You're Not Alone: Talking Honestly About Suicidal Thoughts by Jason La Kier, MS
- mason9194
- Sep 30
- 3 min read

If you or somebody you care about is currently a danger to their own life, contact 911.
Suicidal thoughts, urges, and behavior are more common than most people
think; they can be associated with a variety of mental health disorders, from Ma
jor
Depressive Disorder and Generalized Anxiety Disorder to ADHD or Anorexia Nervosa,
to name just a few. Suicidality is also oftentimes associated with major life stressors
such as ongoing abuse, loss of a job or relationship, and medical issues–it truly can
happen to anybody. Being able to recognize the realities of suicide and talk about it,
even outside of Suicide Awareness Month, can save lives.
One distinction that can be helpful to make when discussing suicidality is the
difference between passive and active suicidal thoughts. Passive suicidal thoughts are
ones where the individual isn’t specifically planning to kill themselves, but they’re
thinking about their own death. Thoughts like “I bet people wouldn’t care if I was gone,”
“I want to go to sleep and never wake up,” or “I hope I get into a major accident” are
passive suicidal thoughts, and they can lead into active suicidal planning if not
addressed. Ongoing passive suicidality is often associated with risk-taking behavior, use
of drugs or alcohol, or self-isolation, and strong negative feelings like hopelessness,
loneliness, and numbness. Active suicidal thoughts usually happen after ongoing
passive ideation (though they can also arise suddenly sometimes) and involve forming a
plan, thinking about specific means, and having an urge to begin taking steps towards
suicide. Passive suicidal ideation is much more common and can often be overlooked
because it’s less immediately dangerous, but it’s a sign that help is needed or the
ideation may transition into a plan and intent.
If somebody is at risk of suicide, demonstrating either passive or active suicidal
ideation, one way to improve their safety is by limiting access to what are called “highly
lethal means” like firearms or medication with an overdose risk. This depends on the
individual’s current level of risk, which can be assessed by a professional, but in general
the less access somebody has to these methods the more likely they are to remain safe
in the event of suicidality. The longer it takes somebody to access means of suicide, the
more chances they have to reconsider or be stopped before completing an attempt.
Talking about suicidal thoughts and plans is a vital step in recognizing what means a
person has access to and ensuring they’re secure in the case of a crisis.
If you or somebody you care about is experiencing suicidal ideation, talk to a
professional; we may be able to help by determining level of risk, collaborating on safety
planning, and exploring alternative ways of dealing with the overwhelming thoughts or
feelings which lead to suicidality. Your local Community Service Board or Behavioral
Health Authority (CSB / BHA) has crisis services available 24/7 for you to call: in
Williamsburg, that’s Colonial Behavioral Health, available at 757-378-5555. Here is a
directory to find the CSB / BHA closest to you in Virginia. You can also request a Crisis
Intervention Team (CIT) if you need to call 911 or contact the police for any reason.
CITs are trained specifically to respond to behavioral health crises such as suicidality.
Many people worry about sharing their suicidal thoughts with therapists or other
mental health professionals, because they fear being involuntarily committed to
inpatient psychiatric treatment. This is a last resort if a client is displaying active suicidal
intent and presents an imminent threat to their own life—passive ideation, past
attempts, and non-suicidal self–injury (NSSI) are risk factors for suicidality but aren’t
sufficient to justify involuntary inpatient treatment alone. You can always ask your
therapist what their steps are when a client reports suicidality, and work together to plan
ways of responding such as referring to a less restrictive level of care like an Intensive
Outpatient Program (IOP) or a Partial Hospitalization Program (PHP) before active
suicidality can become a present threat to your safety.
There are countless ways to effectively respond to suicidality when you notice it:
talking to a loved one about what’s going on, reaching out to a therapist, psychiatrist, or
other mental health professional to explore treatment options, calling a hotline such as
988 or contacting your local Community Service Board for crisis assistance, and using
crisis coping strategies are options for anybody experiencing suicidal thoughts. The
most important thing is to recognize that there’s a problem, and to take action.
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