Every 11 minutes, an American dies by suicide. And in 2023, the CDC reported that about 12.8 million adults in the U.S. seriously thought about suicide or experienced suicidal ideation [1].
Suicidal ideation refers to thinking about, considering, or planning suicide. It can be passive, such as wishing to die without specific plans, or active, involving concrete thoughts or steps toward ending one’s life.
Individuals struggling with substance use are at an even higher risk, as drugs and alcohol can intensify feelings of hopelessness, impair judgment, and make coping with stress or depression more difficult. Substance use and suicidal ideation often feed into each other, creating a dangerous cycle that can escalate quickly if left unaddressed.
If you or someone you care about is struggling with suicidal thoughts, know that support is more accessible than ever, and there are many ways to connect with people who understand and can help.
What is Passive Suicidal Ideation?
Passive suicidal ideation refers to thoughts or fantasies about suicide or dying. It is not an official mental health diagnosis, but rather a symptom of several kinds of mental health challenges.
Passive suicidal ideation refers to thoughts or fantasies about dying or suicide. If left untreated, it can turn into active suicidal ideation (making plans or preparing to end one’s life). Passive suicidal ideation is not considered an official DSM-5 diagnosis, but rather a symptom of many different mental health challenges.
A few examples of passive suicidal ideation include:
- Wishing you wouldn’t wake up or thinking it would be easier if you were no longer alive.
- Feeling indifferent about living, such as not caring whether you live or die.
- Thinking others would be better off without you, even without wanting to act on it.
- Imagining relief from pain through death, without planning or intending to cause it.
- Having recurring thoughts about “disappearing” or not existing, without taking steps toward self-harm.
Other thoughts might include: “I wish I could disappear”, “I wish I were never born”, “I wish I could go to sleep and never wake up”.
Who Is At Risk for Suicidal Ideation?
Mental health challenges don’t discriminate, and suicidal thoughts or ideation can affect anyone, at any age and from any background. However, several factors increase the risk. These include [2]:
- Suffering from a mental health disorder such as depression, anxiety, bipolar disorder, schizophrenia, or PTSD.
- Family history of suicide or generational trauma, such as abuse, domestic violence, or drug use in the home.
- Previous suicide attempts or self-harm behaviors.
- Youth and young adults, particularly those who identify as LGBTQ+, are at an increased risk.
The Cost of Unaddressed Suicidal Ideation
According to suicide intervention specialists, most people who struggle with passive suicidal ideation don’t actually want to die, they just want the pain and suffering to end. This pain often includes emotional and psychological struggles that are invisible to others.
When unaddressed, it can impact several areas of life and drastically increase the risk of death by suicide [3]. Some of the ways suicidal ideation impacts people’s lives include:
- Emotions: Those with suicidal ideation often struggle with intense feelings of shame, hopelessness, guilt, and low self-esteem that can increase depression, anxiety, or emotional numbness.
- Relationships: Suicidal ideation can make people withdraw from friends and family, isolate themselves socially, and strain relationships, increasing feelings of isolation and loneliness.
- Daily Functioning: Those with suicidal thoughts or tendencies may have trouble focusing in school, work, and lack motivation to maintain basic hygiene or participate in self-care.
- Physical Health: Suicidal ideation affects eating or sleeping habits, increases the risk of substance abuse, self-harm, and suicide.
Passive suicidal ideation can quietly increase the risk of substance abuse by creating a sense of emotional numbness, hopelessness, or detachment from life. When someone feels indifferent about living or believes their absence would not matter, the motivation to protect their health often diminishes.
Alcohol, opioids, or benzodiazepines may be used to dull emotional pain, escape negative thoughts, or feel something instead of emptiness. Substance use further worsens passive suicidal ideation by impairing judgment, increasing impulsivity, and increasing depressive symptoms.
Many drugs disrupt brain chemistry involved in mood regulation, making feelings of despair or worthlessness harder to manage. As tolerance and dependence develop, individuals may use drugs more frequently or in higher amounts, increasing isolation and reducing their engagement with protective factors such as relationships, work, or treatment.
This is why integrated, co-occurring treatment is essential, addressing both the underlying suicidal thoughts and the substance use disorder together.
Addressing Suicidal Ideation and Preventing Suicide
An analysis of over 15 studies found that suicide prevention and interventions have helped reduce the global suicide rate by nearly 30%. These intervention methods include a combination of mental health-trained community personnel, psychoeducation, access to evidence-based therapies, restricting access to firearms, and collaborative healthcare [4].
For individuals experiencing passive suicidal ideation, treatment often focuses on reducing distress, increasing coping skills, and fostering safety. Common strategies include:
- Regular Mental Health Check-Ins: Routine counseling, therapy sessions, or check-ins with a case manager or peer specialist can help monitor thoughts and emotional well-being.
- Psychoeducation: Individuals and their families are taught about what suicidal ideation is, the signs, risk factors, and healthy coping strategies.
- Safety Planning: Developing a clear, personalized plan for times of crises or managing intense distress or suicidal thoughts. This might include healthy coping skills, friends or family to call, and hotline numbers for professional resources.
- Evidence-Based Therapies: Clinical approaches such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) challenge negative thinking patterns and regulate their emotions to reduce distressing or suicidal thoughts.
You Don’t Have to Face This Alone. Find Help for Addiction and Suicidal Thoughts Today
At Rushton Recovery, our supervised medical detox and residential treatment center offers a healing space to overcome suicidal thoughts and recover from substance use and co-occurring mental health challenges.
Our compassionate team combines evidence-based therapies, medication management, and holistic healing practices in a serene environment to support the healing of both your body and mind. Contact our admissions team today for confidential support tailored to you.
Sources
[1] Suicide Data and Statistics. 2025. CDC.
[2] Risk and Preventive Factors. 2024. CDC.
[3] Sharma, P. 2024. 8 Common Myths About Suicide. Mayo Clinic.
[4] About 740,000 global deaths from suicide occur annually. 2025. IHME.