Passive Suicidal Ideation: Why It Should Be Taken Seriously

Medically reviewed by: Shane Trujillo, EdM
Tuesday, May 16 2023

If you’re experiencing passive suicidal ideation — the act of thinking about suicide —you may feel afraid, alarmed, and ashamed. Opening up about having suicidal thoughts isn’t easy, and you may not know who to turn to or how to get support. Rest assured, you’re not alone. Help is available. Getting the right care for suicidal ideation — whether it’s for yourself or to help a loved one — can save a life. 

Read on to learn more about passive suicidal ideation, how it differs from active suicidal ideation, and how to get help. 

What is suicidal ideation?

To best understand passive suicidal ideation, it’s important to first know what suicidal ideation is. Suicidal ideation is often defined as suicidal thoughts or ideas and is a broad term used to describe a range of preoccupations with death and suicide. There are two common forms of suicidal ideation — passive and active. In the U.S., nearly 5% of adults have experienced suicidal ideation.

Active vs. passive suicidal ideation: what's the difference?

Passive suicidal ideation is when someone wishes they were dead or has thoughts about killing themselves but doesn’t make a direct plan to act on those thoughts. Passive suicidal ideation is experienced differently from person to person, and it’s common for suicidal thoughts and wishes to vary in intensity and frequency. They may happen many times a day, or only every once in a while.  Passive suicidal thoughts may sound like “I just wish I could go to sleep and not wake up,” or “I wish I could just disappear.” 

It’s important to note that someone experiencing passive suicidal ideation may still act in dangerous ways that are motivated by not caring if they live or die. One study found that the sole presence of passive suicidal ideation was associated with increased rates of suicide attempts. This is why it’s so important to take any form of suicidal ideation seriously and to get help if you or a loved one is thinking about suicide. 

Active suicidal ideation is when someone has thoughts of suicide or harming themselves and has developed a plan to carry it out. Active suicidal thoughts are current and specific, and may sound like “I should kill myself,” or “I am going to kill myself.” They may also involve thinking about the specific method one would use to kill themselves, and a specific time and place in which they would do it. 

Experiencing active suicidal ideations increases one’s risk of attempting suicide. If you or someone you love is experiencing active suicidal ideation, get help right away. Call 988 for the Suicide and Crisis Lifeline or find other suicide prevention resources here

What to do when you have passive suicidal thoughts

Passive suicidal ideation is a serious mental health concern. While most people who think about suicide don’t engage in suicidal behavior, suicidal ideation — both passive and active — is one of the strongest predictors of suicide attempts.  

If you feel you’re in danger and need help right away, call 988. If you’re not in crisis but want to seek help for passive suicidal ideation, contact your primary care physician (PCP) or a mental health professional for evaluation. If you first see your PCP, they’ll refer you to a mental health professional such as a licensed therapist after your visit for further evaluation and more specialized support. 

Therapy for passive suicidal ideation: what to expect 

You may feel wary about opening up to a therapist about having suicidal thoughts. This is understandable, but remember that therapists who specialize in supporting those with suicidal thoughts are specially trained in the matter and won’t judge you. Their first priority is to keep you safe and help you get better. Here’s what you can expect from psychotherapy (also known as “talk therapy”). 

When you first connect with a licensed therapist — whether it’s through your doctor or on your own — they’ll ask you questions and have you take a questionnaire to determine the severity of your symptoms. They’ll then work with you to develop a treatment plan that fits your needs based on this information. They’ll also help you develop a safety plan so you know the resources and support you can turn to when you’re in crisis, and help you develop coping tools you can turn to in the future.

Sometimes, treatment may involve working with a psychiatrist if you and your therapist agree that medication could be a helpful addition to your care plan. If your risk of suicide is high, you may be referred to an inpatient treatment center as part of your care plan to keep you safe until your symptoms improve. 

Seeking help is a brave first step you deserve to take 

Seeking help for passive suicidal ideation isn’t easy, and it takes a lot of courage. Know that you deserve to get the support you need to feel better, and that therapy has been proven to work. According to the American Psychological Association, 75% of people who enter psychotherapy show improvement. SonderMind can help connect you with a licensed therapist who specializes in supporting those experiencing suicidal ideations so you can get the care you need to feel better. 


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