Adam Wood (not his real name) committed suicide in early November, just days before his 43rd birthday. Overcome with depression, he shot himself in the heart; his girlfriend found him on his bed, with DNR (for Do Not Resuscitate) written across his chest.

“My mother has never accepted his suicide,” said Wood’s sister, Sheri, of Boston, Massachusetts. “She told everyone in the family to tell friends and family members he died of kidney failure.”

“Suicide is different — there’s an intense feeling of betrayal and guilt that I let him down,” said the surviving sibling.

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Wood was sick at the time of his death; his illness may have played a role in his decision. But Wood said the inability to be open and honest about her brother’s suicide has left her feeling alone, without friends who can support her grief process.

“I would be sad if he had died of kidney failure,” Sheri Wood said. “But suicide is different — there’s an intense feeling of betrayal and guilt that I let him down, and I can’t talk about it with anyone, especially my mom.”

Let Go of the Stigma 
Most suicide victims die as a result of a mental illness, according to Dr. Lee A. Underwood, licensed clinical psychologist and professor at Argosy University in Phoenix, Arizona. Depression is the major driver.

“Nobody kills themselves without being depressed,” he said. And just as family members would rally behind someone with cancer — so should they accept and help family members struggling with mental illness. “Look at it as another area of health, like diabetes or high blood pressure. Realize that depression is a treatable illness,” Dr. Underwood told LifeZette.

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Acknowledge What Occurred
Families in this situation often face difficult emotions during the holidays as they gather in traditional celebrations. Their family member’s absence can seem particularly palpable around the holiday table.

The first step in easing some of the pain is acknowledging what really happened. When families minimize or deny it, they remain unable to move forward, and it can perpetuate a cycle of suicide. People who struggle with a genetic predisposition to depression are much more likely to commit suicide if they have a family member who has already done so.

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“It’s the lying and the covering up and minimizing and the shame that’s involved that perpetuates future behavior,” said Underwood. “If we can acknowledge that somebody committed suicide, that lessens the likelihood of a family member committing suicide.”

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Wood said that is the case for her as she, too, struggles with a genetic disposition to depression and anxiety. She has sought counseling but “still feels a gaping wound from Adam’s death.” Much of her pain comes from having to brush off her brother’s death when friends talk about how unfortunate or how unfair it was for him to “get sick.”

“He didn’t die because he was sick, OK?” she said with some anger. “He died because he felt he had no other choice, so he put a bullet in his chest. It’s not the same thing, and I’m not even allowed to deal with that in a way that will let me heal.” Thanksgiving proves especially difficult for her, since it comes on the heels of her brother’s birthday and suicide.

Create a Tradition That Celebrates Life
For struggling families, Underwood suggests creating a tradition that celebrates the family member’s life. They could say a prayer dedicated to that individual, they could leave a chair empty at their table, or they could take turns saying something positive about that person. Bringing the problem forward, having a sense of humility about the facts, and discussing it openly works miracles in moving families toward healing.

Related: Guess Who’s Most at Risk for Suicide 

Wood isn’t sure her mother will ever change how she talks about the suicide. “It’s an entirely different and more painful process for a mother than a sister,” she said.

Her brother played an important role in the family. He worked as a doctor — she often turned to him for medical advice. He was also one the best cooks in the family, teaching her how to make mashed potatoes and brine the turkey for Thanksgiving, she said. These are lessons she’ll remember.

“Maybe if I dedicate each Thanksgiving meal to him and to his life, I’ll finally feel at peace about how he died,” she said, adding— “This one’s for you, Adam.”