Be One Increment More Kind

Advice to those who lost someone to suicide.

I got a phone call last night from a very good friend. The number was listed as unlisted on my phone. This was not a choice my friend had made. She lost someone in her life to suicide today. Or maybe it was overdose? In 2025, it's hard to know the difference. It is harder to know if it matters.

As a psychiatrist who works with suicidal patients, I spend time, regularly, almost every day, with people who are thinking of ending their life. That is my actual job.

I can usually do something about it— I'm a physician with access to extra extraordinary tools. Most people thinking about suicide don't complete suicide. Most people who attempt suicide don't die by suicide. That having been said, death by suicide is going up.

Fittingly, when I looked up a statistics for my readers, I got a study from Rochester New York, I went to medical school:

This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (555 males/935 females) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between 01-01-1986 and 12-31-2007

And in this cohort, which includes people right up to the year I started medical school, the following was discovered:

At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported.¹

Having to cope with the inexplicable loss of somebody, often before their time, it's not something we're adequately prepared to handle. I'm not going to solve that problem for you, now. I am going to provide only limited advice.

---

Nothing about this is supposed to feel normal. You're going to feel all sorts of fucked up. It matters how close you were to the person who died by suicide, but it might not matter as much as you think. You may never have met them, and it can still mess you up. You may know them intimately, and feel inexplicably numb.

These feelings will change, and they decay, over time, like the bodies of the dead. Everything gradually changes, including your feelings about unimaginable loss.

You're gonna ask yourself questions. What could you have done differently? What did I miss? Could I have stopped it? Why didn't I say I love you the last time we spoke?

These questions are not particularly useful. There are not answers, waiting, around the corner, to deliver you from grief.

It will be more questions than you imagined. There will be anger. There will be more sorrow, still. Your Sleep is likely to be disturbed. Your heart is likely to feel heavy.

You can make food for your loved ones, and share it. You can do something together. This is not a race. You can do one little thing, and then another. But check-in, with those left behind. Check in for some multiple or even an exponent of the amount of time that makes “sense.” You don't have to say much, and the more you do a little check-in, the less you have to say each time.

Be one iota kinder in every interaction in which are mindful enough to do so, for as long as you can remember to do it. You don't have to be unbearably kind, you don't have to be a unicorn, or a beautiful special snowflake, or a rainbow. You can just be one little bit kinder than you might have otherwise been.

This is in memory, of the person who didn't get to be kind, because of whatever took their life away. It probably wasn't them, in the end. It was probably their brain.

I'm sorry that you're left, alone, without the person who left us all too early.

1. Bostwick JM, Pabbati C, Geske JR, McKean AJ. Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew. Am J Psychiatry. 2016 Nov 1;173(11):1094-1100. doi: 10.1176/appi.ajp.2016.15070854. Epub 2016 Aug 13. PMID: 27523496; PMCID: PMC5510596.