Sad vs. Suicidal: “Normal” vs. Complicated Grief

When the grieving say that they don’t want to be “here” anymore you may wonder…what is the difference between being sad and being suicidal, or “normal” vs. complicated grief? Is it normal for someone who has lost a loved one to say (or think) that they don’t want to live anymore? That they not only can’t imagine a life without the person they’ve lost, but that they’re not at all interested in finding out?

Trying to assess what’s “normal” in grieving or whether a person is truly suicidal is no easy task, even for a trained professional.

You may be worried about a friend or loved one or you may be concerned for yourself. In trying to make this determination and whether more help is needed, consider the following:

When a person who has lost a loved one makes a remark that could be considered a form of suicide ideation (for example, “I don’t care what happens to me”, “I don’t want to live without her”, “If I don’t wake up tomorrow that would be just fine with me”) try to examine whether the statement is a true threat or an attempt to explain the depths of sadness being felt following the loss.

Does the griever REALLY want their life to end…or do they just want the pain to end? This life, this new life without their loved one in it, is so foreign and so unwanted, a griever can feel like they don’t belong in it. Trying to find the words, even in our own minds to express the pain and emptiness, may leave few options.

A look at the difference between “normal” (or “common” or “typical”) grieving vs. complicated grief may help shed some light on when a griever is following an expected path, or when they may need more help.

“Normal” grief is messy, complicated, painful, unsightly, and for some, as far from “normal” as they have ever felt. I find what so often brings someone to a support group is the need for validation that what they’re experiencing is normal or okay. Grief can almost feel like an out of body experience, and in addition to feeling sad, scared, lonely and isolated, a griever may feel that they’re not normal for feeling the way they feel.

Because the spectrum of what is “normal” in grief can be so broad, I tend to focus more on helping grievers understand what may be considered behavior that falls outside of that range.

While it may feel strange to spend a day in bed, sometimes that’s what a person who is grieving a significant loss needs. Even if they were someone who was always busy, always on the go, and always socializing with other people, it’s not unusual for that to change for a time. Skipping a shower, not returning a friend’s phone call, or a loss of interest in an activity previously enjoyed, are all things that fall within the expected pattern of what it means to be actively grieving the loss of a loved one.

Complicated grief can look like “normal” grieving to a point, but typically it’s defined by the extremes. If you find that you or someone you love is consistently day after day staying in bed, forgoing basic hygiene, missing work, neglecting the care of home or pets, isolating from friends and family, not opening the mail or paying bills, drinking or abusing drugs or medication- it may be time to consider getting more help.

Recruit friends and family to help, ask your family doctor, or look for bereavement supports in your area. Remember that complicated grief is not the same thing as being suicidal, but don’t make it your responsibility to distinguish the difference.

If there is grave concern, become familiar with what crisis supports are out there and learn more about what to look for in a person who may be considering taking their own life. Two great resources are the American Foundation for Suicide Prevention www.afsp.org or the National Suicide Prevention Lifeline www.suicidepreventionlifeline.org 1-800-273-TALK.

When considering what’s “normal” for any of us, it’s important to look at history and how difficult situations have been coped with in the past. Although grief can take us far from a person we used to be, past patterns and behaviors should certainly be examined when trying to determine how to help. Consider factors like substance abuse and mental health history. Is there a history of suicidal tendencies, or reckless behavior? Has there ever been a time prior to this significant loss, that this person expressed a desire to take their own life?

Bottom line, don’t do this alone. Whether it’s for you or a friend or a loved one – reach out, turn to the professionals and find help.

For everyone else – for those who may talk about not wanting to go on with this life, but who truly have no intention of taking their own life, remember:

#1 – Everyone has heard of taking life one day at a time. The grieving can only take life one minute at a time. Make small goals, and each day, focus only on what’s right in front of you. Projecting what’s ahead or what’s next or trying to answer too many questions may simply be too much. Focus on small tasks, and stay in the moment as much as possible.

#2 – While it may seem there’s nothing left to live for – take a closer look. Surround yourself with family and friends, things that have brought you pleasure or joy in the past (even if being with these people or doing these things has no feeling right now, no joy), continue to expose yourself to the good things in life – however small or insignificant they may seem.

#3 – Know that while the ache we have for our lost loved ones never goes away, the symptoms of grief eventually soften and fade with time. Allow yourself to be different for a little bit. Have faith that you will return to those things and those remaining loved ones that define you. Know that there is light and love and wisdom to be gained and so much strength and growth that can be found in the hardest and darkest of times.