Any and all thoughts of suicide must be taken seriously and treated with concern.
But there’s a difference between suicidal thoughts that are regular but fleeting, and those that are an urgent, emergency situation.
These two types of suicidal thoughts – also known as suicidal ideation – are known as passive suicidal ideation and active suicidal ideation.
Knowing the difference can help to inform how you respond to someone else’s experiences and offer support.
What is passive suicidal ideation?
This describes the state of having thoughts of suicide, but not having a plan or the immediate drive to carry it out.
Someone who is experiencing passive suicidal ideation might express the desire to not be alive or talk about not making it past a certain age.
Or they might keep these thoughts silent, having regular thoughts of suicide but not take the steps of making a plan.
‘People with passive suicidal ideation can often not get out of bed for days but pretend that everything is fine,’ says Dr Martina Paglia of The International Psychology Clinic. ‘Such people do not have an actual strategy to end their life, but they fantasise about dying in their sleep or being killed in an accident.’
It’s vital that passive suicidal ideation is not dismissed or taken less seriously because someone does not have an immediate plan. Regular thoughts of suicide are an issue regardless of whether attempts are made, and anyone struggling needs ongoing support.
It’s easy for passive suicidal ideation to turn into active suicidal ideation. If you or someone you know is struggling, get help as soon as possible, whether by talking to a GP or approaching a therapist directly.
What is active suicidal ideation?
‘Active suicide ideation is when someone is showing a clear intent to kill themselves and has formulated a plan of action,’ says Martina. ‘Passive suicidal ideation can turn into an active suicidal ideation.
‘In this case, people start to prepare for taking their lives by collecting lethal weapons, overstocking on medication or showing risky behaviour such as reckless driving.’
If someone is showing active suicidal ideation, it’s time to get emergency help. Call 999 or take the person to A&E, where there is mental health crisis care available 24/7.
Signs that someone may be suicidal:
- Feeling restless and agitated
- Feeling angry and aggressive
- Feeling tearful
- Being tired or lacking in energy
- Not wanting to talk to or be with people
- Not wanting to do things they usually enjoy
- Using alcohol or drugs to cope with feelings
- Finding it hard to cope with everyday things
- Not replying to messages or being distant
- Talking about feeling hopeless, helpless or worthless
- Talking about feeling trapped by life circumstances they can’t see a way out of, or feeling unable to escape their thoughts
- A change in routine, such as sleeping or eating more or less than normal
- Engaging in risk-taking behaviour, like gambling or violence
Certain triggering situations should be looked out for, too:
- loss, including loss of a friend or a family member through bereavement
- suicide or attempted suicide of family member, friend or public figure
relationship and family problems
- housing problems
- financial worries
- job-related stress
- college or study-related pressures
- bullying, abuse or neglect
- loneliness and isolation
- challenging current events
- painful and/or disabling physical illness
- heavy use of or dependency on alcohol or other drugs
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