Writing about passive suicidal ideation, I believe, is a vital task. It’s a nuanced topic that often goes unaddressed because it doesn’t always present as an “emergency” in the traditional sense. Yet, it carries immense weight for those experiencing it. And the longer we live with it, the less we might see it as a concern, which can be good-ish and a problem.
What is Passive Suicidal Ideation?
Suicide attempts very rarely happen in a vacuum. Instead, they’re the culmination of suicidal thoughts, also known as suicidal ideation (Ridgeview Behavioral Hospital, 2025). Those ideations also aren’t as clear-cut as we might think.
The most common form is active suicidal ideation, which traditionally was where someone has a specific plan or some form of intent to cause harm to themselves. Many medical professionals focused heavily on this version of suicide ideation (Baca-Garcia et al., 2011).
Unlike active ideation, where an individual has a specific plan or intent to end their life, passive ideation is the desire to no longer exist without a concrete plan to take action or a desire to make it happen. Instead, a person is likely to only harbour a wish to die, or rather wish that they never existed in the first place (Barnes, 2022).
Interestingly, most people who think about suicide don’t engage in suicidal behaviour (Wastler et al., 2023). However, researchers like Baca-Garcia et al., (2011) argue that passive suicidal ideation is a red flag that something is wrong. It’s hard to argue that it’s not. Once maybe a random intrusive thought, but more than that clearly means something is going on, or rather, going wrong.
Furthermore, passive suicidal ideation can also lead to people engaging in more reckless behaviours than they otherwise would be, leading to an increased disregard for their health and safety (Ridgeview Behavioral Hospital, 2025). I think I may fall into that camp. My reckless behaviurs coincide with my passive suicidal ideation, and disappeared when my desire to die went.
It also doesn’t surprise me that passive suicidal ideation is highly prevalent in those with mental health conditions, with about a third of such people experiencing current passive suicidal ideation, and about 50% having a lifetime history of it (Liu, Bettis, and Burke, 2020).
Understanding The Passive Suicidal Ideation Experience
Passive suicidal ideation often acts as a “pressure valve” when life feels overwhelming. It often stems from emotional exhaustion, where we might feel like we’ve run out of ways to cope with stress or grief. It can also come from depression or anxiety (Liu, Bettis, and Burke, 2020; and Ridgeview Behavioral Hospital, 2025), as these conditions can cloud our perspective, making things feel more permanent than they are.
Chronic stress and burnout can make it feel like escape if the only answer, which can lead to substance abuse, but also suicidal ideation. Another one to consider is the role loneliness plays in it, as a lack of meaningful connection can lead to us feeling like we don’t belong. Equally, a lack of purpose and meaning can also leave a void inside.
These are examples of the kinds of thoughts someone with passive suicidal ideation might have:
- I wish I could disappear (Wastler et al., 2023).
- I wish I didn’t exist (Wastler et al., 2023).
- I wish I had never been born (Barnes, 2022; and Wastler et al., 2023).
- My life is not worth living (Wastler et al., 2023).
- They’d all be better off without me (Barnes, 2022).
For me, I never wanted to lose my fear of needles, even though I wrote an article about how to overcome it. But it happened naturally because of the sheer number of times I’ve had needles stuck into me because of my health. I didn’t want to lose my needle phobia because, for the longest time, it was the only thing keeping me alive.
I used to, and still kinda do, want to die high as a kite on drugs. In my darker years, I used to take extreme amounts of drugs and cocktail them to see what would happen, as I didn’t care if I lived or died. There were times I was on seven different substances at the same time, which basically explains why I developed drug-induced psychosis.
I wasn’t actively seeking death, but I wasn’t exactly avoiding the chance that it would happen either through my actions. I kept pushing way past my limits, hoping that I might die, and this worked at stopping me actively trying. A Russian roulette approach, I guess you could say.
Being afraid of needles stopped me from injecting drug cocktails that likely would have killed me. Hence not wanting to loose my needle phobia. It was my safety net. For the longest time, I never saw myself living past the age of 28, and I just readjusted that age as I aged past it. This is also a passive suicidal ideation.
A study by Wastler et al. (2023) showed that active and passive ideation are two very different constructs, but ones that can co-occur. They believe that at a minimum, both passive and active ideation should be included in risk assessments and screenings. This was based on their study using two sample sizes of 6,200 and 10,635 US adults.
This is important because of how passive suicidal ideation can often not be taken seriously (Ridgeview Behavioral Hospital, 2025). I had passive suicidal ideation for so long after they started at such a young age (primary school) that they just became a part of who I was. They were just thoughts I’d always have, like background noise. But then I had a breakdown during a perfect storm of things going wrong while doing my post-graduate degree, and I became obsessed with one specific way to kill myself.
Unchecked passive suicidal ideation still puts us at risk of suicidal behaviours and transitioning to active ideation (Barnes, 2022). In fact, there’s a strong association between this and suicide attempts (Liu, Bettis, and Burke, 2020). If you remember nothing else from today’s article, remember this.
A study by Baca-Garcia et al. (2011) supports this. They found that those experiencing passive suicidal ideation were just as likely to have attempted suicide as those who had active suicidal thoughts. Their study had 85,000 participants.
