This post is a Throwback which was originally published in October 2014

I was on the bus the other day and began thinking how much I miss owning a car, which reminded me that I miss owning a home, which reminded me how much I miss having a job and all the good things (materialistic) that come with it. I became sadder as I thought of how long I’ve been on disability and that lead quickly into self-pity. I began thinking how hard life is and wondered if it’s worth it to continue. I then realized I should write an article about it. The entire incident lasted less than a minute. I was experiencing suicide ideation.

I’ve been depressed a lot lately. This may come as a surprise to friends and family because, on the surface, I’ve been smiling, conversing and generally looking “normal”. It doesn’t mean I haven’t had a good time, enjoyed some laughs and even enjoyed people’s company. I’m not experiencing the traditional, heavy, debilitating type of depression. Instead I have the feelings of depression floating underneath the surface of the skin, which manifests itself via ideation. Frequently, that is my first trigger that I’m feeling depressed.

What is suicide ideation? Well, apparently it depends on who you ask. The Center for Disease Control >defines it as thinking about, considering, or planning for suicide. It’s kind of hard to argue with the CDC, but I find that definition unsatisfactory because it doesn’t fit what my understanding of what suicide ideation is. When I experience it, I don’t go into the planning stage.

The World Health Organization describes it as entertaining suicidal thoughts, but never attempting to kill oneself. This one kind of works for me because it’s short and simple, but still doesn’t feel right.

Medical News Today describes suicidal ideation as

a feeling people may have when they are no longer able to cope with an overwhelming situation… There may be a feeling of bleakness and an erroneous assumption that taking their own life might be the answer. If the individual’s mental state is heightened enough, suicide may seem to be the only exit.

Still feeling unsatisfied, I decided to delve further and learned that much of my confusion is because there are two types of suicide ideation – active and passive. I found many definitions for these as well, but the most succinct comes from an unlikely source – ehow.com. Their definition is much more in line with my thinking. They say,

Passive ideation is when stressful events in life may drive a person to think, “I wish I were dead.” Fleeting thoughts, including wishful thinking, are considered passive because the thinker hasn’t acted on the thoughts.

This is what I’ve experienced most in my life. Usually too tired to think about taking action to kill myself, but wishing I could quietly curl up and die.

Active ideation as when someone has taken steps to end his own life. Taking action for the depressed person could include writing a suicide note, giving meaningful items away or just planning how to “end it all.”

As I was searching the net for these definitions I began to wonder why. Why was it so important for me to find a definition that suits me? Why was it so important for me to blog about? I gave it some thought and I understood. I was trying to find a way to minimize my suicidal thoughts as no big deal. I was wrong. It is a big deal.

The American Academy of Family Physicians says most patients who voice or admit to suicidal ideation when questioned do not go on to complete suicide. However, some of these patients will go on to commit suicide; thus, suicidal ideation warrants thorough evaluation.

The following passage is from the website of Highland Hospital in Charleston, West Virginia:

Whether suicide ideation is active or passive, the goal is the same—terminating one’s life. Suicidal ideation, such as the wish to die during sleep, to be killed in an accident, or to develop terminal cancer, may seem relatively innocuous, but it can be just as ominous as thoughts of hanging oneself. Although passive suicidal ideation may allow time for interventions, passive ideation can suddenly turn active.

It’s been a very long time since I’ve experienced active ideation, however, I experience passive ideation almost daily. I bring it up with my therapist and pdoc occasionally, but I think it’s time for me to take it more seriously and really have a good conversation about it. Will I have to learn to live with, or is it something I need to work on? Hopefully, they can help me find those answers.

If you, or a loved one, is in a crisis state you should immediately call 911.

An excellent resource during any stage of suicidal tendencies is the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). On their website you can choose to not call and chat with a counselor instead. There is a link on their homepage: www.suicidepreventionlifeline.org. Whether you need information for yourself or a loved one, you’ll find a wealth of information on their website.