To address the impact of this heartbreaking epidemic, the editors at Everyday Health are offering “Surviving the Suicide of a Loved One,” a companion guide to the book Life After Suicide: Finding Courage, Comfort, and Community After Unthinkable Loss (HarperCollins, May 2019), for people who order the book here. The guide is available to download here.  In the memoir Life After Suicide, ABC News Chief Medical Correspondent Jennifer Ashton, MD, offers firsthand knowledge and advice to people who have lost a loved one to suicide. Dr. Ashton’s ex-husband died by suicide in 2017. “I still have days when this all seems surreal,” Dr. Ashton writes in the book. “I still wonder sometimes if I’ll ever feel unbroken again, and I can’t pretend that this whole hard journey is behind me once and for all.” Everyday Health’s companion guide is intended to help others navigate that journey through courage, comfort, and community. For those who have lost someone, life after suicide is a complex tangle of emotions — grief and loss, guilt and failure, confusion, and distress. Those who have survived an attempted suicide face the physical, emotional, and psychological challenges of recovery as they try to arrive at a hopeful future. The following are two such stories of loss and survival.

Mallory’s Story: A Life Lost

The bullying occurred in the classroom, at lunch, and through social media. “You have no friends,” one of the girls texted Mallory, beneath a Snapchat photo that she had taken of Mallory walking alone. At school, Mallory was publicly confronted with comments like “When are you going to kill yourself?” No one would sit with Mallory at lunch. During the car ride home, Mallory was silent — and angry. What would her classmates do once they found out that she had told the principal? “You just made it worse,” she told her mother. Mal, as her family called her, was the youngest of four children. She was a gymnast and a cheerleader. Mallory had a small circle of good friends in gymnastics, but they didn’t attend the same school. Being bullied in front of the other students made it hard for Mallory to make friends at school. Mallory had her emotional ups and downs and sometimes threw a temper tantrum, Dianne recalls, but what tween girl doesn’t? Any warning signs were mostly kept tucked away, and Dianne had no idea just how deep her daughter’s pain ran. After their meeting with the principal, Dianne tried to console Mallory. “It’s fine,” Mallory said — an oft-repeated signal to leave her alone, which Dianne had learned to heed. Dianne and Mallory’s older sister had planned a trip to New York City from their home in Rockaway Township, New Jersey. Dianne saw no reason not to go. Her husband would be home in a little while to keep Mallory company. A few hours later, Seth called Dianne: Mallory had hurt herself. (Dianne has chosen not to reveal how). When she arrived at the hospital, Dianne found Mallory lifeless and bruised from the paramedics’ attempts to save her daughter. Back home, “there was an aura of darkness and sadness,” Dianne says. “I remember feeling paralyzed. The weight of it was so overwhelming. You don’t know where to turn.” Mallory never told her parents that she wanted to die, and she had never before tried to harm herself. “It was a complete and utter shock,” says Dianne. “Why didn’t I see the signs? Why didn’t I know? Why didn’t I take her to the doctor? You say, ‘It was right in front of you,’ but you only have that vision because of hindsight.” Survivors of suicide deal with a loss like no other, says Vanessa L. McGann, PhD, a clinical psychologist in New York City who chairs the loss division of the American Association of Suicidology. She began specializing in this kind of grief following her sister Nadine’s death by suicide in 2004. “So many survivors feel it’s an isolating experience to grieve a suicide,” Dr. McGann says. With isolation and grief also comes self-recrimination, Dianne says. “You say to yourself, ‘Why did you leave her? How did I miss that? How did I not make the decision to take her with us? That to me is the hardest thing.” One way Dianne deals with her grief is through writing about what she refers to as her family’s journey since Mallory’s death. “It’s important for us to share our journey to make others aware,” she says. “Writing and sharing give me a place to park the pain, a place for the pain to live.” Dianne has posted thousands of words on her Facebook page, Mallory’s Army, including personal reflections, memories, and information about programs and events to combat bullying. It has given Dianne a way of connecting with others who may not understand or, on the other hand, know all too well what it means to lose a loved one to suicide. “I think there is judgment associated with losing a loved one to suicide,” she says. “It allows me to share the experience, so that people can say, ‘Hey, I’m just like you. That’s how I felt when I lost my mom. We’re no different.’” According to McGann, it’s not uncommon for loss survivors to feel that they are different. They may feel judged or even stigmatized by others. “Unfortunately, if a mother lost a child, there may be questions of what did the mother do or not do to cause her child to do that. What kind of a family has suicide? There is a lot of that type of thing,” she says. Loss survivors “may do things to protect and isolate themselves, which goes against what they need,” McGann says. “And when they reach out for help and expect the usual outreach, there is the stigma coming from without.” Dianne found that her willingness to open herself up sparked a flood of compassion from her community and beyond — from the flowers left on the Grossmans’ doorstep and a candlelight vigil of townsfolk on the one-year anniversary of Mallory’s death, to many random acts of kindness. “Just to say, ‘We know she is not forgotten,’ is priceless,” Dianne says, through her tears. “You can never say thank you enough.” Dianne started the Mallory’s Army Foundation in her daughter’s honor to help teach children and their parents how to stand up to bullying. “I probably should be in some form of therapy, but I am not ready for it,” she says. “My writing and sharing my story and turning our tragedy into something good, that is my therapy. Hearing we are making a difference, that is what works for me.” RELATED: Understanding Suicide — From Risk Factors to Prevention, and How to Get Help

