Can People Have Passive Suicidal Thoughts?

By Kristina Randle, Ph.D., LCSW

Hi… there are mildly similar questions like this, that I found, and I apologize if this is redundant, but I found my situation slightly more different and was hoping I could get a more specific answer.

I am a freshman nursing student in a high pressure college, however the issues I’m delving into have been continuing longer, so while they may be brought out a little more due to new stressors, I don’t believe it to be relevant to the cause.

I’ve been a part of the “nerd” society since as long as I can remember. Thus, we function a little differently than normal social groups, I think. I have 1-3 very close friends, but also a community of around 9 I care about and we stick together in our corner of Commons. (more background information, I suppose. It said to be specific…)

For a long time, many different people/types of doctors have been attempting to psychoanalyze me (I believe I’m on my sixth or seventh). The general belief is that I have a mixture of anxiety and depression– hardly original and naturally a pain to attempt to treat. Most drugs don’t seem to work on me- though I and my sort-of psychiatrist (I don’t see her very often, though after not seeing her for a few months I requested to see her 4-5 weeks ago) found Pristiq to be at least mildly affective, though I can’t specify how.

To specify slightly more on my anxiety, I am constantly worried about “What if”s, although they don’t always manifest in detectable ways. People’s feelings, outcomes of situations, etc… it makes decision making extremely difficult for me.

In the past, around the time of eighth grade, I did make minor attempts at suicide, but nothing too serious. I know all suicidal thoughts are serious, but I think they were more cries for attention. I freaked out the one time I took scissors to my wrists and blood actually came pouring out. Though I admit I think about it every now and then.

My problem arises in that rather than actively wanting to hurt myself, I wish something terrible WOULD happen to me. I’ve been fascinated with pathological diseases– when I learned what Diabetes was when I made a friend who had it in elementary school, I thought it was cool and wished I had something like it. When we played pretend, my characters would have diabetes or epilepsy. Even now, understanding the pain and psychological distress that comes with the diseases (I have two friends, each with one of them, plus I’ve been in Nursing/Anatomy courses for some time now), I still envy those who have them.

It’s not just diseases, though. I walk across the street and wonder what would happen if a car will came speeding by and hit me. Heights make me far more anxious than they used to and often when I’m on the 4th floor of my Science building here, I wonder what would happen if I were shoved off.

I’m not sure if it’s because I’m scared to do it myself or if I’m just a head case. I don’t have any REASON to be broken like this, but I’m not sure if I can help feeling like it. I wonder what my roommate (the friend with Type 1 Diabetes) would do if I died– I wonder what a lot of people would do if I died or got hurt. It could be a manifestation of my need to know I matter in the world, as I do question it sometimes, but I know while the world would keep turning, my few close friends would be sad. When I spoke to my psychiatrist about it not too long ago I had other things to worry about and her advice was to take my meds (I hadn’t been since May of last year) and see if my thoughts improve. Meds are like contacts, she said, and my thoughts should be clearer with the meds in my system.

I had a second question about sexuality and my possible lack of the ability to love, but this has gone on long enough– I don’t want to trouble you more than I already have. For more information, I just joined the site and took the Sanity Test out of curiosity and I scored a 85 or 87, I don’t remember. I had an extremely high number for self-esteem, which is nothing new; I’m aware and have been aware of the self-loathing of my appearance for a very long time. Being a 210lb 18 year old female with a man-voice can do that to a person.

Thank you very much for your time– to be honest, I’m not sure where the question is in all of this. I suppose I was hoping maybe your team could make sense of it. I know I have a psychiatrist who I do like very much, but I can’t see her when I’d like as she’s 4 hours away in my home town and I was hoping for a new perspective– someone who’s unbiased and can make sense of the mess that is myself.
Again, thank you very much. I greatly appreciate you taking the time to read this. I’ll understand if it gets ignored for having a bit TOO much to it… sorry.

A. I’m not certain of your exact question but I will do my best to address what I believe to be your major question.

What is very positive about your situation is that you are actively participating in treatment. You have a psychiatrist that you like and with whom you have a good relationship. You are also persistent. You been to six or seven psychotherapists and though they have provided minimal assistance, you never gave up.

Your primary issue seems to be passive suicidal ideation. Passive suicidal ideation is not uncommon, especially among individuals with depression. Oftentimes individuals feel this way when they are convinced that their friends and family do not care about them.

Part of your desire to die includes the development of a terminal illness. This desire may stem from a belief that you are unloved. It may also be a desire for attention. Generally speaking those are the primary reasons why individuals would want to develop an illness. They want people to notice them. Individuals have sympathy for those with a terminal condition. If you had a terminal illness, then your friends and family would have to pay more attention to you. It would ensure that you are the focus of their world. Their focus would be evidence of their love.

It is good that you are in contact with treatment professionals but seeing your psychiatrist every four months is not enough. Many psychiatrists can focus on medication only. You need psychotherapy to address your negative thoughts. In addition, studies consistently show that medication alone is not a comprehensive treatment approach for depression or anxiety.

I would encourage you to continue searching for a psychotherapist. A good psychotherapist can help you address your ongoing issues.

If you have additional or more specific questions please do not hesitate to write again. The find help tab at the top of this page can help you locate a therapist in your community. I wish you the best.

Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 22 Apr 2011

APA Reference
Randle, K. (2011). Can People Have Passive Suicidal Thoughts?. Psych Central. Retrieved on December 20, 2014, from http://psychcentral.com/ask-the-therapist/2011/04/22/can-people-have-passive-suicidal-thoughts/

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