Here’s What Passive Suicidal Ideation Actually Looks Like

Trigger warning: Suicide. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

What is passive suicidal ideation?

Passive suicidal ideation refers to having thoughts of death without a clear plan or intent to actively end your own life. According to Charlie Health Primary Therapist Meghan Jensen, LPC, “passive suicidal ideation can occur when an individual no longer has the motivation to live, but does not have a clear plan to take their life.” For example, someone with passive suicidal ideation may think, “I just don’t want to wake up” or “I wish I could just disappear,” she explained.

Other examples of passive suicidal thoughts can include:

• I wish I was never born. 
• I hope I get into a car crash.
• My family would be better off without me.

Passive suicidal ideation versus active suicidal ideation

Passive suicidal ideation is actually one of two types of suicidal ideation: passive suicidal ideation and active suicidal ideation. With passive suicidal ideation, a person has thoughts of suicide. They may feel hopeless or want to end their life, but they don’t have an actual intention or plan to harm themselves. By contrast, folks with active suicidal ideation experience suicidal thoughts with suicidal behavior, meaning a motivation and intention to carry out their plan. 

Risk factors for suicidal ideation

Suicidal ideation has become an increasingly serious public health problem in the U.S., with suicide rates increasing by approximately 36% over the last two decades, according to the Centers for Disease Control and Prevention (CDC). Young people are particularly at risk: Current CDC data shows that suicide is the second leading cause of death for young people ages 10-14 years old and 20-34 years old. In 2021, nearly 2 million adults attempted suicide, but more than 12 million seriously considered it (the latter encompassing passive suicidal ideation), the public health agency reported.

So, what’s causing this increase in suicidal ideation across the country? Research suggests that passive suicidal ideation, like other forms of suicidal ideation, can be influenced by several possible risk factors. Here’s an overview of four common risk factors for suicidal ideation. 

1. A mental health diagnosis

Certain mental health conditions may increase a person’s risk of suicidal thoughts, especially without the proper resources to manage and treat the condition. Examples include:

• Depression
• Bipolar disorder
• Substance abuse
• Obsessive-compulsive disorder (OCD)

2. History of trauma

Research suggests that experiencing childhood trauma or abuse increases a person’s risk of suicidal ideation later in life. Common forms of childhood trauma include physical neglect, emotional abuse, physical abuse, sexual abuse, school violence, serious accidents, or life-threatening illness.

3. Stressful life events

Experiencing stressful life events can trigger thoughts of hopelessness and worthlessness, potentially leading to suicidal ideations. Examples may include losing a loved one, ending a relationship, being bullied, having financial problems, or failing at work or school.

4. Identifying as LGBTQIA+ 

Research shows that members of LGBTQ+ community may face higher rates of mental health challenges, including passive suicidal ideation. According to a 2022 report, 45% of LGBTQIA+ youth seriously considered suicide in the past year, including more than half of transgender and nonbinary youth and one in three cisgender youth.

Warning signs of passive suicidal ideation

Passive suicidal ideation isn’t always easy to recognize, so learning about potential warning signs is an important step in keeping you and your loved ones safe. According to Jensen, the following may be warning signs or indicators of passive suicidal ideation:

• Engaging in risky or reckless behavior
• Expressing feelings of extreme sadness, hopelessness, isolation, rejection, or apathy
• Withdrawing or self-isolating
• Change in sleep patterns
• Depression or mood swings
• Giving away meaningful personal possessions
• Scars or other visible signs of self-harm
• Anxiety, irritability, or aggression 
• Increased use of drugs or alcohol
• Researching or seeking out objects to assist in suicide, such as prescription drugs, dangerous substances, and guns
• Saying goodbye to loved ones

4 tips to manage passive suicidal ideation

Although passive suicidal ideation doesn’t involve an explicit plan for taking one’s life, it’s still a sign that someone is struggling with their mental health and may benefit from treatment. Below, we highlight several ways to manage passive suicidal ideation.

1. Reflect on your feelings

Passive suicidal ideation is often a sign that someone is struggling to manage their mental health and well-being. If you’re experiencing intense feelings of hopelessness and despair or are unable to perform daily activities, take some time to understand the root of the problem. What might seem like a passing suicidal thought may actually indicate a deeper problem. Here are a few questions to ask yourself:

• Is there a particular event or circumstance that seems to trigger suicidal thoughts?
• Have I experienced any recent changes in my life? (e.g., changes in school, friendships, relationships, or living situations.)
• Have I noticed any changes in sleeping or eating habits? 
• Have I engaged in any risky behaviors that might lead to a suicidal thought?

And if you notice that a friend or loved one seems to be struggling with negative emotions, offer them an opportunity to share what’s on their mind. For example, try asking:

• How do you feel right now?
• I noticed that you’ve seemed a bit off lately. Is something bothering or upsetting you? 
• What can I do to help and support you?
• Is there anything that helps you feel better in the moments of distress?

2. Consider talk therapy

Another effective option for managing suicidal ideation is to work with a therapist, psychiatrist, or other mental health professional. According to Jensen, talk therapy offers people a safe space to breathe, gain perspective, and sort through challenging and confusing experiences. 

“Therapy can assist in the prevention of treating passive suicidal ideation by allowing a client to openly express thoughts and feelings in a safe and comfortable therapeutic environment,” explained Jensen. “This can allow a client to openly discuss the suicide risk, which can otherwise become ‘bottled-up’ emotions in individuals.“

Seeing a therapist for mental health treatment can also help people with chronic thoughts of suicide to build better coping skills to help them move towards a more balanced life.

3. Practice self-care

If you’re experiencing passive suicidal ideation, self-care may be an effective way to help you eliminate harmful thoughts and adopt a healthier perspective. Self-care offers countless benefits, such as reduced stress, better emotional health, and improved resilience. Here are a few ideas to get you started:

• Prioritize sleep, especially as a young person. According to the American Academy of Sleep Medicine, teenagers ages 13 to 18 should sleep eight to 10 hours per night. 
• Show yourself some kindness by creating honest, specific, and positive affirmations. For example, you might say, “There will be good and bad days, but every day is full of potential,” or “I am loveable, I am worthy, I am enough.”
• Make healthy food choices. Eating a balanced diet is shown to contribute to better moods, mental clarity, and overall energy levels.

4. Plan for emergencies

If you’re struggling with suicidal thoughts, know that help is always available. Having passive suicidal ideation may feel lonely or isolating, but there are suicide prevention organizations working specifically to support folks during their most challenging moments.

For emergency situations or additional support, consider contacting one of the following organizations.

• The Crisis Text Line (text HOME to 741741)
• The National Suicide Prevention Lifeline (988)
• The National Alliance on Mental Illness HelpLine (1-800-950-NAMI (6264))
• SAMHSA’s National Helpline (1-800-662-HELP (4357))

How Charlie Health can help with passive suicidal ideation

If you or a loved one are struggling with passive suicidal ideation, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for young people dealing with complex mental health conditions, including suicidal ideation. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing thoughts of suicide is possible. Fill out the form below or give us a call to start healing today.