At times, other people’s belief systems, including that of the survivors themselves, can be a barrier to accepting the death and a deterrent to talking about it. When coping

with a loss, people often turn to religion for comfort and guidance. A challenge for some survivors is that several religions impose shameful restrictions on the grief rituals for those who have been bereaved by suicide. selleck kinase inhibitor suicide survivors face Inhibitors,research,lifescience,medical additional logistical barriers when handling the deceased’s business after a suicide, as most insurance policies even have clauses with built-in stigma.49 Despite alarmingly high rates of suicides in the United States military, it was only until very recently (July 6, 2011) that the United States Government began to honorably acknowledge the bereaved after a military suicide, as is done for other deaths that occur in combat zones. For many people, talking about their loved ones is vital for their recovery from their loss. The stigma of suicide poses a barrier to the healing process.37 Inhibitors,research,lifescience,medical Trauma Survivors of suicide are more likely than other bereaved individuals to develop symptoms of PTSD.50 The majority of suicide methods involve considerable bodily damage. Occasionally,

survivors are witnesses to the final act, or the first to discover the dead body. Those left to find Inhibitors,research,lifescience,medical the deceased’s body struggle to get the gruesome images of out of their minds.51 In such circumstances, Inhibitors,research,lifescience,medical traumatic distress, marked by

fear, horror, vulnerability, and disintegration of cognitive assumptions ensues. One survivor told us the poignant story of her boyfriend, who immediately after a breakup, climbed to a nearby bridge and leaped to his death while she looked on in horror. Not unexpectedly, her grief was replete with such trauma symptoms as preoccupation with reminders, terror-filled recollections, avoidance of high places, and other reminders. After a death by suicide, themes Inhibitors,research,lifescience,medical of violence, victimization, and volition (ie, the choice of death over life, as in the case of suicide) are common and may be intermixed with other aspects of grief. Disbelief, despair, anxiety symptoms, preoccupation with the deceased and the circumstances of the death, withdrawal, hyper STK38 arousal, and dysphoria are more intense and more prolonged than they are under nontraumatic circumstances.52 Suicide risk in survivors Suicide and mental illness runs in families, likely a result of both heritability and environmental factors.7,8 Survivors of suicide may be left to struggle with their own suicidal ideation, while seeing that the deceased escaped the anguish and put an end to their suffering. Despite the fact that the suicide bereaved intimately understand the intense pain and suffering experienced by all those who survive a suicide loss, survivors are at higher risk themselves for suicidal ideation and behavior than are other bereaved individuals.