What’s The Difference Between Suicidal Thoughts & Ideations?

Millions of people contemplate suicide yearly, far fewer plan it, and even less take their own lives. But suicide is still a leading cause of death in America, resulting in almost 46,000 deaths in 2020 . In all cases, thoughts of ending their life are the beginning of a potentially dangerous, life-altering journey.

There is no difference between suicidal thoughts and ideations, but it’s essential to know when they’re dangerous, and when you or someone else may need professional help. Many people contemplate suicide, briefly thinking of it before dealing with the feelings complicating their lives. Others go further, actively looking into ways to end their life and planning for that outcome.

In the first case, that’s an example of what healthcare professionals label passive suicidal ideation . In the second example, planning your suicide means you’re contemplating what’s known as active suicidal ideation .

Many factors can trigger suicidal thoughts and ideations, but they’re different for everyone and have various severity levels:

Passive suicidal ideation​ (or Passive SI) happens when you wish you were dead or could die, but without having plans to harm yourself or attempt suicide. Passive SI means you’re indifferent to an accidental death which would happen if you didn’t take steps to maintain your life. This form of ideation gets “ less attention from clinicians and researchers than active suicidal ideation .”

Active suicidal ideation (Active SI) is more serious, indicating the presence of daily, explicitly suicidal thoughts. Active SI is characterized by a mindful desire to cause self-harm, and the person harbors any measure of desire, greater than zero, for death to happen consequently. The possible deadliness of their actions, based on the method employed for the suicide attempt, isn’t the focus. Instead, the person’s expectation that such an attempt could be fatal is the primary consideration.

Whether you or someone else has active or passive suicidal ideation can be quickly identified by assessing potential symptoms. Some are more obvious than others and include:

There are many reasons for suicidal thoughts and ideation . Most often, they’re caused by feeling like you can’t deal with life when encountering what appears to be an overwhelming, unwinnable situation. If you think there’s no hope for the future, suicide can mistakenly appear to be a viable solution. You could have tunnel vision, where you believe suicide is the only option during a crisis.

Suicidal ideation, whether passive or active, signals that you need professional help to understand what’s happening and how your problems can be resolved. There are numerous professional resources to consider. You can also reach out to a trusted family member, friend, co-worker, spiritual advisor, healthcare professional, or local support group.

In nearly all cases, thinking of suicide means you need to talk with a healthcare provider for diagnosis and treatment options. A medical doctor may uncover a condition or illness and treat it to lessen your emotional distress. A psychiatric professional will investigate your emotions, thoughts, and behaviors as potential triggers, and help you develop coping skills to manage stress better and reduce the risks of suicidal thoughts and ideation.

Treatment options may include ongoing psychotherapy, antidepressants, or medicine like ketamine. Stellate Ganglion Block has also been shown to alleviate suicidal ideation especially in those who also suffer from PTSD.   Ask your healthcare provider which option is right for you.