Passive Suicidal Ideation in ADHD: Can ADHD Make You Suicidal?

Navigating life with ADHD can feel like traversing a maze filled with unexpected twists and turns. Amidst these complexities, one challenge that often arises is passive suicidal ideation in ADHD. This phenomenon involves fleeting thoughts of death or self-harm, which can silently permeate the mind of someone with ADHD. It's a weighty subject, but one that deserves attention and understanding.

Passive suicidal ideation refers to frequent thoughts about wanting to die or intentionally hurt oneself without taking any action on those thoughts.

• Some examples of passive suicidal thoughts are:

• Wishing to fall asleep and never wake up

• Thinking you don't want to be alive anymore

• Imagining ways you could die, like in a car crash

• Fantasizing about the peace of being dead

• Minimal planning, like looking up less lethal suicide methods

• Thinking loved ones would be better off if you disappeared

These thoughts are usually transient and come and go. But over time, they may occupy more mental space and feel more appealing.

Other typical symptoms of passive suicidal ideation include:

• A sense of numbness, sadness, and despair

• Feeling like a burden on others

• Loss of interest in social activities

• Withdrawing from family/friends

• Fatigue, brain fog, and lack of motivation

People with passive thoughts still have conflicting emotions about dying. They may desperately wish for relief but also feel guilty, frightened, or ambivalent. The key distinction from active imagination is that the person is not yet fully resolved to take their own life. They still see dying as a last resort only. However, as per a study published by the National Library of Medicine (NLM), the indications of passive vs active suicide thoughts coincide more strongly than they differ.

However, as we'll discuss more below, passive ideation should always be addressed quickly before reaching a crisis point.

There is no single cause for suicidal thinking. But in ADHD, some common factors that may contribute to passive ideation include:

Biochemistry

Imbalances in dopamine and serotonin modulation can trigger depression symptoms like suicidal thoughts. ADHD meds, like stimulants, rarely induce ideation. However, withdrawal after stopping certain medications can destabilize mood.

Executive Function Deficits

Impaired planning skills make it hard to break down big problems into smaller steps. Suicidal thinking may seem like the only way out. Poor organization and time blindness result in missed tasks, lateness, and forgotten obligations that worsen depression.

Emotional Dysregulation

Difficulty regulating emotions can cause feelings to spiral out of control, leading to suicidal thoughts. Emotional intensity in ADHD means we feel even minor setbacks deeply.

Rejection Sensitivity

People with ADHD often feel rejected due to social struggles. Constant feelings of isolation can contribute to suicidal thinking. We tend to take criticism personally and ruminate over it.

Comorbid Conditions

As per the National Institute of Health (NIH), ADHD commonly occurs with other mental health issues like clinical depression, PTSD, and substance abuse disorder - all suicide risk factors. Additional resources published on the NLM also observe that approximately two-thirds of people with ADHD also have another mental health condition.

Chronic sleep disturbances in ADHD deprive the brain of the rest it needs for mood stability.

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Passive suicidal thinking involves less immediate risk than active planning. But it still requires urgent attention for several reasons:

Changing Thought Patterns

Thought patterns can change rapidly - Someone passively wishing to die today may be drafting a suicide note tomorrow as emotions intensify. Passive ideation is on the pathway to full-blown suicidal behavior.

Discourages Treatment

People trapped in frequent suicidal thinking often feel hopeless about improving their situation. This stops them from reaching out for help, which could pull them out of crisis.

Cognitive Distortions

The more time the mind spends imagining and yearning for death, the more suicidal thinking gets reinforced. This makes it harder to generate alternate positive visions.

Makes Life Worse

Passive suicidal thoughts can sap motivation for relationships, work, health, and all the things that make life worth living. Preoccupation with dying leads to just existing, not living.

Makes Suicide Less Frightening

Thinking extensively about ways to die often reduces fear and increases comfort with lethal self-harm. This builds up capability, making action more likely.

Disturbs Loved Ones

Voicing repeated suicidal thoughts, even passively, takes a toll on family/friends. It can weigh heavily on the minds of those who care most.

For these reasons, the saying 'suicidal thoughts require suicidal actions' is a myth. Passive ideation can be just as dangerous in the long term. Getting help early and learning healthy coping is extremely important.

Sometimes, people living with ADHD may experience fleeting thoughts of death after a terrible day. For example, saying aloud in frustration, 'Ugh, I wish I could die right now; I just want this to end.' This is distinct from suicidal ideation because there is no envisioning of dying or desire for life to end. It's a random venting thought that immediately passes.

Likewise, sad reflections around the time of a major loss are also typical. Mourning a loved one may briefly bring thoughts like missing them in the afterlife. But with true passive suicidal ideation, detailed mental visions of dying recur regularly. They go beyond common expressions of frustration or grief.

Some ways to distinguish passive suicidal ideation from typical thoughts:

• Frequency: Occasional vs multiple times a week

• Duration: Fleeting vs extensively elaborated

• Intent: No desire to die vs persistent longing for death

• Function: Venting frustration vs imagining escape

• Control: Easily dismissed vs consuming mental space

• Hope: Still sees options vs trapped feeling

• Timeline: Temporary mood vs ongoing desire over weeks/months

Recurring thoughts of death that provide comfort or escape signal it is time to speak to a doctor or counselor. The sooner this is addressed, the better the outcome.

