There is a type of suicide that people don’t talk about in the media or in support groups. It is often missed by clinicians and even close relatives aren’t aware of what is going on. It is called passive suicide, which is preceded by passive suicidal ideation.
The Definition of Passive Suicidal Ideation
Passive suicidal ideation is explained online as a wish to die during sleep or being killed by an accident. The person suffering from these feelings often cannot get out of bed for days, or doesn’t eat, drink or take medications that are vital to their health. It is a general wish not to live while trying to pretend in public that everything is okay.
Passive suicide has another sinister and little-known component, it can turn active quickly.
Not discussing and publicizing passive suicidal behavior, researchers and mental health professionals are complicit in the suffering and deaths of many who could have been helped. The public needs to know that the behaviors their loved ones or friends are exhibiting are indeed dangerous. They need to know that these frustrating behaviors can be harbingers of a life- threatening decision to die by suicide.
I have read online stories of people who exhibit passive actions for years. They may suddenly become convinced they must complete their deaths. They will secretly take out insurance policies on themselves, and even set up their own funeral services before taking their own lives.
What Loved Ones Need to Know
Too often these folks who may be suffering from severe depression and low self-esteem are made worse by family members thinking and accusing them of being lazy. They become frustrated that their loved one will not get motivated to even get off the couch and weep or space out without explaining what is going on inside. The wife of a man who lies in bed instead of working or engaging with their children might resort to threats and angry name calling.
This is understandable because they are frustrated, scared, and ill-informed as to what has happened to the significant other they married. They don’t understand the severe changes they are witnessing and often feel that they are responsible somehow. Sometimes the spouse of someone who is experiencing passive suicidal behaviors will take the kids and leave.
Even when forced to see a therapist by their significant other’s cajoling, these folks often will go but they do not admit to having any thoughts of not wanting to live. This leads to the clinician not recognizing what is going on, and this can have tragic consequences.
Sadly, clinicians are ill-equipped and ill-trained to recognize, let alone treat, victims of the tragic condition of passive suicide.
Research has found some profound facts about this type of suicidal behavior. In a paper written by Baca-Garcia, et. al. (2011)1, they stated in their findings the following statement:
“The risk for lifetime suicide attempt was similar among those with lifetime desire for death with no suicidal ideation and those with lifetime suicidal ideation with no desire for death. Respondents with both lifetime desire for death and suicidal ideation had the highest risk for lifetime suicide attempts.”1
In other words, they found that a person with suicidal ideation of any type, whether they express a desire for death or not, are equally at risk for dying or trying to die by suicidal actions.
So, whether a patient walks into a therapist’s office and states they wish to die or not, they should be assessed for their behaviors at home. Do they spend all day in bed and “forget” to take their medications or eat?
Therapists, including Psychologists, are not trained to know how to recognize passive suicidal actions, or what to do to treat it. One astonishing article I read stated that 77% of people who die by suicide visited their therapist or medical doctor within a year of their deaths, and an astonishing 45% had contact with them within a month of dying.
To illustrate just how bad this lack of training is, the suicide prevention sites I visited stated if you know someone who is actively suicidal to call for help right away but give no advice to people whose family member or friend is lying in bed all day or has stated they wish they would die in their sleep.
That is so tragic that I am at a loss for words.
There Are Clinical Ways to Recognize It, But A Severe Lack of Training
There is a recently designed questionnaire developed by W. M. Reynolds2 , that asks the important questions to help identify suicidal ideation, including those of passive suicidal ideation. It is aptly called the Adult Suicidal Ideation Questionnaire. However, many clinicians are not trained in its use and so people who live with Passive thoughts of dying by suicide continue to fall through the cracks.
If you or someone you know has continual thoughts and behaviors of passive suicidal ideation, do not hesitate, get help. Scream if you have to but get the attention of a mental health professional. Don’t be wait because the distance between thoughts and actions isn’t that large and you may be running out of time.
If you take nothing else from this piece, let it be this.
Life is hard, life is not fair, and yes, life can be down-right shitty.
Once you have received proper treatment and worked on finding better ways to cope life will become worthwhile once again. I can guarantee that the clouds will eventually part and you will feel the warmth of the sun on your face.
Please, get help. We need you. You are valuable. You are the only you in the entire universe.
“You Are Unique.
You may not think that the world needs you, but it does. For you are unique, like no one that has ever been before or will come after. No one can speak with your voice, say your piece, smile your smile, or shine your light. No one can take your place, for it is yours alone to fill. If you are not there to shine your light, who knows how many travelers will lose their way as they try to pass by your empty place in the darkness?”
– Author Unknown
1. Baca-Garcia, E., Perez-Rodriguez, M. M., Oquendo, M. A., Keyes, K. M., Hasin, D. S., Grant, B. F., & Blanco, C. (201). 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. http://doi.org/10.1016/j.jad.2011.06.026
2. Reynolds, W. M. (1991). Psychometric characteristics of the Adult Suicidal Ideation Questionnaire in college students. Journal of personality assessment, 56(2), 289-307. Retrieved from: https://www.tandfonline.com/doi/abs/10.1207/s15327752jpa5602_9