Suicide Ideation

It’s often not just one thing that causes someone to get lost in thoughts about suicide. Suicide ideation comes when one crisis melds into another. A difficult situation at home, then another at work along with an impossible-to-navigate relationship conflict. Everyday stress turned into overwhelming circumstances. Trauma that seems insurmountable. 

When difficult situations threaten our emotional, mental, or physical well-being, seeing past them can be a real challenge. Someone experiencing these struggles may feel desperate for an escape, and the hopelessness of facing odds stacked way too high may leave them believing suicide is the only way out. 

Contrary to those feelings, suicide is never the only option, and anyone who’s concerned about yourself or someone you know should reach out for help immediately. The number for the Suicide & Crisis Lifeline (988) is a good place to start. 

To learn more about suicide ideation, read on. Also, discover the warning signs that someone is struggling with thoughts of suicide, and learn to recognize the signals that point to an immediate need for help.

What is Suicide Ideation?

The definition of suicide ideation in its basic form is simply thinking about suicide. 

“But suicidal ideation isn’t always like flipping a switch. Rather than suddenly arriving at once (though that is possible), it may instead come on gradually, or ebb and flow over a period of weeks or months. Someone who has experienced fleeting or passive suicidal thoughts for a long time may not immediately recognize when those thoughts turn truly dangerous.”  – Psychology Today

Active Suicide Ideation

When someone is not only thinking about suicide but also making plans to go forward with it, experts suggest they are experiencing “active suicide ideation.” The Neuroscience Institute says individuals in an active state can behave very differently from one another. Some may convey a sense of calm; others may withdraw. Some may begin putting their plan in place by giving away their belongings while others gather the needed resources.

Passive Suicide Ideation 

On the other hand, those in a passive state of ideation may be thinking about suicide frequently but have no concrete plans they intend to act on. They may desperately want a situation they’re facing to end or even imagine that friends and family members might be better off without them. But those thoughts are just that… thoughts, with no action taken.

In the classic movie It’s a Wonderful Life, George Bailey was bombarded with suicidal thoughts after money-hungry Mr. Potter taunted him with the idea that his family would be financially more well off if Bailey wasn’t alive. The thought tortured him enough that he started moving from passive ideation — just thinking about suicide — toward active ideation, going forward with planning his death. As you probably know, in the end the movie takes a different turn, and Bailey gets past the crisis and back home to his very satisfying life and family. 

In real life, endings aren’t always so tidy. Passive and active suicidal ideation are signs of someone at serious risk for suicide. Let’s look at other signs to be aware of should you or someone you know be experiencing extreme stress that is inducing thoughts of suicide.

Warning Signs of Suicide

The National Institute of Mental Health provides lists of suicide warning signs, categorized into what someone is saying, feeling, and doing.

Someone who’s thinking about suicide may be expressing a lot of shame or guilt. They may be saying they feel like a burden to family members, colleagues, or friends. You may also hear them communicate a desire to die. 

The feelings that accompany thoughts of suicide can be intense. They may include:

  • Extreme sadness
  • Emptiness
  • Hopelessness
  • Anxiety
  • Agitation
  • Rage
  • Emotional distress
  • Physical pain

How people respond when they’re considering suicide varies widely from person to person. Some react by:

  • Withdrawing from those close to them
  • Putting a plan together
  • Giving away their possessions
  • Engaging in addictive behaviors such as drinking alcohol or using drugs
  • Taking more risks

It’s not always easy to know the difference between when someone is experiencing a difficult but passing struggle and when there is imminent danger of a suicide attempt. 

Healthcare professionals use suicidal ideation scales to determine how severe someone’s thoughts are and the inherent risk they’re facing. GoodRx outlines some of the questions built into suicide ideation scales. They relate to: 

  • How often someone thinks about suicide
  • How strong the desire to escape is
  • How long the struggle with suicidal thoughts has been going on
  • How capable someone is for going through with a plan 
  • Whether or not the person has created a plan

Knowing the answers to these questions helps healthcare professionals as they begin treating individuals who are experiencing suicide ideation. 

When To Get Help

“Typically, people with active suicidal ideation require more urgent care, especially if they have a specific suicide plan. Those with passive suicidal ideation need support and monitoring over time. Ultimately, healthcare providers use their best judgment to determine what interventions are needed. 

And it’s important to ensure safety no matter what type of suicidal ideation someone has.” – Good Rx

Knowing when to get help is so important. Persistent thoughts about ending your life or overwhelming emotions that make you want to disappear are signs that you should get help right away. 

Take the step and call a friend. Talk about what you’re feeling. A conversation with someone who’s supportive and kind may be enough to make you feel better.

If, however, your thoughts are escalating or your behavior’s becoming more risky, you need professional support. Reach out right away to a mental health professional at your school, workplace, place of worship, or community center. Anyone at risk of imminent danger, call or text the Suicide & Crisis Lifeline at 988. 


Best Day Psychiatry and Counseling is also here to assist you. Our team is trained to treat a wide range of psychiatric conditions for both children and adults, and we’re ready to help you find a better way. Contact us today.