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Living with passive suicidal ideation is exhausting. The constant background thoughts erode self-worth and make ADHD symptoms harder to manage. While professional help is critical, developing your own toolkit of coping skills can help reduce ideation frequency and intensity. Some techniques to try:

Create a Safety Plan

• Identify warning signs that thoughts are escalating, like mood changes and isolation.

• List healthy activities that provide joy and decrease suicidal thinking. Things like walking outdoors, listening to music, taking a shower, or viewing funny videos.

• Remove lethal means from your environment. Limit access to anything that could be used for suicide.

• Write down names/numbers of family, friends, therapists, and hotlines to activate as lifelines.

Manage Triggers

• Track thoughts and mood daily to identify high-risk situations like moving, job loss, and other similar situations.

• Bolster supports around known triggers. Plan fun outings after historically hard days.

• Reduce exposure to suicide-related media that may increase thoughts.

Practice Mindfulness

• Meditate daily, even starting with 5-10 minutes. Focus on the present rather than ruminating on the past or future.

• Try grounding techniques like noting 5 things you see, hear, and feel in the current moment.

• Imagine thoughts passing by like clouds. Don't cling to or suppress them.

• Use mental imagery to picture a safe, comforting place that feels 'suicide-free.'

Improve Coping Skills

• Build distress tolerance through exercises like dunking your face in ice water, which jolts you into the present.

• Adopt healthy thought patterns - remind yourself, "This too shall pass."

• Vent feelings in a journal, art, or audio diary without judgment or censorship.

• Soothe intense emotions with activities like yoga, deep breathing, and listening to soothing music.

Foster Connections

• Push back against isolation urges and attend social events even when unmotivated.

• Share feelings with trusted friends/family who won't minimize your experience.

• Consider peer support groups to reduce stigma and alienation.

• Volunteer to help others to increase purpose and community.

Take Care of Yourself

• Reduce stress through relaxation techniques, enough sleep, saying no to obligations, and breaks from media/news.

• Eat nutritious anti-inflammatory foods. Stay hydrated and minimize alcohol.

• Move your body with activities like walking or dancing to boost endorphins.

• Seek sunlight and fresh air, which are nature's antidepressants.

With daily practice, the above strategies can slowly change thought patterns. The goal isn't to completely eliminate suicidal thinking (which may be impossible). It's to expand space between the thoughts with islands of relief. Over time, passive ideation loses its grip. But you have to put in the work - these changes won't happen through hope alone.

Seeking professional treatment is critical for recovery. The Substance Abuse and Mental Health Services Administration's (SAMHSA) treatment guide for suicidal ideation highlights that effective interventions must be tailored to each individual's unique needs. There is no singular approach that will work for everyone struggling with suicidal thoughts and behaviors. Some of the most effective options to treat suicidal thinking include:

Medication

Antidepressants like SSRIs are often prescribed when ideation is severe, along with ADHD meds. Anti-anxiety and antipsychotic medications may also assist. Studies have indicated that people taking stimulant medications like Ritalin, Vyvanse, Adderall, etc., for ADHD tend to experience lower rates of suicidal thoughts.

Psychotherapy

CBT, DBT, and ACT therapies help address unhelpful thought patterns and impulsive behaviors. Supportive counseling provides tools for building a meaningful life.

Brain Stimulation

Non-invasive treatments like TMS therapy have shown promising results for reducing suicidal thoughts and behaviors.

Residential Programs

Partial hospitalization or inpatient admission may be required if self-harm risk is high despite outpatient care.

Peer Services

Having an ADHD coach or peer supporter provides community, accountability, and motivation for change.

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When someone you love reveals passive suicidal thoughts, it can feel overwhelming. You may alternate between wanting to shake them out of despair and tiptoeing around to avoid worsening their mood. Here are some dos and don'ts:

DO:

• Listen without judgment and validate their feelings. Don't minimize their experience.

• Offer hope by sharing stories of others who recovered from suicidal thinking.

• Check-in regularly through calls, texts, and visits. Isolation fuels depression.

• Remind them of their strengths and talents. Low self-worth drives ideation.

• Brainstorm healthy distractions like games, nature walks, and cooking together.

• Assist them in scheduling and getting to the first therapy appointment.

• Learn about mental health resources so you can point them to help.

• Be patient - the road is long, with setbacks expected along the way.

DON'T:

• Guilt or force them when they resist your suggestions. This causes more shame.

• Talk about suicidal thoughts casually or jokingly. Take all statements seriously.

• Shy away from using words like 'suicide' or 'dying.' Address it directly but sensitively.

• Assume you as a friend/partner can replace professional help - experts are still needed.

• Leave their side if self-harm seems imminent despite promises. Stay until the crisis passes.

• Lecture about the value of their life. Instead, help them re-discover it.

• Panic or lose hope if progress seems slow. This further demoralizes them.

With empathy, patience, and care, you can support your loved one's recovery while also practicing self-care. Therapeutic tools aid you both in overcoming this excruciating challenge.

The Edge Treatment Center provides comprehensive treatment for those struggling with suicidal thinking related to ADHD and other conditions. Our individualized programs combine evidence-based psychotherapy, medication management, peer support groups, life skills training, and holistic wellness services to address suicidal ideation. With expertise in dual diagnosis care, The Edge can help you build coping skills while also treating any underlying illnesses contributing to passive suicidal thoughts.

Contact us today to learn more.

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