Dear Therapist: I Blame Myself for My Son’s Death
I can’t stop thinking about how much he suffered—and my own inability to save him.

Dear Therapist,
My adult son died recently from a drug overdose, after a lifetime of struggles with depression, learning problems, peer rejection, and addiction. A large part of my grieving is self-blame. I blame myself for choosing a person to father my children who was himself afflicted with depression and other problems. I should have thought ahead, realizing that there was probably a genetic element that could affect our children.
I did my best to help our son have a rewarding life, as did his father, but the happy times were few, and his struggles were many and heartbreaking. Now I can’t stop replaying in my mind how he suffered and how I was unable to help him. I don’t know how to move forward.
Mary
Chicago
Dear Mary,
I’m sorry that your family has experienced so much pain and heartbreak. The grief must feel bottomless, the helplessness devastating. I’m referring, of course, to your son’s death, but also to the many aspects of his difficult life. The loss, trauma, rumination, and guilt—I suspect all of this began decades ago, leaving you now in a state of self-flagellating despair.
This is the story you’ve told me, and as true as it is, I believe there’s more that you haven’t been able to voice. It’s the part of the story that might be even more painful to contemplate than your enduring self-blame—the part about your enduring love.
What I hear in your letter is a deep, ferocious, and complicated love for your son. And it’s in this love—more than in the blame—that your grief resides. So let’s explore that love.
I imagine that when your son was born, you and his father, like most parents, pictured a certain trajectory for him. Maybe the fantasy involved a childhood filled with the usual images of birthday parties and sleepovers, sports teams and school plays, bedtime snuggles and morning kisses. Sure, there would be plenty of bumps and challenges along the way, but your child would find his way, grow strong and resilient, and embrace who he is—and you as his parents would delight in the unique person he turned out to be.
Along with this fantasy often comes another one common to new parents—the belief that they can protect their children from misfortune. Eventually, though, parents must face the reality that there are limits to what they can do and that so much is out of their hands—if a cut from a routine fall becomes a fatal infection, if a parent gets cancer while the child is young, if the child experiences a school shooting or sexual assault, if the kid steps into an intersection at the moment a drunk driver enters it, if the child marries someone who is heartless and cruel, if a family member’s genes predispose the child to a lifetime of struggle.
There’s nothing harder than watching the child you love suffer and not being able to alleviate his pain. But in addition to feeling empathy for your son’s pain, you were experiencing your own. Just as he was living in a parallel universe to his peers who navigated through the world more smoothly, you were living in a parallel universe to parents with kids who weren’t so afflicted. Many days, you probably felt isolated and alone and angry—and then also guilty for feeling isolated and alone and angry, because of a false belief that parents who love their child deeply should be more concerned with the child’s predicament than their own. Sometimes you may have wished that your life were different, that you had a less challenging child—and then felt guilty for these thoughts too, because of the misconception that parents who love their child can’t also wish for an easier life for themselves.
So what do people do when they aren’t able to accept the complexity of their love for their child? Many direct their feelings of rage and despair away from taboo targets like the child, or the partner who suffers from depression, or other parents with happier kids, and toward the safest target of all—themselves. To alleviate their guilt, they punish themselves by turning themselves into emotional punching bags—the parental equivalent of Dobby the house elf in Harry Potter.
It’s your love for your son that makes you wish you could have changed his life, but there’s another aspect of your love that you can’t see when you focus on his suffering. Perhaps your son got some genetic loading that contributed to his struggles, but he also got two parents who loved him deeply. For every person who suffers the way your son did because of genetic wiring (which may or may not have caused his depression), there are people who suffer the way he did because they didn’t have loving parents like you and his father. You gave him something many people don’t get from their parents: If you couldn’t take away his pain, you unflinchingly bore witness to it. And that was an exquisite act of love.
So what can you do to move forward? Instead of imprisoning yourself in a cell of self-recrimination, you can start by opening a space for all that you did give your son. You might want to make a list of things you did to try to help over the course of decades, even if you didn’t feel that they were helpful. In other words, make a list with no “but”s or caveats such as I could have used different words in that conversation or I could have put him in a different school or I could have chosen a different treatment provider or rehab or I could have flown to see him when he called and asked me to come that time I was working or what have you. I want you to have a record of your love.
Second, you can join a support group for parents whose adult children have died from an overdose—intentional or otherwise—so you can meet others who have experienced feelings of self-blame and regret similar to yours. In this group, you’ll find a whole community of people who understand that you have been fundamentally changed by your experience of having been your son’s parent, and they will do for you what you did so beautifully for your son: They will bear witness to your pain, even if they can’t take it away.
Dear Therapist is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental-health professional, or other qualified health provider with any questions you may have regarding a medical condition. By submitting a letter, you are agreeing to let The Atlantic use it—in part or in full—and we may edit it for length and/or clarity.