How does suicide affect friends and family?

Suicide deaths often leave scars on family and friends: guilt, sorrow, anger, abandonment, silence. Even young children instinctively know this when they scream (or fantasize) to their parents, "I'll die and then you'll be sorry!"

Mark Twain describes this situation in Tom Sawyer's elaborate death ruse, he is supposed to have drowned, but is actually hiding under the bed listening, while his Aunt Polly and her friend, Mrs. Harper, sorrowfully express their belated love and guilt at his untimely demise.

In one study, all family members said they were shocked by finding the body or being informed of the suicide. 89% said they were later angry, and 57% reported depression. Some described persistent memories of the smell of gunpowder and finding bone and tissue parts.

The family is left to pick up the pieces, figuratively and sometimes literally.

On the other hand, depending on attitudes and circumstances, sometimes the death is also a relief, particularly in cases of terminal illness or chronic suicidality.

One 57-year-old woman said, of her husband, "It was at the back of my mind that it was going to happen. And when it did, it was a shock, but I felt, `Okay, he's finally at rest...' I felt relieved that he was finally at peace, because I had done all I could."

Before You Kill Yourself:

You've decided to do it. Life is impossible. Suicide is your way out. Fine, but before you kill yourself, there are some things you should know. I am a psychiatric nurse, and I see the results of suicide, when, it works and, more often, when it doesn't.

Consider, before you act, these facts:

Suicide is usually not successful. You think you know a way to guarantee it? Ask the 25-year-old who tried to electrocute himself. He lived. But both his arms are gone and he has to write with his feet. He can't use a computer because his toes are too big, but he is getting a special government grant for a special keyboard/mouse.

What about jumping? Ask John. He used to be intelligent, with an engaging sense of humor. That was before he leaped from a building. Now he's brain damaged and will always need care. He staggers and has seizures. He lives in a fog. But worst of all, he knows he used to be normal.

What about pills? Ask the 12-year-old with extensive liver damage from an overdose. Have you ever seen anyone die of liver damage? You turn yellow, it's painful, and it takes a long time. It's a hard way to go.

What about a gun? Ask the 24-year-old who shot himself in the head. Now he drags one leg, has a useless arm and has no vision or hearing on one side. He lived through his foolproof suicide, but if you do, you might end up looking similar to this.

If you have no friends now, what will looking like this do to your social life? Aside from some really sharp halloween costume parties - not much.

Who will clean your blood off the carpet or scrape your brains from the ceiling?

Commercial cleaning crews may refuse that job, but someone has to do it. Who will have to cut you down from where you hanged yourself or identify your bloated body after you've drowned? Your mother? Your wife? Your son?

The carefully worded loving suicide note is no help. Those who loved you will never completely recover. They'll feel regret and an unending pain.

Suicide is contagious. Look around at our family. Look closely at the four year old playing with his cars on the rug. Kill yourself tonight and he may do it ten years from now.

You do have other choices. There are people who can help you through this crisis. Call a hot line. Call a friend Call your minister or priest. Call a doctor or hospital. Call the police.

They will tell you that there's hope. Maybe you'll find it in the mail tomorrow. Or in a phone call this weekend. But what you're seeking could be just a minute, a day or a month away.

You say you don't want to be stopped? Still want to do it? Well, then, I may see you in the psychiatric ward later. And we'll work with whatever you have left.