SUICIDE AWARENESS Part III: Family and friends are the survivors of suicide:

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Since her son, Cody Bauer, died by suicide in January, Cassie Diver has become a devoted advocate for suicide awareness and suicide prevention efforts. Every day in September, she posted a fact, a meme, a helpful quote or a photo of Cody to her Facebook page because it was Suicide Prevention Awareness Month. She still posts most days on the page.

Death by suicide can be the cruelest for those it leaves behind. They are often left wondering why, what they could have done, how such a terrible thing could have happened to them and their loved one.

"I lived through every parent's worst nightmare: losing a child. I have told myself I have to make more of this. I have to give it meaning," Diver said. "It needs to be talked about, and I think a lot of people are afraid to say it."

Many people respond. Some share memories of Cody, while others send messages of support for Cassie and her family. A few talk about their own losses, some for the first time.

Diver said her posts will sometimes motivate readers to randomly share comments: "So-and-so died by suicide, and no one ever talked about it."

"But they're sharing it, and then I know I'm reaching other people who feel the same way," she said.

Connecting with others who share the same experience helps.

"(Suicide is) a different death than others," said Meghann Levitt, the Carlton County Public Health educator who helped initiate the TXT4Life program for the county and region. "You don't have the answers to a lot of questions. You don't have closure.

"When families can connect who've gone through the same kind of loss, it helps in the grieving process, that understanding and connection," she said.

Corrine Campbell of Cloquet lost her son, Jeremy, to suicide several years ago. It was the worst thing that will ever happen to her, she said.

"I needed to know I wasn't the only one feeling what I was feeling, that I wasn't the only one to go through losing a child," Campbell said.

A guide for suicide survivors by Essentia Health advises that it is OK to grieve, to cry, to laugh when someone you love has died by suicide. Don't suppress your feelings. Don't turn to alcohol, which is a depressant. Journaling can help.

Helping survivors

When counseling families who have lost a loved one to suicide, Human Development Center psychologist Caroline Phelps stresses that it's not a question of something they did wrong.

"It's not about 'you did not love them enough'" she said. " It's about a tragedy that you now need to learn how to live with and that job is hard enough."

Survivors need to know they are not to blame and there is no shame for them to feel, Phelps explained. Any shame they feel is "unearned" shame, because they haven't done anything wrong.

Being sad is enough.

"People don't kill themselves because their parents aren't perfect," Phelps said. "It's not that your love of the individual wasn't enough. In fact, people (who die by suicide) often come from very loving families."

Suicide is a traumatic death for survivors, the people a person who dies by suicide leaves behind.

"There are deaths that are not called traumatic," Phelps said. "Suicide certainly is, regardless of how the person dies or who found the body. It's always traumatic."

It can also cause physical side effects. Campbell couldn't sleep, and her short-term memory suddenly wasn't good anymore.

Diver said she feels like she's in a fog much of the time now, and has to make lists for everything and take super detailed notes. Her memory isn't working like it did.

Laurie Audette also can't sleep at night. She said she gets up multiple times every night, practically every hour, since her son, Allen, died by suicide last year. He was 16.

"For survivors, it's like PTSD. It's a sudden trauma that you're not prepared for emotionally, or financially," said Diver. "It's draining."

Like Diver and Campbell, Audette has found comfort in sharing her son's story, and trying to make sure other people know that suicide isn't the answer and where to go for help.

The Askov resident, who works in Cloquet, has started a Facebook page called "Allen's Hope," and worked to bring suicide awareness events to local schools. She's also trying to put a "face" on suicide, she said.

"If you talk about suicide, people brush it off," Audette said. "If you put a face to it, somebody that you know, you make it real."

Schools are also doing a better job of providing crisis counselors and helping other students cope when a classmate dies by suicide, Phelps said.

"We know suicide sends a message that it is one solution to your problems," she said. "We want the message to get out that it's the wrong solution to your problems. We believe if you would have given us enough time to help you, to allow enough time to pass to get a different perspective, that you no longer would want to take your own life."

Diver says the same thing about Cody in an essay, that if he had gone with the "three-day rule" for life-changing decisions, he would still be here.

So what should friends and family of survivors do?

Phelps said "keep checking in." Not just a week, a month or a year later. Two years later, five years later.