Liu, Bettis, and Burke (2020) systematic review and meta-analysis of the prevalence of passive suicidal ideation, where they reviewed 86 studies, found that one in 20 of the general population can experience it in a given year. This increases to one in 10 over the course of a lifetime.
Most interestingly for me, who never planned any of my attempts to end my life, Baca-Garcia et al. (2011) argued that these impulsive attempts may be the result of living with a passive suicidal ideation for a long time. It had never occurred to me that this desire may have been a factor, as the attempts always came out of the blue when it felt like my despair switch had been flipped on.
What To Do If You Or Someone You Know Is Struggling With Passive Suicidal Ideation
Don’t dismiss the “wish”
I grew to dismiss my desire to die as just being another intrusive thought, just one that never really went away. But we, doctors, and our loved ones shouldn’t ignore it when someone says they “wish they weren’t here”, or if we think that ourselves. It is a clinical marker for risk, not just a passing mood (Baca-Garcia et al., 2011).
Structure
Adding structure and routine can help us to manage our passive suicidal ideation (Ridgeview Behavioral Hospital, 2025).
Variety
Adding variety can also help keep things interesting in our lives; that’s why it’s the spice of life. This will help us avoid feeling stuck.
Hobbies
Making time for our hobbies or reconnecting to old hobbies and interests is great for our wellbeing. It can also help give us a sense of meaning and purpose, which we might not get from work.
Eating better
It’s easy to fall into depression eating, and not looking after ourselves when we’re experiencing passive suicidal ideation. Don’t let that happen, as that will only erode our wellbeing.
Medication
Starting on an antidepressant can be an effective method to help with the underlying cause of our passive suicidal ideation. Although this might not work for everyone.
It should also be noted that antidepressants can also come with one big downside. Antidepressants can cause a boost in energy levels, which in rare cases has given people the energy to switch to active suicidal ideation and attempt to take their lives (Barnes, 2022). Thus, we should be cautious when starting such medication by bearing this in mind.
Goals
Creating goals for ourselves (Ridgeview Behavioral Hospital, 2025) can also be a great way to feel like we’re doing something and tap into the meaning and purpose that can help make life worth living.
Reconnecting
Loneliness is one of our biggest killers. So reconnect with old friends and family, or make new friends using friendship apps or hobby and interest apps like Meetup.com.
Talking
Breaking the silence and sharing our thoughts with a trusted friend, family, or someone else we trust can help reduce the power of our ideation. Once the thoughts are externalised, they become a problem to be solved rather than a secret to be kept.
Therapy
Whether active or passive ideation, therapy is the best option for coping with and managing our suicidal ideation (Barnes, 2022). I strongly recommend this option.
Summary
Passive suicidal ideation shouldn’t be ignored. Although active suicidal ideation is an emergey that likely needs support right away, passive suicidal ideation is still a red flag that we’re not doing well. Whatever form of ideation we or others might be experiencing, it’s important not to ignore them and taken action. Therapy is the best option, but there are other options that can be tried if therapy isn’t an option, or to do alongside therapy.
As always, leave your feedback in the comments section below. Also, please share your experiences with passive suicidal ideation in the comments section below as well. Don’t forget, if you want to stay up-to-date with my blog, you can sign up for my newsletter below. Alternatively, click the red bell icon in the bottom right corner to get push notifications for new articles.
Lastly, if you’d like to support my blog, please find the PayPal and Ko-fi donation payment options below. Until next time, Unwanted Life readers.
References
Baca-Garcia, E., Perez-Rodriguez, M. M., Oquendo, M. A., Keyes, K. M., Hasin, D. S., Grant, B. F., & Blanco, C. (2011). Estimating risk for suicide attempt: Are we asking the right questions?: Passive suicidal ideation as a marker for suicidal behavior. Journal of Affective Disorders, 134(1-3), 327-332. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3172880/pdf/nihms315322.pdf.
Barnes, M. (2022, September 30). Passive Suicidal Ideation: What It Is and What You Can Do. HealthCentral. Retrieved from https://www.healthcentral.com/condition/depression/passive-suicidal-ideation.
Liu, R. T., Bettis, A. H., & Burke, T. A. (2020). Characterizing the phenomenology of passive suicidal ideation: a systematic review and meta-analysis of its prevalence, psychiatric comorbidity, correlates, and comparisons with active suicidal ideation. Psychological medicine, 50(3), 367-383. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7024002/pdf/nihms-1067912.pdf.
Ridgeview Behavioral Hospital. (2025, January 8). Passively Suicidal: A warning sign you should never ignore. Ridgeview Behavioral Hospital. Retrieved from https://ridgeviewhospital.net/passively-suicidal-a-warning-sign-you-should-never-ignore.
Wastler, H. M., Khazem, L. R., Ammendola, E., Baker, J. C., Bauder, C. R., Tabares, J., Bryan, A. O., Szeto, E., & Bryan, C. J. (2023). An empirical investigation of the distinction between passive and active ideation: Understanding the latent structure of suicidal thought content. Suicide and Life‐Threatening Behavior, 53(2), 219-226. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/sltb.12935.