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What is Passive Suicidal Ideation?

Dec 22, 2022

Suicide is among the top four causes of death in the American population under age 44. Of the nearly 46,000 suicides recorded in 2020, suicide was the:

  • the second leading cause of death for ages 10–14
  • the third leading cause of death for ages 15–24
  • the second leading cause of death for ages 25–34
  • the fourth leading cause of death for ages 35–44

Rates of suicide have steadily risen since 2000 — now almost double the rate of homicide and impacting men over 50% more than women.

For deliberate suicides, every individual likely began experiencing passive ideations of suicide that escalated in the absence of effective treatment. While a condition termed “passive” may seem less problematic than it might otherwise be, passive suicidal ideation is no small matter.

What is Passive Suicidal Ideation?

Passive suicidal ideation involves feelings and thoughts about wanting to die, though without actual planning. These thoughts and feelings are non-specific. Once they become specific, passive suicidal ideation gives way to active suicidal ideation. The primary dividing line between passive suicidal ideation vs. active ideation is whether the individual experiencing suicidal ideation has made plans or taken steps toward it.

Causes of Passive Suicidal Ideation

More than any other factor, chronic anxiety is associated with heightened suicidal thoughts. Suicidal ideation and behaviors then become more common. The severity of anxiety-driven suicidal ideation has been found to correlate most primarily with the following:

  • Depression
  • Mental health-related impairment
  • Social support

Given the breadth of interrelating factors, treatment options for passive suicidal ideation must be considered equally broadly. People who experience passive suicidal ideation should consult with a mental health professional about treatment options. 

Suicidal Ideation Symptoms

Symptoms of both passive and active suicidal ideation should never be overlooked or diminished. The symptoms of suicidal ideation are broad, reflecting the vast spectrum of people it affects. Consider the following only a partial list of the most common signs of passive suicidal ideation:

  • Risky behavior
  • Feeling hopeless or trapped
  • Heightened anxiety or agitation
  • Increased withdrawal and isolation
  • Uncontrollable drug or alcohol habits
  • Anhedonia (decreasing ability to feel pleasure)
  • Preoccupation with death or violence
  • Intolerable emotional pain, such as intense shame, guilt, or vengefulness

People who are living with passive suicidal ideation may need to find healthy coping skills and support for their mental health. People who struggle with major depression or other mental health conditions should seek professional support to manage their symptoms. 

Passive Suicidal Ideation vs. Active Suicidal Ideation

The symptoms of passive suicidal ideation vs. active ideation overlap much more than they differ. However, researchers have found one notable distinction. Self-hatred or disgust is reported by 60% of “active ideators” compared to 25% of “passive ideators.”

If any symptoms of suicidal ideation persist, they should be thoroughly investigated for the cause and meaning behind them. Care should be taken to act extraordinarily gentle and compassionate towards oneself. Multiple symptoms, in particular, are major signals to avoid or reduce things that consistently trigger suicidal thoughts.

Should You Seek Help if You Have Passive Suicidal Ideation?

It’s crucial to make significant changes to overcome passive suicidal ideation. Left unchecked, it may transform into active suicidal ideation. Even mild forms of these symptoms are likely a sign that a change is in order.

Many find reaching out for help can be a turning point to returning to their natural state of ease and well-being. Often, the most comprehensive help is only possible in a clinical setting. A psychiatric clinic’s specific services and specialties also largely impact treatment efficacy.

Common Obstacles to Treatment

Because one of the major factors of suicidal ideation is hopelessness, it can be hard to believe help is possible. Many who experience suicidal ideation become rightly skeptical about the mixed success rates of pharmacological therapies.

At the same time, how patients are informed about treatments can, astonishingly, impact the success of that treatment. This is at least true for drugs, which researchers refer to as the “nocebo effect.” It can be a vicious circle of worsening expectations and outcomes, but new treatment possibilities exist.

Breaking Through

It’s essential to educate oneself on the broadest range of treatment options available today for passive suicidal ideation. Now, there are more treatment methods than ever for suicidal ideation and its most commonly related conditions. This includes innovative non-invasive methods that patients are increasingly turning to.

How Are Suicidal Ideations Treated?

The SAMHSA’s treatment guide for suicidal ideation emphasizes that there is no “one-size-fits-all” approach to treatment. Besides drugs, they list the following treatments for suicidal ideation:

  • Dialectical Behavioral Therapy (DBT)
  • Integrated Cognitive Behavioral Therapy (I-CBT)
  • Attachment-Based Family Therapy (ABFT)
  • Multisystemic Therapy (MST)
  • Outreach and support groups

At the same time, they point out that non-specialized clinicians usually lack the skill set to treat suicidal ideation. This is especially true amongst those treating age groups most at risk of suicidal ideation. Lack of training in passive suicidal ideation is, unfortunately, a common issue.

Further, the SAMHSA advocates psychiatric medications almost first and foremost. They temper their medication recommendations by noting that antidepressants sometimes increase suicidal ideation and behaviors. The risk of suicide from psychiatric medications is also raised for those under 25.

It’s difficult to hear when assessing treatment options — although there are now other possibilities. Risk factors for suicidal ideation should be considered seriously before a suicide attempt is made. 

Alternative Treatment for Passive Suicidal Ideation

Transcranial Magnetic Stimulation (TMS) is a promising, physically non-invasive treatment option for suicidal ideation. It aims to strengthen and reset the “cortical control pathway” between the pre-frontal cortex (PFC) and the limbic system. This pathway allows for greater conscious governance of limbic system activity, where deep-seated emotions are highly active.

TMS has been studied as a treatment for suicidal ideation related to traumatic brain injury, anxiety, and depression. Research shows TMS can result in significant improvements and a reduction in suicidal ideation. These benefits allow patients to be free from the side effects of psychiatric medications and the limitations of standard treatment programs.

Passive Suicidal Ideation Treatment in San Diego

For any experiencing suicidal ideation or know someone who is, TMS may be the game-changing treatment option they’re looking for. Brain Therapy TMS strongly believes in the efficacy of TMS, which has been found to create actual structural changes in the brain. We’ve also experienced a 60–70% success rate of total remissions for suicidal ideation.If you’re interested, please schedule a consultation or contact us with any questions. We specialize in the Theta Burst Stimulation Express TMS machine and look forward to participating in your recovery.

Considering TMS Treatment? Schedule a Consultation!

Tired of the results you’re getting from your standard treatment? Transcranial Magnetic Stimulation may be able to increase your chances of long-term remission, reducing your symptoms and allowing you to live a more joyful life.




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