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Relationship Themes in Suicide Notes

Relationship Themes in Suicide NotesYears ago I worked in a psychiatric emergency room in a large metropolitan hospital. My job consisted of evaluating a steady stream of patients to determine whether they should be hospitalized or sent elsewhere.

I saw people in the throes of mania, psychosis and suicidal depression. I still remember the man who asked if I was a witch who would place a spell on him. And the woman who came barreling at me down the hallway, warning, “You best get out of my way, or I’m going to go Ninja Turtle on your ass!” I remember the man who swallowed six bedsprings in a suicide attempt. And countless others with bandaged wrists, bruised necks, and broken souls. I learned a lot about the breadth and depth of human suffering.

One day I was waxing philosophical about suicide with one of the charge nurses who had worked there for more than 20 years. She shared that she had a collection of 350-odd suicide notes that had been collected by a medical examiner over the course of his career. The notes had been collecting dust in her attic for the past 10 years.

She asked if I wanted them.

It’s not everyday that an archive of grief in the form of suicide notes falls into your lap. I hesitated for just a moment before saying, “Sure.” Her gaze settled in the distance as she told me that having the notes had been fascinating and also a terrible burden. The following week I left work carrying a banker’s box full of yellowing scraps of paper, greeting cards, receipts, napkins, and hotel stationery, on which were scrawled a few hundred people’s last words.

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The musty smell when I opened the box was overwhelming. All of the notes were written by individuals who completed suicide between the mid-1940s and the mid-1960s, apparently before privacy rules would have precluded their being collected and filed away.

Gingerly picking up the fragile slips of paper, I read the words, in fits and starts. The notes, most of them no more than a few sentences, telegraphed such heartbreaking despair, hopelessness, and grief. And somewhat surprisingly, they also communicated gratitude, warmth, and an unmistakable concern for others. I couldn’t help but wonder about the lives of these individuals who, for one reason or another, had reached the end of their respective paths, and couldn’t see any further.

“I’m sorry to have to do this to you and the children, but I’ve come to the end.”

I eventually used the notes in a qualitative study exploring the interpersonal nature of suicide (Sanger & McCarthy Veach, 2008). My co-author and I focused on the suicide notes as acts of communication that demonstrated a desire to acknowledge and maintain connections with others, even in the face of death.

In their suicide notes, individuals said goodbye, apologized and asked for forgiveness, and attempted to exonerate others from blame. They provided instructions, expressed love and gratitude, and praised others for their upstanding qualities. Sometimes they discussed loneliness, isolation, and lost or unrequited relationships. They very rarely expressed hostility or pointed their fingers at others for their demise.

In simple and poignant prose, the decedents reached out to loved ones, seemingly trying to ease the unspeakable loss associated with suicide:

“You’ve been a sweet, dear, faithful wife. Thank you for that.”

“I’m sorry to have to do this to you and the children, but I’ve come to the end.”

“I hate myself for giving you this shame, but people will understand that none of it is your fault.”

“It is best I go now before things get worse for you and yours. Please forgive me for unknowingly hurting you. I should know by now that people do not want anyone with problems around them.”

Perhaps most striking was the finding that positive relationship themes, such as saying “I love you” and praising others, were more prevalent in the notes than negative relationship themes, including loneliness, isolation, and overt hostility. Expressions of concern for others also implied positive connections in the lives of these suicidal individuals. It was troubling, though, that this concern was sometimes communicated in the form of fears of being a burden or minimization of the impact of the suicide on others.

From birth, we are wired to need other people in our lives. In the study, more people focused on efforts to maintain their relationships or reconcile relationship difficulties (including those anticipated to result from the suicide) than on directly acknowledging the impending end of relationships. To me, this was a reminder of people’s strong needs for social ties, even as they approached an act that would sever all relationships.

By the end of the study, I was immersed in the balance of fascination and burdensomeness that came with owning a collection of suicide notes. I carefully placed the notes, encased in plastic sheets and organized in binders, back into the banker’s box, which has now been sitting in my attic for the past six years. I certainly cannot throw them away, but I also can’t quite bring myself to open the box again. I am quite literally keeping a lid on all of the pain they represent.


Sanger, S., & McCarthy Veach, P. (2008). The interpersonal nature of suicide: A qualitative investigation of suicide notes. Archives of Suicide Research, 12, 352-365.

Relationship Themes in Suicide Notes

Sandra Sanger, PhD

Dr. Sandra Sanger ( is a therapist in private practice in St. Paul, Minnesota. She specializes in working with adults coping with depression, anxiety, and transition stress. When she’s not seeing clients, she attends to the multitude of random thoughts that wander through her head.

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APA Reference
Sanger, S. (2018). Relationship Themes in Suicide Notes. Psych Central. Retrieved on December 3, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 24 Oct 2011)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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