What’s The Difference Between Active & Passive Suicidal Ideation?

What’s The Difference Between Active & Passive Suicidal Ideation?

Suicide is a topic that has for long been shrouded in taboo. The mere mention of the word can strike terror in the hearts of even the most strong-willed individuals. And yet, suicide is among the leading cause of death in the United States, according to the National Institute of Mental Health.

What is Suicidal Ideation?

Suicidal ideation refers to thoughts about committing suicide or wanting to take your own life. For most people, suicidal ideation can manifest as passing and cause little to no distress. However, for some people, thoughts of suicide can turn into a strong desire to end their lives.

Most people will experience suicidal thoughts at some point in their lives. In 2020 alone, the CDC estimates that around 12.2 million Americans had serious thoughts about suicide.

What Causes Suicidal Ideations?

There is no single cause for suicidal ideation. Instead, it is often the result of a combination of different factors. For some people, suicidal thoughts may be triggered by a specific event or experience, such as the death of a loved one, relationship problems, financial difficulties, or job loss.

Other risk factors that can make someone more susceptible to suicidal thoughts include terminal illness, loneliness, disability, family history of suicide, or having a mental illness such as bipolar disorder, depression, anxiety disorders, or substance abuse.

Active Suicidal Ideation vs. Passive Suicidal Ideation

There are two types of suicidal ideation; active and passive suicidal ideations. The main difference between active and passive suicidal ideation is the level of intent and planning involved.

Passive Suicidal Ideations

Passive suicidal ideation refers to thoughts of suicide that do not involve a specific plan, the means to carry out the plan, or an intention to commit suicide.

While passive suicidal ideation does not always require emergency medical intervention, it is crucial to seek professional help as soon as possible. Without proper medical intervention, passive suicidal ideation can progress to active suicidal thoughts and ultimately lead to suicide or suicide attempt(s).

Active Suicidal Ideations

Active suicidal ideation typically refers to thoughts of suicide that involve a detailed plan, the means to carry out the plan, and an intention to commit suicide.

When a person is experiencing active suicidal thoughts, they see no other way out of their current situation and often have a strong desire to die. People who have active suicidal ideation may:

  • Talk about wanting to die or express a strong desire to commit suicide
  • Express feelings of being a burden to others
  • Withdraw from friends and activities
  • Give away prized possessions
  • Increase their drug or alcohol abuse
  • Look means to commit suicide
  • Make a detailed plan for how they would commit suicide

Active suicidal ideation is a medical emergency and requires immediate professional help. If you or someone you know is in immediate danger, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255. Early intervention is key in preventing suicide.

Treating Suicidal Ideations

There are several proven treatment options available that can help people manage suicidal thoughts. Treatment typically begins with a comprehensive evaluation by a qualified mental health professional. 

This evaluation will help determine the underlying causes of the suicidal thoughts and develop a treatment plan tailored to the individual’s needs. Common treatments for suicidal ideation include psychotherapy, medication, and hospitalization.


Psychotherapy, also known as talk therapy, is an effective treatment option for suicidal ideation. During therapy sessions, you will work with a therapist to identify and address the thoughts and behaviors that may be contributing to your suicidal thoughts.

Different types of psychotherapy can prove effective in managing suicidal ideation. Common approaches include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and interpersonal therapy (IPT).


In some cases, your doctor may prescribe medication alongside therapy to help treat suicidal ideation. Medications commonly used to manage suicidal thoughts include antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers. In recent years, ketamine infusion therapy has also shown great promise in providing rapid relief from suicidal thoughts.


In very severe cases of suicidal ideations or a suicide attempt, hospitalization may be necessary to effectively de-escalate the situation and provide around-the-clock care. Once stabilized, your doctor will get you started on an inpatient or outpatient treatment plan that may include therapy, medication, and other support services.

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