Passive Suicidal Ideation

Trigger Warning: The Article is based on Suicidal Ideation and can be discomforting for sensitive readers

There are several issues that need attention but are left unspoken about due to the stigma attached to it. The sensitive topic of suicidal ideation is one of them. Suicidal thoughts can haunt anyone regardless of age, gender or background, and their existence indicates a deep inner turmoil that demands understanding, compassion and help.

Suicidal ideation, commonly known as suicidal thoughts, are thoughts, feelings or plans of ending one’s own life. According to Harmer et al., (2024), “Suicidal ideations (SI), often called suicidal thoughts or ideas, is a broad term used to describe a range of contemplations, wishes, and preoccupations with death and suicide.” It is an important concern, widely prevalent across the globe. As per a report by WHO in August 2023, more than 700000 people succumb to suicide each year, and several attempts remain undisclosed. A prior suicide effort is the strongest risk factor, making it the fourth leading cause of death among 15 to 29-year-olds.

Active vs Passive

While discussing suicidal ideation, it is essential to differentiate between its active and passive forms. Active suicidal ideation denotes the experience of current, explicit and specific thoughts about one’s death. It is a deliberate intention to engage in self-harm behaviours for death to follow as a consequence. On the other hand, passive suicidal ideation manifests itself as a more subtle, yet equally distressing, presence of thoughts about one’s death without specific plans or explicit intentions to act upon them immediately.

According to Clinical Psychologist Shourya Gupta, “In Active Suicidal ideation, the person has a motivation to end their life with a clear intent and planning. So, it would sound like “I wish to kill myself by …… (the actual method of dying, i.e., overdosing or jumping in front of a metro)”. And Passive Suicidal Ideation is when a person has a motivation to end their life but do not have a clear plan or intent yet, so it would sound like “I wish something happens that ends my life or I wish I get into a situation that ends my life, i.e., an accident”.

Passive suicidal ideation 

Preliminary findings suggest that passive suicidal ideation is a significant aspect to consider in evaluating the risk of suicide (Baca-Garcia et al., 2011). It can be understood as feeling that life is not worth living or that the person would be better off dead (Raue, Meyers, Rowe, Heo, & Bruce, 2007; Schulberg et al., 2005). According to Baca-Garcia et al., (2011), one-third of those who had attempted suicide in the past reported passive suicidal thoughts but no active ideas or plan. 

Signs of Passive Suicidal Ideation

Understanding the signs and symptoms of suicidal ideation can help in early detection and possible intervention. Here are some signs that can indicate if and when a person is contemplating suicide–

• Withdrawal and isolation: People who are having passive suicidal thoughts may distance themselves from friends and family and withdraw from social gatherings.
• Self-Criticism: Extreme negative self-talk and overt self-criticism is very common at such times. They may express feelings of worthlessness and unnecessary guilt. 
• Changes in Behaviour: Considerable changes in sleep patterns, appetite and a loss of interest in activities they once enjoyed may also be observed.
• Expressing Despair: They may express feelings of hopelessness, of being a “burden” to others or even express a desire for everything to end.
• Sudden Calmness: They might display a sudden sense of calm after exhibiting emotional upheaval which may be an indication of deciding to stop struggling with life. 
• Giving Away Possessions: This often goes unnoticed but it is one of the most common signs of experiencing distressing thoughts. Such behaviour can signal the desire to leave behind something for their loved ones to look back upon. This can also be their way of seeking closure or expressing farewell.

It is important to understand that such signs may differ from person to person, and having one or more of them does not necessarily imply suicidal intentions. However, if someone is displaying these signs, it is crucial to first, acknowledge their behaviour and offer them genuine assistance. 

Supporting someone with passive ideation

It takes empathy, patience, and active listening to support someone who is contemplating suicide passively. Offering a compassionate ear for them to share their feelings of helplessness, anger and loneliness can help. Encouraging them to talk will allow them to unload their emotional burden providing a sense of little relief. One should avoid trying to solve their problems quickly or dismiss their feelings, instead, offering empathy and understanding.

Regularly checking in with them can convey your support and reassure them that they are loved and important. It’s okay to ask about suicide and show you care—it won’t make things worse. Other than this, it is important to take care of yourself too, as supporting someone in distress can be difficult. If a situation appears beyond control, consider encouraging professional help. This may include reaching out to helplines, arranging a therapy session and involving their parents or guardians. 

According to Clinical Psychologist Anushka Negi, “A thorough evaluation should be done to identify signs and symptoms associated with any psychiatric diagnosis (as suicidal ideations are more common with the diagnosis of depression: hopelessness, worthlessness, helplessness). Risk assessment should be done, before assessing any suicidal plans or Behavior a clinician must acknowledge the patient’s current feelings about living.”

Related: Suicide Awareness: Unveiling the Truth

Conclusion

Passive thoughts about suicide are nonetheless severe and should be treated seriously, even if they don’t have the same urgency as active ideation. They indicate serious mental suffering and a need for intervention and support. Addressing passive suicidal ideation requires providing a safe and non-judgmental space where individuals can express themselves freely and access mental health resources and get interventions tailored to their needs. This emphasizes the need to be observant and empathetic with those around us, as everyone has their silent battles going on which they don’t talk about, and their suffering often goes unnoticed. But together, we can create a supportive community where individuals feel assured that they are not alone in their struggles and that seeking help is quite courageous.