Note: This piece discusses the topics of suicide in detail. Please use your discretion.
“I don’t want to make a suicide plan, but I don’t want to be alive anymore.”
This statement is one we’ve heard over and over again. We’ve engaged with countless individuals who would not be labeled as actively suicidal but still need and deserve care. So where does that leave them and how can those who love them best lend support?
Suicide is an immensely stigmatized, shame-filled, and misunderstood reality. It tends to, and understandably so, alarm folks when mentioned and make them uncomfortable. But this shame and fear can begin to dissipate when we start engaging in honest, non-judgmental, and proactive conversations.
In order to determine how to deliver kindness, compassion, and assistance to those we love or know who may be struggling with suicidal thoughts or tendencies, we must first differentiate between passive and active suicidal thinking.
Folks who are experiencing passive thoughts of suicide or death ideation do not have a plan, but rather think about their death or believe they would be better off dead. These thoughts can result from a lack of a desire to live, a decrease in personal interests, and feelings of hopelessness.
Some who have personally experienced passive thoughts have described them to be quiet whispers in the back of their minds where they hope they don’t wake up tomorrow morning or wish for a fatal accident to occur so that the choice is taken from them. Whereas those who are undergoing active suicidal thoughts not only think about suicide but intend to follow through on an action that would cause harm to them and potentially end their life.
Suicide, much like addiction, disease, and other mental health diagnoses can happen to anyone. It impacts people regardless of socioeconomic status, race, gender identity, sexual orientation, religion, etc.
Potential Causes of Suicidal Thoughts
Factors that can contribute to someone experiencing suicidal thoughts may involve any of the following:
- A family history of suicide
- Experience with mental health struggles
- Identifying as LGBTQIA+ and not having the support of one’s family/community
- Struggling financially
- Undergoing a physical illness
- Experience with bullying
- Exposure to suicidal ideation in others
- A history of abuse
- Survival of sexual assault or sexual trauma
- Direct or indirect experience with racism, stigma, and/or biases
- A lack of affordable and equitable mental and physical health care
Possible Symptoms of Suicide Ideation
The symptoms one can experience when processing thoughts of suicide can be different for each individual but may include:
- The relinquishing of personal belongings
- Discussion of feeling lost, hopeless, and as though everything would be better once they’re gone
- Increase in reckless or unsafe behavior
- Decrease in social interactions
- Heightened rage or anger
- Researching suicide methods
- Crafting suicide notes
How Passive and Active Suicidal Ideation Interact
An increase in mental health struggles or a triggering event can quickly shift someone from having passive thoughts of suicide to active thoughts. This transition can happen rapidly and seemingly without warning.
One of the ways professionals assess risk is by utilizing the Scale for Suicidal Ideation (SSI). This scale is made up of 19 questions that help determine the level of suicide intention. This is done by measuring the individual’s desire to live versus their desire to die and determining one’s transfer from a free-floating thought of death to a determined plan of action.
How to Approach the Topic of Suicide + Knowing What Help is Available
While it can feel scary and overwhelming to breach the topic of suicide, we’ve seen just how impactful open communication and conversation can be for those who may be struggling. If you are a parent or a caregiver, you can try bringing it up in the car as studies have found that tough moments of dialogue can be more productive without forced eye contact. Or if you are looking to check in on someone you know who has been having a hard time, reminding them that you are willing and able to help them carry some of the tough feelings can be an important and even life-saving reminder.
Oftentimes, knowing we have the support of our friends and loved ones leads us to ask professionals for additional help, which can help move us from fear and pain into hope and trust. Our friend Louise shared how opening up and being brutally honest with her therapist about her suicide plan saved her life and brought her peace:
“Daily tasks became difficult. Showing up to my relationship and friendships became a chore. Waking up and putting on clean clothes evolved into my big daily accomplishment. It wasn’t until months later that I finally turned the light on and exposed the monster when I accidentally unveiled my plan to my therapist.
For a while, I had been mulling over a company transition. In breathy increments, I told my therapist about all the jobs I had been rejected from. She asked, ‘What plans do you have for yourself if things don’t work out?’ That’s when I blurted out, ‘I’m going to kill myself on my 30th birthday.’
The tears steamrolled down the sides of my face and dripped down to my blouse. Despair overcame me. It was the most vulnerable I had ever been. And to my surprise, my therapist didn’t retaliate or berate me. She didn’t send me to the hospital. She didn’t recommend medication. She just listened as I told her how I held onto this plan for a month without telling another soul. I left the appointment feeling lighter than before. The next day, that heaviness that I had come to know so well disappeared. The next week, hope returned. I felt so much better.”
We believe in the power of therapy and professional help. We also believe healing is possible. If you or someone you know is struggling or contemplating that the world would be better without them in it, we’re here to dispel that lie. But we know suicidal ideation, like many mental health experiences, does not have a light-switch fix. We can’t press a button and make you or someone you care about feel better, even if we desperately wish we could.
We do want you to know that there are people—TWLOHA included—who will sit in the darkness with you. And as we wait and process and feel and work through it all, we hope you’ll take a moment to explore the resources available:
- Use our FIND HELP Tool to find a counselor near you by entering your zip code
- Learn more about Meru Health x TWLOHA for digital mental health support
- Access Talkspace for online therapy with a licensed therapist
- Read about people’s honest experiences with self-harm and self-injury on the TWLOHA Blog