Take Passive and Active Suicidal Ideation Seriously
When you have a teenager, one thing you have to learn to handle is the drama.
If you can remember back to your teen years, you may remember that everything in your life seemed like a big deal.
The new romantic interest. The breakup in your friend group. The classmate who got busted drinking and driving. The big test coming up on Friday. Plans for the homecoming dance and prom. Making the cheerleading squad. Getting a varsity letter in football.
Remember the way you talked about things?
This is the worst day ever!
Studying trig is literal torture.
This is the best day ever!
If I have to hear this teacher lecture one more time I think I might kill myself.
It all sounded funny to you back then, when you were the teen, and didn’t have to try to figure out the subtext behind your hyperbole.
Now that you’re the parent of a teen, and the shoe is on the other foot, you realize that teen exaggeration can, indeed, be cute and endearing, but it can also be the opposite.
It can be scary.
Like when your teenager says something in a text or on the phone to one of their friends like this:
OMG…FML…I want to die.
So, what do you do about that?
Do you take it seriously? Does your teen really hate their life? Do they really want to die?
Or is it all just teen drama, exaggeration, and hyperbole?
Does your teen say those things because they mean them or because they’re kidding and it sounds funny to their friends?
Maybe you’re one hundred percent sure they say those things to shock you, scare you, or get your attention.
You’re positive it’s all just typical teen drama.
However.
You Have to Take It Seriously
It may well be all those things. It might all be drama and exaggeration. Your teen might not have any desire to end their life at all.
But the chance it’s not drama and exaggeration is far too great to risk minimizing or dismissing any talk of suicide.
If your teen talks about suicide and you think they’re in immediate danger, we recommend you call 911 immediately or take them to an emergency room at a regular hospital or a psychiatric hospital.
Don’t wait. If they’re serious – and the drama is serious and not typical teen drama – the possible consequences far outweigh the consequences of the chance they’re not serious.
With that said, there’s another thing we need to discuss. It’s a topic we introduce in the title of this article: the subtle signs of suicidal thoughts and behavior that are easy to miss. Some teens – including teens with mental health disorders such as depression or anxiety – might be quiet about their troubles. They may not voice their thoughts to anyone out loud. And when they do, they may do it under their breath, in a way that seems offhand.
They may roll their eyes about something in their lives they don’t like and mutter I wish I were dead or I just wanna die and then go to their room.
As a parent, what do you do with that?
What we can tell you is that in order to gauge the seriousness of statements like that, you have to look at the big picture. You need to consider everything going on in your teen’s life at the time and decide how the various factors and circumstances at play inform or shed light on any statements they might make about suicide.
And you need to consider one more thing:
Sometimes it’s when a teen goes quiet that the risk is greatest.
What Issues Increase Risk of Teen Suicide?
We’ll start with what we just mentioned.
If a teen makes repeated threats to you or others about suicide or talks openly and often about suicide – meaning they engage in suicidal ideation in front of you frequently – and then they suddenly go quiet about it, withdraw, and change their behavior dramatically, that’s what mental health professionals call a warning sign and what most non-experts would call a red flag.
It falls under the category of warning signs called dramatic/drastic/extreme changes in behavior. If your teen goes from agitated and vocal about their problems or goes from talking about or threatening suicide all the time to saying nothing at all, that’s a radical behavioral change.
Among adolescent mental health experts, that radical behavioral change is a known and accepted warning sign for increased suicide risk.
if you’re the parent of a teenager, that’s something you should know. We think you should also know about the other factors, risks, and warning signs that increase the risk of teen suicide. Knowing the warning signs, risk factors, and the protective factors can help you make sense of your teen’s words and behavior during this often challenging, sometimes chaotic, and occasionally turbulent period of development known as adolescence.
We’ll start by defining important terms, like suicidal ideation.
There are two types: active suicidal ideation and passive suicidal ideation.
We’ll start by defining active suicidal ideation.
Active Suicidal Ideation
Active suicidal ideation implies three things. A teen who engages in active suicidal ideation has three things:
- A plan to commit suicide. They’ve gone past thinking about it to deciding how they can do it.
- A time frame during which they’ve decided to put their plan into action. They’ve gone from “I wish I wasn’t here” to “By [insert specific date/time], I won’t be here anymore.”
- A means by which to carry out the plan. This means they have acquired the ability to carry out their plan. It might mean they’ve acquired a gun, acquired medication that can induce death, or finalized other details that allow them to follow through with their decision to end their life.
It’s also important to understand that active suicidal ideation includes “…a conscious desire to inflict self-harming behaviors [when] the individual has any level of desire, above zero, for death to occur as a consequence…the individual’s expectation that their attempt could produce a fatal outcome is the key consideration.”
Now let’s define passive suicidal ideation.
Passive Suicidal Ideation
A teen who engages in passive suicidal ideation does not have the three critical things a teen who engages in active suicidal ideation has. They do not have:
- A plan to commit suicide.
- The means to commit suicide
- A time frame within which they plan to carry out a suicide attempt. I
In addition, passive suicidal ideation includes “…indifference to an accidental demise which would occur if steps are not taken to maintain one’s own life.”
Here’s the takeaway from those two definitions:
Active suicidal ideation is defined by the presence of a suicide plan and the means or access to the means to carry it out.
Passive suicidal ideation is defined by the absence of a suicide plan and the means to carry it out. With regards to passive suicidal ideation, it’s important to pay attention to that last part of the definition. While a teen who engages in passive suicidal ideation does not plan to attempt suicide, they’re also “indifferent to