Note: This article contains thoughts involving suicide and suicidal ideation. If you or someone you know are considering suicide, please call the 988 Suicide & Crisis Lifeline at 988. Additional resources are listed below.

It’s most tempting when I drive through an intersection. If I were to get t-boned—directly into the driver’s side, so I had no shot of surviving—that wouldn’t be so bad. Other times it shows up when I’m lying in bed, covers yanked over my head, my lifelong companion depression suffocating my thoughts and body. If I sleep, I can’t feel it. If I don’t wake up, I won’t feel it ever again.

It’s not that I want to die. I don’t. All things considered, I live a charmed life. I’m surrounded by people I love, I’m squirreling away money for retirement, and I genuinely enjoy most days. Let’s get this straight, mostly for the sake of my mother: I’ve never been in danger and can confidently say I’ll never be in danger of dying by suicide.

Still, since I was ten years old and didn’t get out of bed for the entire month of April, I’ve oftentimes felt unattached to the idea of being alive.

What a terrible thing to say, huh? How ungrateful. What about your five-year-old goddaughter who you’d move Mount Everest for? What a selfish thing, putting that pain on the people who love you. It’s a privilege to be alive—don’t you know that?

I do know that. I just wish I felt more connected to it.

Jess Doughty, a Licensed Professional Clinical Counselor based in Wayzata, Minnesota, explains the passivity to being alive this way: “Passive suicidal ideation is subtle but provocative,” Doughty says. “It seems to be a helpless and hopeless message of wanting to escape, of life not being worthwhile or the individual not being worthy of good. It can be attention-getting but not substantial enough for those in their life to ‘call them out’ about it.”

Two-plus decades into living with depression, and no one has ever called me out on it.

It feels reckless to confess this to an internet full of strangers, and even more reckless to confess this to friends and maybe a couple of foes. What if people use this against me? To not give me a job or opt out of loving me? What if this rusts my reputation as a smart, kind, capable woman into this thankless, unstable crazy person who doesn’t deserve good things because, hell, she doesn’t even care if she’s alive?

Doughty views it much more rationally. “I see it as learned hopelessness, typically the result of being in a family of origin or longstanding relationship where the individual was neglected emotionally,” she says. “Likely asking for help resulted in shame or neglect, leaving the individual feeling powerless and without options.”  

Without options. In the United States alone, more than 45,000 people die by suicide every year. That makes it the 11th leading cause of death in the country, behind diabetes, influenza, pneumonia, and nephritis. On average, there are 132 suicides per day in the U.S.—one every 10.9 minutes. The number of attempted suicides is many times that; there are an estimated 1.2 million attempts to die by suicide annually.

Those are the statistics we can track. It’s impossible to know, however, how many of us live—get groceries, walk our dogs, sit in rush-hour traffic—in the void, grey area of passive ideation.

I didn’t admit to my passive suicidal ideation until I was thirty years old in a therapist’s office trying to gasp air between sobs, having blown off the cliff of depression and exhausted from trying to climb back up. I’d never said it out loud before: I don’t want to die by suicide, but sometimes I don’t want to be alive either. Her nod was so understanding, the pinch between her eyebrows so compassionate.

I was an easy baby, I’ve been told. The kind of baby that tricks you into having more babies. So when did the depression devil choose to prey on me? I’ll spare you the play-by-play of my childhood, but that April under the covers led to years of occasionally debilitating depression which led to an unfortunate familiarity with feeling forlorn. “So much of what presents presently in a person’s life is a reflection of something that was adaptive in childhood—at the time very helpful for survival but as an adult disruptive and disturbing,” Doughty says.

I’d never said it out loud before: I don’t want to die by suicide, but sometimes I don’t want to be alive either. Her nod was so understanding, the pinch between her eyebrows so compassionate.

According to the CDC, depression affects 20-25% of Americans ages 18+ in a given year. Though suicidality isn’t exclusively paired with mood disorders, such as depression, anxiety, and bipolar, they oftentimes complement each other. Not everyone with those disorders imagines suicide and not everyone who imagines suicide suffers from those disorders. Those dealing with substance abuse or bullying, or those who identify as part of a marginalized population also are more at risk for suicide, but no one is exempt from the chance of having suicidal thoughts, passive or active.

If someone in your life is dealing with passive suicidal ideation, Doughty emphasizes the importance of legitimizing the hopelessness that they feel—reframing the situation by saying they must be experiencing something so difficult that escaping feels like their only option.

“Oftentimes asking ‘how old they feel’ when they think this way can be a helpful way to validate the origins of learned helplessness, worthlessness, and shame,” Doughty says. “For children, things typically are black and white. If they grew up learning there is only one way to be with regard to hard things—either helpless or ignored—then it would make sense to act this way as an adult when things are big or overwhelming.”

Anna Borges, a senior editor at SELF Magazine, recently wrote about the idea of chronic suicidal ideation for The Outline. She equates it to treading water, constantly in motion to keep your head above the surface.

“For me, and I suspect for countless others like me, the threat of suicide isn’t like being carried over a waterfall—it is like living in the ocean. Not as sea creatures do, native and equipped with feathery gills to dissolve oxygen for my bloodstream, but alone, with an expanse of water at all sides. Some days are unremarkable, floating under clear skies and smooth waters; other days are tumultuous storms you don’t know you’ll survive, but you’re always, always in the ocean,” Borges writes.

“And when you live in the ocean,” she continues, “treading to stay afloat, you eventually get the feeling that one day, inevitably, there will be nowhere for you to go but down.”

Some days, the particularly dark ones, I slip under the surface, but I always, eventually, come up for air. I grasp for the life preservers that I’ve placed within arm’s reach. On the sunnier days—the clear skies and smooth waters Borges references—I take inventory of my lifesavers so I know exactly where to grab them when the storm hits, even when saltwater stings my eyes.

I attend therapy every week, pop a little blue pill every morning, and, just as importantly, I lean heavily on my pulse checkers. Debby, Juan, Rachel, Jess, Sam—I’m talking to you. They’re on lifeguard duty, ready to dive into the water at any moment.

Who are your Debbys? Who keeps you alive one day at a time? Who stops you from driving through that red light or suffocating under the covers?

Acknowledging my passive suicidal ideation didn’t give it more life; it gave me more life, empowering me to dig into the emotional dirty work. “To overreact can be counterproductive,” Doughty says. “Approaching it with curiosity as to its origins and purpose can be very freeing. It also becomes the gateway to finding other possibilities to feel better and thus reduce the passive suicidal ideation behavior.”

Acknowledging my passive suicidal ideation didn’t give it more life; it gave me more life, empowering me to dig into the emotional dirty work.

With the help of therapy and medication, I’ve been able to dampen my passive nonattachment to being alive, and today I’m happy to be here. I pay my bills on time, I have the loudest laugh in the room, and I love even though I know love sometimes ends the hard way.

It’s you and me, depression. We’re in this together for a lifetime, one I don’t intend to cut short.

Resources

If you are considering suicide, please reach out to one of the resources listed below.

988 Suicide & Crisis Lifeline
988

Crisis Text Line
Text HOME to 741741 to text with a trained crisis counselor (free, 24/7)

SAMHSA Treatment Referral Hotline (substance abuse support)
1.800.622.HELP (4357)

RAINN National Sexual Assault Hotline
1.800.656.HOPE (4673)

National Teen Dating Abuse Helpline
1.866.331.9474

The Trevor Project (LGBTQ+ crisis support)
1.866.488.7386
Text “START” to 678.678