What Is Passive Suicidal Ideation? Risk Factors And Mental Health Support Options
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-HELP (4357)
Suicidal thoughts occur in many forms, and not all of them involve making a plan or taking steps to end one’s own life. For many people experiencing suicidal ideation, these thoughts may be quieter and less direct, such as wishing they could disappear or feeling indifferent about living. These thoughts can be referred to as passive suicidal ideation, which can be a significant sign of emotional distress.
Passive suicidal ideation can be challenging to identify and may go unrecognized by the person experiencing it and those around them. Unlike active suicidal ideation, in which a person is actively planning or thinking about suicide or self-harm, those experiencing passive suicidal ideation may not be thinking about suicide attempts at all. Nevertheless, this symptom can cause significant distress. Here, we will examine the signs and underlying causes of passive suicidal ideation and explore mental health support options.
What is passive suicidal ideation?
A person living with passive suicidal thoughts is often feeling a deep sense of pain and hopelessness. It can be important to treat suicidal ideation seriously, even if the thoughts are passive, as they may progress towards active thoughts or behaviors if left unaddressed.
Passive suicidal ideation is thought to be relatively common, with over 10% of individuals reporting experiencing passive suicidal thoughts at some point in their lives. By understanding what to look for, individuals experiencing passive suicidal ideation may be able to reach out for support to address underlying causes and symptoms earlier, which may reduce distress, reduce suicide risk, and improve well-being.
Risk factors and causes of suicidal thoughts
The underlying causes of suicidal thoughts can be complex and tend to vary from person to person. That said, understanding common risk factors may aid in the early identification of suicidal ideation, which may improve suicide prevention efforts. Some common causes and risk factors of passive suicidal ideation are listed below.
Mental health conditions often associated with risk of passive suicidal ideation
Certain mental health conditions may be linked to an increased risk of suicidal ideation. These mental health challenges and disorders include but are not limited to:
- Depressive disorders. Conditions like major depressive disorder and persistent depressive disorder can cause feelings of sadness and hopelessness, which may lead to suicidal ideation.
- Anxiety disorders. Severe anxiety can cause a person to feel hopeless and unable to cope with challenges. These feelings may sometimes correlate with an increase in suicidal ideation.
- Post-traumatic stress disorder (PTSD). Individuals with PTSD may experience intrusive memories, hypervigilance, and emotional numbness, which can create a sense of disconnection from life and increase feelings of hopelessness.
- Bipolar disorder. During depressive episodes, people living with bipolar disorder may experience intense hopelessness and feelings of despair.
- Schizophrenia. Schizophrenia may involve hallucinations, delusions, and a disconnection from reality. Distress from these symptoms can increase the risk of passive suicidal ideation.
Trauma and loss
Experiences such as abuse, neglect, or the loss of a loved one can sometimes make life feel empty or overwhelming, and it can be hard to see a way forward. Untreated trauma can cause a person to feel disconnected from life, and it can seem like healing is not possible. Passive suicidal ideation in this context may not be about actively wanting to end one’s life, but rather a desire to experience relief from the feelings and emotions connected with trauma.
Life circumstances
Challenging life circumstances may sometimes be linked to passive suicidal ideation—especially when other factors, such as a co-occurring mental health condition, are present. Examples of such circumstances include:
- Financial challenges
- Major life transitions
- Ending a relationship
- Losing a job
- Academic pressures
Signs of passive suicidal ideation
Understanding the signs of passive suicidal ideation may help people receive support in order to prevent passive thoughts from progressing to active plans. The signs may vary from person to person depending on their unique life circumstances and personality. That said, some symptoms that often accompany signs of passive suicidal ideation include:
- Verbal expressions of hopelessness
- Feeling detached from life
- Experiencing emotional numbness
- Feeling hopeless or sad
- Depression
- Withdrawal and isolation
- Loss of motivation or energy
- Expressions of worthlessness
- Feeling like a burden
- Significant changes in sleep or appetite
- Risky or neglectful behavior
The presence of these signs alone may not indicate passive suicidal ideation; however, when paired with major life events, trauma, or other challenges, they may be signs of emotional distress and an indicator that professional support may be needed.
