In the United States, 18% of people under the age of 18 have thought about suicide. While parents may be aware of the rising rates of teen suicide, many have not heard of passive suicidal ideation. Learn about the condition, how it differs from active suicidal ideation, and how it presents in teens.
What Is Passive Suicidal Ideation Compared to Active Suicidal Ideation and Intrusive Thoughts?
The key distinctions between these three types of thoughts are desire and intent toward dying.
Passive suicidal ideation is a desire to die without active planning or suicide attempts. Struggling teens may have thoughts about hopelessness or wish to die. They may express a desire to magically stop existing without specific thoughts on the realities or process of death.
- “I wish I was not here anymore.”
- “I don’t see the point in life.”
- “Things would be better if I could just disappear.”
Active suicidal ideation involves specific plans or intentions to end one’s life. Teens with active suicidal thoughts may think about when and how to end their life. They may research lethal means or obtain items to aid in suicide. They may plan pre-death rituals, like saying goodbye to loved ones. Passive suicidal thoughts can escalate into active suicidal thoughts if left untreated.
- “Everything would be better for my family if I were dead.”
- “I’ve made a plan for when I want to die.”
- “I’ve done research on the way I want to die.”
Intrusive thoughts are unwelcome involuntary thoughts, sometimes related to anxiety or obsessive thought patterns. Teens with intrusive thoughts about death or suicide typically do not want to engage in related behaviors.
Examples of intrusive thoughts include unwanted, disturbing images of death; someone might imagine themselves dying even though they do not want to.
Risk Factors for Passive Suicidal Ideation
Passive suicidal thoughts often stem from feelings of hopelessness, which can be particularly intense for teens who are still developing their sense of self and their social connections. Teens who are bullied, socially isolated, or feeling intense pressure at home or school are especially vulnerable.
The sense of being trapped can magnify these feelings. Because teens are still developing coping skills for stressors at this age, suicide may feel like the only available option to escape an overwhelming situation. Suicidal thoughts may also be influenced by:
- History of suicide or suicide-related thoughts and behaviors in the teen or their family
- Mental health disorders such as depression, substance use disorders, and psychosis
- Trauma or other triggering events, such as abuse or a significant loss
- Medical health such as chronic pain or increasing symptoms of an ongoing condition
- Substance use, particularly new or altered use
Substance use can mask and enhance suicidal feelings, so sudden changes in consumption can open teens up to increased or amplified feelings of distress. However, a reduction in substance use can still put them at risk if it is not accompanied by overall mental wellness and access to healthy coping techniques.
Teens are also at risk because they lack access to care and resources. Learn more about risk factors for teen suicide.
Warning Signs and Symptoms of Passive Suicidal Ideation
Recognizing warning signs of suicidal ideation can help parents support a teen and direct them to appropriate treatment. When suicidal, teens may express pervasive sadness, exhaustion, or apathy. They may express thoughts of low self-esteem or being a burden.
If they do not talk directly about their feelings, teens may engage in behaviors that indicate their emotional state. Behavioral warning signs include:
- Dramatic changes in sleep or appetite patterns
- Increased substance use or other risky behaviors
- Mood changes, such as unprompted irritability or anger
- Withdrawal from social activities or previously loved hobbies
- Giving away possessions, particularly well-loved ones
- Researching or consuming media about death and suicide
- Talking about death or suicide
If you see any of these warning signs in your teen, seek help. A suicidal ideation scale can help you or a clinician evaluate a teen’s suicidal thoughts to find appropriate intervention methods.
The Importance of Early Intervention and Safety Plans
Nearly all cases of active suicidal ideation or suicide attempts start with passive thoughts about dying. As distress and hopelessness intensify, passive thoughts may escalate in frequency and intensity, potentially evolving into active suicidal thoughts. Early intervention helps prevent feelings of hopelessness while strengthening protective factors against suicide and providing connectedness, support, and coping skills.
A safety plan is one common part of treatment for suicidal ideation. This tool guides a teen through moments of crisis, even in the early stages. It helps them understand their feelings and available support. Accessing information and resources in a crisis can be difficult, so having them pre-planned and recorded somewhere makes it easier for teens to remember the plan and take appropriate action.
A safety plan includes:
- Personal warning signs: Teens should identify feelings, behaviors, or thoughts that indicate a crisis. This helps them recognize when a crisis is imminent or occurring.
- Healthy coping strategies: These should involve things the teen can do even if they are alone. The teen should identify and problem-solve potential roadblocks to coping.
- Family or friends that can help: Teens should identify and prioritize social contacts they can reach out to for support. Some may be to distract from suicidal thoughts, while others may be outlets for talking through stress. As part of this step, teens should identify and problem-solve potential roadblocks to accessing support.
- Professional resources: A current clinical provider, if any, is typically at the top of this list. Local emergency rooms and crisis hotlines can also be professional resources. Teens should have names and numbers easily accessible.
- Safe environments: Teens should identify their plans for lethal means and how to limit their access to those items. As part of this step, teens should plan how to remove themselves from an unsafe environment during a crisis.
While a parent or clinical professional often aids in making these plans, a teen should write them down in their own words. Writing the plan helps them process their feelings and ensures it truly resonates with their needs. The safety plan is designed to be used during crises until the teen alleviates distress.
Therapy, medication, and residential treatment programs are other intervention strategies used for teens experiencing suicidal ideation and, if necessary, co-occuring substance use.
Suicidal Ideation Treatment Options at Muir Wood
If you notice signs of passive or active suicidal ideation in your teen, seek professional help immediately. Your intervention and support is a key lifeline for a struggling teen.
Muir Wood works with teens who are experiencing passive suicidal ideation. Our approach combines talk therapy, substance use treatment, and family support along with psychiatric assessments to identify any underlying diagnoses. Call us at 866-705-0828 or begin by filling out an assessment form. You can also call, text, or chat with the National Suicide Lifeline by dialing 988.