TRIGGER WARNING: This post discusses suicide. Please keep this in mind when choosing to read.
“Passive suicidal ideation” is therapy speak for suicidal thoughts that have no intention or plans behind them. I’ve been living with this for close to two decades and my last psychiatrist felt the need to correct me when I said I had been having more suicidal thoughts with, “Well, suicidal ideation, not suicidal thoughts.” Paired with a patronizing smile, of course.
I’ll never understand why mental health professionals feel the need to use clinical language with patients or “correct” them as if they are the expert on what you are experiencing, but that’s a whole other conversation.
The thing about passive suicidal ideation is that you don’t have to be feeling super depressed (as in your depression is there as usual but not acting up) to experience them.
You could be having a calm or happy conversation with someone and then an image of you throwing yourself off the balcony will flash before your mind, and then it’ll go as quickly as it came. There was no clear trigger (as in how the person was making you feel, the topic of conversation, the day of the year, etc.), it just came and went.
You could be at the grocery store at the end of the day, tired but otherwise okay (considering you’re living with depression), and then you’ll get the thought, “kill me” quickly followed by “no, don’t!” just in case you can ward off any evil that might have been listening in.
Other visions can include you repeatedly stabbing yourself in the chest, hanging, shooting, cutting, drowning, or otherwise hurting yourself. These can come and go when you’re laughing, reading, swimming or sitting on the toilet – intrusive thoughts come at their own will.
They often come when we’re feeling not good enough, or unworthy, which is especially true for those of us living with good girl syndrome (and honestly, which of us doesn’t?).
I want to be careful with terminology here. Actively spending time on passive suicidal ideation is not the same as active suicidal ideation. Active suicidal ideation comes down to risk and intent wherein someone either has a plan or is working on a plan to kill themselves and intends to carry it out. They are classified as higher risk than those without a plan or intent.
Actively spending time on passive suicidal ideation, on the other hand, is like intentionally ruminating about one’s own death kind of like you might ruminate about past pain or transgressions or that stupid thing you said or did in 10th grade. It’s by no means less serious, as it feels almost good to inflict more pain on ourselves.
It happens when we’re in the depths of despair, when frustration snowballs into anger, then grief, then despair or hopelessness, or just when we’re in the office having a sh*t day.
The passive often leads to the active [form of passive suicidal ideation] and the passive can often show up once we’ve dragged ourselves from the pit of despair that is the active form.
Does it matter or am I spending way too much time on semantics?
Well, that one’s up to you. Personally, differentiation between the two helps me get a sense of “am I suffering right now or is Trauma Brain being invasive again?” If I’m suffering, I remind myself to be kind to myself and do some of the things I know can help get me out of my own head (and pain). I’ll be posting about those strategies in a future post.
If you are actively engaging in suicidal ideation, you might daydream like this:
You walk outside to find yourself in a situation where a guy pulls a gun on a kid and you go into savior mode and step between them, trying to talk the man down, but he’s set on doing damage. So you talk him down enough where the kid runs away and you stay put (or the kid runs while you distract the guy). Then he shoots you and all you can think is “Finally, it’s over.”
In other words, two birds, one stone: you protect a child (saving a life) and end your suffering once and for all. A win-win.
That is the active form of passive suicidal ideation.
You know how people say that those who suffer the most are the kindest to others or the brightest stars? Take Avicii, Anthony Bourdain, Alexander McQueen, Kate Spade, and Robin Williams who were all bright stars that struggled and eventually committed suicide.
Our kindness and brightness are enhanced by what we live with every day. We not only have our trauma, memories, depression, anxiety, PTSD, insomnia, headaches, etc. to deal with on top of regular life responsibilities, but we’ve also likely internalized what our bullies and abusers said or did to us.
We know what it’s like to live in constant pain and exhaustion. Why would we want anyone else to feel like that?
We know how a kind word can brighten someone’s day. We know that coming to another person with a “solution” to their “problem” isn’t the answer unless requested – actively listening is. To be seen, heard, and valued as a human being worthy of kindness and support is so important.
I’ve said it time and again: it costs nothing to be kind (except some patience but that’s where communication and taking breaks come in).
Just because your light is bright doesn’t mean you aren’t struggling. We’re often still struggling even when we’re laughing – underneath the laugh is a feeling of flatness that doesn’t go away. Being momentarily happy or feeling joy does not mean you aren’t suffering.
I know it’s there. I see you.
It can be a low-grade annoyance, like a mental fly you just want to swat, a barrage of thoughts Trauma Brain screams at you, or it can be a way of (intentionally) intensifying the pain.
What most of us who struggle with any variation of suicidal ideation want is not to actually end our lives, but rather to end life as we know it today and/or to end our pain. But because we feel so far away from anything resembling a doable, healthy, and balanced life, we feel misery at the thought that it will never get better and never go away.
We feel stuck in the same place, in the same feeling, the same pattern and same daily reality. And it is really, really hard to keep going when you [feel as though you] already know how the next day is going to go, and the next, and the next one after that until the end of your days.
I can understand why someone would question what the point is if they consistently experience more pain and suffering than joy, love and support.
You are worthy of kindness. You are worthy of love, laughter, and support. I can’t wave a wand and make it all go away, but know that Better Days will come. Look for the glimmers in the meantime.
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