The Ku-Ross Model: The Five Stages Of Suicide After Suicide

Throughout our lives, at some point all of us will experience loss. In that split second, that loss will have a profound impact. Life as one once knew it will change dramatically. The wound is new, open, and extremely painful. The mental/emotional stress can be overwhelming and extremely difficult. When a person’s stress levels/stressors go beyond their coping capacity, reactions can encompass anxiety, fatigue, depression and suicidal thoughts. It is the shifting levels of depression the person faces, and a lack of capacity to cope after loss that can eventually open the suicide door.
Statistics say that risks of suicide after bereavement occur within the first week after death of a spouse. Those who are divorced are three times more likely
to go through with death by suicide compared to those still/currently married. Divorced women are more apt to attempt suicide, while divorced men are more apt to succeed. Children who experience death of a parent by suicide are also likely to die by suicide. Parental death by other means in childhood also increases suicide risk. Grief and mourning can last as long as 25 years, and leads to an earlier death after the loss of a child. Every year, there are approximately 2.5 million deaths in the United States that leave behind a mean of 5 grieving/bereaved people.
Learning to cope is the greatest task, with its many levels and differing elements and behaviors.
To cope is to survive.

Loss takes many forms. It can be (but not limited to) the death of (a) loved one or something loved, or its impending inevitability. The loss could be that of employment, separation/divorce (and eventual blended families), or limb(s).
To introduce the stages in what to expect in regards to the range of emotions a person may feel, I will begin with the Kubler-Ross model. With this model, there are five stages of death and dying. Someone grieving may or may not experience all of the stages, or occur in order. Each person’s level of bereavement is different.
1st stage - Denial/Isolation
Initial reaction is to deny is happening or will. It is a coping mechanism, designed to shield against the shock/reality of dying/death.
Ex: “This can’t be happening” “You must be kidding, right?” “He/She was just here!” “No, that did not happen!” “Is this a joke?” “Are you
sure?”
2nd stage – Anger
Angry at the person dying/dead/ God.
Ex: “How could you?” “Why?” “You were reckless and careless!” “You were the lucky one” “Must be nice!” “I guess it was worth it!” “What kind of God are you?” “Why take the good people, when there are so many bad ones left?”
3rd stage – Bargaining
Talking with God about making a deal.
Ex: ”God, just take me and bring him/her back”.
It is after these first stages to be most observant to any changes in behavior.
4th stage – Depression
It is in in this and the following last stage that the grieving person is most susceptible to suicidal thoughts. Depression is the main catalyst for death by suicide.
Upon the realization that bargaining has failed, depression sets in.
Ex: Lethargic; sad; uncontrollable crying; sleeping a lot; numbness; unable to function normally; hopelessness; suicidal thoughts/thoughts of being together again; guilt; confusion; intense sorrow; void of the ‘good’ memories; despair; loss of identity/purpose/meaning.
The effects of depression are very physical in nature. The inability to sleep, and appetite/weight loss result in fatigue, which weakens the immune system (also known as somatic symptoms).
5th stage – Acceptance
Accepts the impending/death.
Ex: Self-protection mode; lacking emotion; detachment; disconnected; withdrawal;
anti-social.
In 1982, William Worden theorized four tasks of mourning. Void of time limits and sequentialism, it offers the grieving an outlet to grow, and experience something new. These tasks are:
 Accepting the reality (of the loss)
 Expressing feelings (openly)
 Applied adjustments (to the loss)
 Reinvesting energy/emotional reinvention and relocation
To grieve is a natural process. States of grieving includes not only emotional, but physical, cognitive, and behavioral. Given the opportunity and willingness to talk, the person will give clues as to their state of mental/physical health. Their physical state would be first to be recognized as a possible problem. Extreme weight loss, an unkept appearance, headaches, shaking/trembling, heart palpitations, and frequent periods of illness are some obvious signs to watch/listen for.
In a cognitive sense, the initial reaction to loss is confusion, completely lost in thoughts, and even disturbances (seeing/hearing/talking to or with the deceased). Behavior changes can include angry outbursts, severe mood swings, dramatic shift in eating patterns, interrupted normal sleeping patterns, excessive crying, and anti-social behavior.
If the thought of suicide has crossed a person’s mind, seek help for them immediately. I cannot stress enough that though it may seem like there is no other way out of the intense emotional/physical pain involved with their loss, I can testify from personal experience that they can pull through this. Let them talk about and release it, no matter how long this takes. There is no set time frame to stop grieving. Each person and circumstances are unique and separate. It could be months or several years before a person recovers, while some never truly recover at all. It is who, what, why, and how that are all determinants, as well as the persons available coping skills, that determine the length of time it takes to heal.
Be empathetic. Let them talk, cry, or wonder. Remind the person that it is important to maintain one’s health, and seek help if needed. Help them mourn, and divide the sorrow. Survivors of loss require extensive support, time, comfort, empathy, attention and patience.
During the time of bereavement, it is important to let the person to know that there is hope, they are not alone, and they will survive. Given both time, guidance, and a strong support system, the sun will shine on them again. Help them focus on life, not death. In time, they will adjust to the new life. I like to think of it as turning the page, and beginning a new chapter.