Coping strategies and self-help
It may be important to note that for individuals experiencing passive suicidal ideation, there are coping strategies and self-help techniques that may improve mental health. Examples include mindfulness strategies, establishing daily routines, and fostering social connections.
Engaging in mindfulness strategies
Mindfulness strategies are techniques that help a person experience their emotions and circumstances in the present moment without judgment. Particularly when practiced often, these strategies may help a person regain control over their thoughts and calm the mind and body during stressful times. Common mindfulness practices may include deep breathing techniques, mindfulness meditation, and journaling.
Building daily structure
A person’s daily structure can help reduce anxiety and stress—both of which are often associated with passive suicidal thoughts. Creating a routine that supports positive mental health can be helpful, such as eating a balanced breakfast, going for a walk, and scheduling time for rest and relaxation. Routines can help a person build a sense of stability and control, which may reduce suicidal thoughts.
Setting small, achievable goals
Breaking large, overwhelming tasks or goals into small steps can often make life feel more manageable. Completing even minor goals, like doing the dishes or taking a short walk, can help build momentum and confidence. It may be helpful to engage in reflective practices, like journaling, to identify large goals and break them down.
Increasing social connectedness
Social isolation can deepen feelings of hopelessness and detachment from the world. Reaching out to a friend, family member, or support group may help reduce loneliness. Close loved ones and trusted friends can also notice subtle changes in mood or behavior more quickly, which can help with early detection.
Support options for suicide prevention
Even if passive suicidal ideation does not evolve to immediate intent or plans, it is still a serious signal that support may be needed. Seeking help early may help reduce the risk of these thoughts becoming more severe and may also reduce the risk of suicide later on. For individuals who experience passive suicidal thoughts, there are several options available for support.
Therapy options for suicidal thoughts
Therapy with a licensed mental health professional has the potential to reduce suicidal ideation and improve overall mental health. Some common forms of therapy that may be used to reduce suicidal thoughts include:
- Cognitive behavioral therapy (CBT). CBT is a form of therapy that centers on learning how to identify and challenge negative thought patterns that may cause hopelessness. Research suggests that it can often be a highly effective treatment option for reducing suicidal thoughts.
- Dialectical behavioral therapy (DBT). DBT is a type of CBT that focuses on developing emotional regulation skills and increasing distress tolerance abilities to cope with challenging situations more effectively.
- Trauma-informed therapy. For individuals who have experienced trauma, a trauma-informed therapy approach can help them process painful experiences that may be driving or contributing to suicidal thoughts.
Crisis intervention and suicide prevention resources
Reaching out to crisis intervention or suicide prevention services can provide free support to address urgent needs. These services can connect individuals to mental health resources that are often available at any time of day. It may be important to note that emergency intervention resources may not be a substitute for long-term care, but they can often help with immediate stabilization and connection to longer-term resources.
Some crisis support resources include:
- 988 Lifeline
- Veterans Crisis Line
- Trevor Project Lifeline for LGBTQ+ youth
- AARP Friendly Voice for older adults
How can loved ones offer support
When someone is experiencing passive suicidal ideation, the support of friends and family can make a difference. Loved ones can help by listening without judgment and taking signs seriously. This can mean avoiding minimizing the person’s feelings and treating them with care and compassion.
That said, loved ones may not be able to reduce a person’s suicidal thoughts on their own, and it may be helpful to encourage the individual to seek professional help. It could be beneficial to help research providers or drive them to their first appointment. Consistent check-ins throughout the healing process can also provide comfort and show that you care.
Connecting with a mental health professional
For individuals experiencing suicidal thoughts or ideation, connecting with a mental health professional can be a good first step. A licensed therapist will typically have the tools and training required to address these thoughts and help improve a person’s mental health.
