Understanding Passive Suicide: A Personal Journey Through Mental Health's Hidden Struggle

⚠️ Content Warning: This article discusses suicide, suicidal ideation, and mental health struggles. If you're experiencing thoughts of self-harm or suicide, please reach out for immediate support. Contact details are provided at the end of this article.

In the landscape of mental health discussions, we often focus on active suicidal ideation—the deliberate planning and intent to end one's life. But there's another, quieter phenomenon that deserves our attention: passive suicide. As someone who has lived with borderline personality disorder and worked extensively in mental health training, I want to share my understanding of this complex experience that affects more people than we might realise.

With World Suicide Prevention Day approaching on 10th September, organised by the International Association for Suicide Prevention, it feels particularly important to shine a light on these often-overlooked experiences. This year's theme emphasises the need to start conversations about suicide prevention, and understanding passive suicidal ideation is a crucial part of that dialogue.

What is Passive Suicide?

Passive suicide refers to thoughts of death or non-existence without active planning or intent to harm oneself. It's the quiet wish that "something would just happen"—a car accident, a sudden illness, or simply not waking up. Unlike active suicidal ideation, passive thoughts don't involve specific plans or methods. Instead, they represent a desire to escape pain without the responsibility of acting. For me, these thoughts were once a daily companion.

Driving over a bridge, I might think, "I could just drove off the edge, maybe it would be classed as ‘an accident’" Boarding a train, the fleeting thought: "Maybe today is the day it derails"

These weren't plans—they were escape fantasies, ways my mind processed overwhelming emotional pain without the guilt of actively choosing to leave my loved ones.

 

The Hidden Nature of Passive Ideation

What makes passive suicide particularly challenging is its subtlety. People experiencing these thoughts often don't recognise them as concerning because they're not "planning anything." They might dismiss them as normal stress responses or temporary low moods. This invisibility means many suffer in silence, never receiving the support they need.

In my experience, passive suicidal thoughts served as a pressure valve for emotional overwhelm. When life felt unbearable, these thoughts provided a sense of potential relief without the immediate terror of active planning. They were my mind's way of saying, "There's always an escape route," even when I had no intention of using it. They were also a way I could make it easier on those I left behind, being run over, having cancer, being murdered were all things I believed my loved ones could grasp easier than “he ended his life”

The Dangerous Shift

However, passive ideation isn't always benign. What I've learnt through my own journey is that these thoughts can rapidly escalate under certain conditions. Alcohol, stress, isolation, or significant life changes can transform passive thoughts into active planning with alarming speed.

Recently, I experienced this shift firsthand. What began as familiar passive thoughts during an evening of drinking (just a couple of social drinks) quickly evolved into detailed planning—specific location, method, timing. The transition happened within minutes, catching me off-guard with its intensity and clarity.

This experience reinforced a crucial truth: passive ideation requires the same serious attention as active suicidal thoughts.

The Role of Mental Health Conditions

For those of us living with personality disorders, mood disorders, or other mental health conditions, passive suicidal ideation can become particularly entrenched. In borderline personality disorder, the chronic feelings of emptiness—one of the nine diagnostic criteria—often manifest as these persistent background thoughts of non-existence.

The emotional dysregulation that characterises BPD means that when passive thoughts do surface, they can quickly intensify. The same emotional storms that drive other BPD symptoms can rapidly transform passive ideation into active crisis.

Protective Factors and Hope

Despite the challenges, there are protective factors that can help manage passive suicidal ideation. In my personal experience, my mindfulness practice has been transformative. Whilst formal meditation doesn't work for me due to aphantasia (the inability to visualise), body scanning and present-moment awareness have helped reduce the frequency of these intrusive thoughts.

Regular physical activity, particularly walking, serves as both prevention and intervention. The rhythm of movement, connection with nature, and physical release of tension help process difficult emotions before they escalate to dangerous levels.

Most importantly, considering the impact on loved ones has consistently served as my strongest protective factor. Even in my darkest moments, thinking about how my death would affect my son and wife pulls me back from the edge.

Recognition in the Workplace

As Mental Health First Aiders, we need to recognise that passive suicidal ideation is more common than we might expect. Colleagues might express these thoughts indirectly:

"I'm so tired of everything"

"Sometimes I wish I could just disappear"

"It would be easier if I wasn't here"

"I wouldn't mind if something happened to me"

These statements deserve the same careful attention as more direct expressions of suicidal ideation. They represent genuine emotional distress and potential risk, even without active planning.

The Path Forward

Understanding passive suicide isn't about pathologising normal stress responses or creating unnecessary alarm. It's about recognising that the spectrum of suicidal ideation is broader than we often acknowledge.

By bringing these experiences into the light, we can:

• Reduce shame and isolation for those experiencing these thoughts

• Improve early intervention and support

• Prevent escalation to active suicidal crises

• Create more nuanced conversations about mental health

For those experiencing passive suicidal thoughts, please know that you're not alone, and these feelings don't define your future. They're symptoms of emotional pain that can be addressed with proper support, understanding, and professional help.

Moving Beyond Survival

Recovery isn't just about eliminating suicidal thoughts—it's about building a life worth living. Through my work in mental health training and my personal journey, I've learnt that healing involves developing emotional regulation skills, building meaningful connections, and finding purpose beyond our pain.

The goal isn't to never have difficult thoughts again, but to develop the tools and support systems to navigate them safely when they arise.

As we approach World Suicide Prevention Day, let's commit to having these difficult but necessary conversations. By understanding the full spectrum of suicidal ideation—including its passive forms—we can better support ourselves and others on the path to mental wellness.

If you're experiencing thoughts of self-harm or suicide, please reach out for support:

Emergency Services: 999 Samaritans: 116 123 (free, 24/7) Text SHOUT to 85258 (free, confidential, 24/7 crisis text support) NHS 111 for non-emergency mental health support

World Suicide Prevention Day Resources: Visit www.iasp.info/wspd/ for additional information and resources about suicide prevention.

Remember: You are not alone, and help is available.

Adrian Thomas is a Mental Health First Aid instructor, mindfulness teacher, and founder of The Resilience and Wellbeing Company. He specialises in workplace mental health training and has personal lived experience with borderline personality disorder. This article reflects his personal experiences and should not replace professional medical advice.