"Ask them 'How can I support you best, what do you need from me?' Tell them, 'I've been thinking about you. I can't imagine what it's like,'" Phelps suggested. "Sometimes just sending a message helps, telling them about a beautiful memory of the person who died, letting them know you're thinking of them and sharing what a special person he or she was. It's not just about death. It's about the life and human being they were. "

Diver agreed wholeheartedly. It's OK if you don't exactly know what to say to her, just try. It helps, even if you feel awkward.

She loves it when people share photos and stories about Cody. So many people have told her how Cody impacted their lives, from teachers to friends and family. She's been collecting those stories. She and Campbell have also both traveled to see places their sons had been.

"It helps to heal when you talk about him. The pain is there, but so are wonderful memories," Diver said. "I want to know how he impacted people, whether it's by his death or something he's done," she said. "It's those stories that make me go, 'Yeah, he was here. He did exist."

Remove the stigma

Finally, every expert and parent interviewed for this story stressed how important it is to work to destigmatize mental illness and suicide.

If you suspect someone is considering suicide, the best thing to do is ask them: "Are you thinking about suicide?" Don't be afraid to talk about it, Levitt said, referring to the historic stigma that "if you ask, they will do it (kill themselves)."

"We now know from research that talking about it and asking straight up can actually open up the conversation with somebody. If they say, 'No, I'm not thinking about suicide,' then they're not thinking about it. It's not going to do any harm. But if they're struggling, they will know you're someone it's OK to talk about it with."

Another point Levitt discusses when she visits schools is that mental illness or suicidal thoughts can be caused by a chemical imbalance in the brain.

"It's a physical disorder, just like diabetes," Levitt said. "If it's affecting your brain, an organ, it will affect the thoughts that you have, the words that you say, the things that you do. So even though it's physical, it's going to come out a lot differently.

"No one asks to have thoughts of suicide. Nobody asks to have anxiety, to be depressed, just like nobody asks to have asthma. It's something going on that's outside their control."

Medication will target that chemical imbalance while therapy can help the person with suicidal thoughts make different connections in the brain so suicide isn't the only answer to the problem he or she can see. Ideally, the two approaches work together, Levitt said.

Phelps pointed out that 25 percent of Americans will develop a mental health problem over the course of their lifetime.

"We want to stop thinking of mental illness as being a narrowly defined illness, or a grossly serious illness," she said. "There's a spectrum, just like you can have a range of physical problems from the common cold to a three-day flu to a cancer that you die from. To say someone has a mental illness, you know as much about that person as if I told you they have a certain physical illness.

"We also know anyone can experience mental illness symptoms when they're in an acute personal crisis. That doesn't mean it evolves into an entire illness."

Getting help from a trained counselor can help someone get back to a place where they can be their true, authentic self, she added.

If that help is available.

There is a shortage of mental health professionals in northern Minnesota and most rural areas. It can often take months to get an appointment.

In the meantime, people continue to fall through the cracks.

"As parents we didn't get help after my son left the hospital," Audette said, explaining that Allen was hospitalized after his first suicide attempt. "Maybe there was a list of resources in the fine print, but it would have been great to learn about support groups, family therapy or somehow get help from the county before it was too late."

So she has vowed to get the word out herself. It's making a difference, she said.

"My son's life has already saved other lives," Audette said. "I get Facebook messages, text messages, calls from other high school students asking for help, asking what can they do."

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Resources for suicide survivors

• Essentia Health offers a Suicide Family Members Support Group that meets the third Monday of each month in the 2E Classroom (2216) of St. Mary's Medical Center (next to the chapel on the second floor). Contact Kari Parsons at 218-786-4402.

• The National Alliance on Mental Illness (NAMI) has a family support group for families and friends of people living with mental illness that meets from 6-7 p.m. the last Tuesday of the month at Miller Dwan Hospital, Conference Room 3, 502 E. Second St., Duluth.

• REACH Mentoring has started a Students Offering Support group at Cloquet and Esko high schools, and is working to bring the group to all Carlton County high schools. The group's mission is broad, but includes suicide prevention and talking about mental health. Contact the individual school for meeting information.

• Human Development Center (HDC) psychologist Caroline Phelps has a TV show, "Speak Your Mind," that runs on WDSE/WRPT public TV. This locally produced live show was developed by the HDC to help start the conversation in our communities about mental health issues and to encourage people to ask the questions they've always wanted to ask. There are several episodes on suicide prevention, suicide survival and suicide loss. Find archived and upcoming shows and more at speakyourmindonline.org.