as                 “ Psychache.” He maintained that in such pain, thinking becomes constricted, there is tunnel vision and the only compelling need is to end the pain. When suicidal, the thought of ending the pain is not always equated with ending life.

 Intolerable, Interminable and Inescapable. 

Dan Bilsker and Peter Forster (2003) also define suicidal thinking in terms of a crisis of pain. They describe it in terms of “ The Three I’s” – The person suffering perceives the pain as Intolerable, Interminable and Inescapable.


The benefit of on-going mental health treatment or if indicated, a short-term intervention in an emergency room can make a difference. They aim at relieving despair by demonstrating to the suicidal person that emotional pain can be addressed with help, that the moments of pain will not persist and that with support their are alternatives to those aspects of life that can feel inescapable.

The Protective Factors

 In suicide assessment, protective factors are the presence or existence of reasons for living. They can include social support, children, family members, self-esteem, the needs of others, spirituality, proper treatment and the assets that the person may be unable to see themselves. Connecting with a loved one who is struggling and seeking help is crucial to reminding them and utilizing protective factors.


The loss of a loved one can leave us feeling helpless and hopeless. If you have lost a loved one to suicide, seek support and help by connecting with other survivors. Often people cope by the tragic loss of a loved one by joining with others to prevent suicide or by a survival mission of helping others that keeps alive the best of their loved one.

 Help for Those Suffering From Depression and Those Who Have Lost A Loved One To Suicide

There is the National Suicide Prevention Hotline 1-800-273-8255

The Trevor Project for LGBTQ Youth 

The American Foundation for Suicide Prevention,

Military Suicide Prevention

Life-lines School Programs

Competent mental help professionals can be found by connecting with the American Psychological Association. Or The American Group Psychotherapy Association.

We need to work together to ease the pain, seek the help and reduce tragic loss by suicide.


Be sure to listen in to hear the podcast

Preventing Physician Suicide – Dr. Lorna Breen Heroes’ Foundation on Psych Up Live – Be Safe Suzanne