Kevin’s Story: A Life Regained

On September 25, 2000, 19-year-old Kevin Hines, who had been battling bipolar disorder and depression for years, jumped off that bridge. He survived. A couple of years before the suicide attempt, Kevin was taken off of epilepsy medication because the seizures he was having were under control. What no one realized at the time was that the seizure medication had also been acting as a mood stabilizer. When he stopped taking the drug, Kevin “spiraled out of control.” Kevin says there was no specific trigger that brought him to the Golden Gate that day. He remembers staring at the waters of San Francisco Bay below. The voices inside his head were saying: “You must die. Jump now.” And he did. A moment later, in freefall, Kevin felt deep regret. “I said to myself, ‘What have I done? I don’t want to die. God please save me,’” he recalls. “I recognized that I made the greatest mistake in my life, and I thought it was too late.” Kevin fell about 240 feet in four seconds. He crashed feet first, crushing spinal vertebrae and breaking an ankle. But he lived. More than 1,700 people have jumped off the Golden Gate and fewer than 1 percent have survived. Doctors were able to surgically repair Kevin’s physical injuries. After four weeks, he entered psychiatric care at St. Francis Hospital in San Francisco. It was the first of seven in-patient stays over the next 11 years to deal with his recurring depression, paranoia, and hallucinations. He says that his road to recovery was a combination of therapy (psychotherapy and light box therapy), medication, proper nutrition, and exercise — a regimen he continues to follow to maintain his mental health. He also credits his close-knit family and friends for providing much-needed emotional support and motivation. Kevin has put together a 10-step plan called The Art of Wellness, which he posted in the hope that it will help other people living with mental illness. He also appears in the new YouTube podcast “Stay Alive,” moderated by suicide prevention expert Mark Goulston, MD. In person, Kevin is upbeat, enthusiastic, and chatty. But he is still plagued by suicidal thoughts. “I’ve chosen to accept my disease and, despite the chronic thoughts of suicide, I will never kill myself,” he says. “It is a commitment to life.” Kevin, who lives in Atlanta, Georgia, with his wife Margaret, has become a spokesperson, advocate, and coach for people coping with mental illness and struggling with suicidal thoughts. He has given hundreds of talks around the world, written a memoir, and produced the documentary Suicide: The Ripple Effect. Kevin used to get upset when his father asked if he was okay. “Then I realized that if anyone who asks me has been traumatized by my attempt, I have to tell them truthfully how I am feeling — good or bad — because it affects them,” Kevin says. “I have to tell them how I feel, so they know I’ll be here tomorrow.”

How to Get Help for Yourself or Others

McGann says that an individual’s suicide attempt should be “a wakeup call for the people around them to get them the help they need.” So how can you help at-risk individuals and survivors? If someone is at a high risk for suicide, immediately call 911. The National Suicide Prevention Lifeline (800-273-8255) and the Crisis Text Line (text HOME to 741741) provide urgent support and access to local resources. To learn more about preventing suicide, visit the National Suicide Prevention Lifeline website BeThe1To. Live Through This offers a collection of suicide attempt survivors’ inspirational stories, along with links to resources. The American Foundation for Suicide Prevention website offers specific information and resources for people who have attempted suicide or lost someone. McGann recommends that anyone coping with the loss of a loved one consider therapy or joining a survivors’ support group. She adds that it’s important not to disengage from family and friends. If you’re a loss survivor, she says, “Tell a loved one: ‘It’s okay to ask me how I’m doing. If I don’t want to talk about it, I’ll tell you. But don’t stay away if you’re not sure what to do.’”