If in-person therapy is not available or not convenient, online therapy can also be an effective way to reduce suicidal ideation. In a virtual environment, a therapist can implement techniques, such as CBT or DBT, to get to the root of negative thought patterns. Many people find online care to be more comfortable than commuting to a therapist’s office and speaking with a provider face to face. Plus, online therapy tends to be more affordable than in-person therapy without insurance in many cases. Please note that BetterHelp is not right for you if you are in an urgent crisis or emergency situation.
Takeaway
What are five signs that a person may be depressed and suicidal?
Five of many possible signs that a person could be experiencing signs of depression and/or suicidal thoughts include:
- Verbal expressions of hopelessness
- Feeling detached from life
- Experiencing emotional numbness
- Feeling hopeless or sad
- Withdrawal and isolation
How to not let suicidal thoughts get to you?
If you're having suicidal thoughts of death and dying, seeking professional support can be an important step—that is, a crucial step for promoting safety and well-being. A mental health professional can help you develop coping skills that empower you to address concerning thoughts, receive treatment for any underlying conditions (such as depression) that may be potentially leading to these thoughts, and cultivate improved well-being.
What are three evidence based treatments that directly target suicidal thoughts and behaviors?
There are multiple evidence-based treatments that may help a mental health professional target suicidal thoughts and behaviors, such as actively making a plan for taking one's life, in a patient. Three examples include:
- Cognitive behavioral therapy (CBT)
- Cognitive behavioral therapy for suicide prevention (CBTSP)
- Dialectical behavior therapy (DBT)
What should you do if you discover a participant has suicidal ideation?
Suicidal ideation should always be taken seriously. An individual who is experiencing such thoughts is encouraged to meet with a mental professional as soon as possible to create a safety plan and receive compassionate treatment. For someone who is experiencing an urgent mental health emergency, contacting a crisis line can be crucial.
What are four warning signs of depression?
There are many different potential warning signs of depression, since it can manifest differently depending on the person. Some common symptoms include persistent feelings of sadness and hopelessness, substance use or misuse in an attempt to cope with such feelings, significant changes in eating or sleeping patterns, and a lack of interest in activities once enjoyed. There is often a strong correlation between biological factors, genetics and family history, and past trauma like emotional abuse, physical abuse, or sexual abuse and the development of depression, so people with risk factors may benefit from regular depression screenings.
How to get out of a depressive episode?
According to the Centers for Disease Control and Prevention (CDC), speaking with a qualified mental health professional as soon as possible can be crucial if you're experiencing signs of depression. Symptoms of a depressive episode will typically not resolve without professional treatment. You deserve to feel supported, and help is available.
Which therapy is often effective in reducing suicidal thoughts?
Dialectical behavior therapy can be effective for addressing suicidal thoughts because it aims to help a client build distress tolerance skills. Cognitive behavioral therapy—particularly cognitive behavioral therapy for suicide prevention (CBTSP) and other forms specifically for this purpose—can also be effective. The core of CBT is about helping clients learn to recognize and then challenge distorted thoughts that may be causing distressing symptoms.
What are DBT skills to reduce suicidal ideation?
When you talk with a therapist to receive dialectical behavior therapy (DBT), they will typically focus on helping you learn four key skills. These are: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. After CBTSP, DBT is often viewed as the second-leading cause of healing from suicidal thoughts.
Which strategy can a person use to cope with suicidal thought on his or her own?
Cognitive behavioral therapy and dialectical behavioral therapy principles are often used for addressing suicidal thoughts. While workbooks or other educational materials may be found for both of these modalities online, seeking professional support for suicidal thoughts immediately is recommended. This symptom is unlikely to resolve without care from a school psychologist, a therapist, or another qualified mental health professional.
Is CBT good for suicidal ideation?
Cognitive behavioral therapy (CBT) is a form of talk therapy that may be used to treat suicidal ideation, since it's all about helping a client learn to recognize and shift distorted thoughts in their brain and cultivate hope. Cognitive behavioral therapy for suicide prevention (CBTSP) is a subtype of CBT that may be particularly helpful.
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