Several days ago I sat with a group of adults who lost a colleague to suicide. As we talked about his death, several in the group started crying. Despite the passage of time, simply talking about him brought waves of grief.

But unlike other causes of death, the group also felt guilt. Why didn’t they know how depressed he was? Why didn’t they see his pain?

Sadly, suicide is the 10th leading cause of death in the United States. More than 45,000 individuals die by suicide yearly. It’s the fourth leading cause of death among adults between the ages of 35-45. Despite advances in the treatment of depression and the decreased stigma of mental health care, the suicide rate has increased over the past 15 years.

When I asked the group if any of them had a friend, acquaintance or relative who killed themselves, close to half of the group raised their hand. Many of us have known someone who died by suicide. Many of us knew someone in high school or college who died by suicide — it’s the second leading cause of death in that age group.

I had a close friend, Andy, who killed himself. He was a professor of mine in graduate school. He was a wonderful, talented man. But he was also an alcoholic. And over time, his drinking increased. He lost his job at the university, he lost his partner, and hung himself in his 50s. I have his picture on my kitchen window sill, and look at this photograph every day. I miss him terribly.

Like all survivors of suicide, I felt a sense of guilt. Why didn’t I know he was so desperate? I wished I had known and reached out to him. It’s been 25 years since he died, and I still feel that way.

Throughout history, suicide has been a cause of death. It’s not particular to modern life, the industrial revolution or the 21st century. But that doesn’t make it less painful for survivors.

When someone takes their own life, family and friends feel a sense of failure. Why couldn’t we do something? We wonder, did we, as a community, neglect this person? After the fact, it’s sometimes easy to see signs of depression with our perfect 20/20 hindsight.

I think of suicide as a form of accidental death. I imagine that many suicide victims, if they could look back, would choose a different path. It’s often impulsive (although not always) and the victim feels that their family would be better off if they were gone. But this is never true — it’s a distorted belief that arises out of deep despair. Given time, more rational thoughts could take hold.

As a mental health professional I am not immune to the statistics of suicide. As a psychologist, over my 40-year career, seeing thousands of patients, I have had several patients die by suicide. I felt intense grief over their death and terrible sadness for their families.

So how can we cope with this kind of loss?

Don’t rationalize your feelings. When someone dies by suicide, survivors will experience a wide range of emotions. Let them be and recognize that they have their place. They are a response to something tragic that occurred. Telling yourself not to feel guilty is not helpful. But just because you feel guilty doesn’t mean that you are guilty.

We don’t get over loss. Yes, there is often a year or more of intense mourning. Grief comes in waves, and during the first year, those waves come more often. But 20 years later, those waves can still knock you over. We don’t get over loss, but we do get used to the loss of a loved one. Their absence becomes more familiar over time.

Get help. The suicidal death of a friend or relative can generate what we call “complicated” grieving. Coping with suicide is challenging. Don’t be afraid to seek counseling for yourself.

Paul Schoenfeld is director of The Everett Clinic’s Center for Behavioral Health. His Family Talk Blog can be found at www.everettclinic.com/family-talk-blog.