A young woman sits on the ground with her head between her knees against a grey brick wall.
Suicidal Ideation: From Crisis to Chronic

According to the CDC, over 12 million adults experience suicidal ideation in the U.S.

Suicidal ideation is a lot more common that people would like to think. Many have intrusive thoughts about driving off the side of the road into oncoming traffic, or what would happen if they jumped off the railing of a tall balcony. This does not necessarily mean they are a danger to themself. For people with passive suicidal ideation, meaning they think about what would happen if they were dead but not necessarily on taking action, these sorts of thoughts can function as a self-soothing mechanism -- a fictionalized escape from an unbearable present moment.

Calculating the Risk of Suicide is Complicated

Passive suicidality can usually be addressed safely through open communication, validation, and safety planning. Rushing a person with passive suicidal ideation to the hospital would likely cause them to distrust the mental health system, be less open in the future when they might really need help, and open them up to a wide range of adverse experiences in a high control / low agency setting.

On the other hand, once a person has considered suicide, they don't forget it. That's why even if a person has considered a plan, additional information should be gathered. It's kinda like chicken pox; part of the original illness sticks with you the rest of your life, but isn't necessarily active. Nevertheless, many mental health professionals are trained to take extreme measures once a person discloses a plan and means. This just doesn't work well for the reality of chronic suicidality. We at Willow & Leaf Counseling complete thorough suicide assessments to ensure that people maintain as much agency and control over their treatment while staying safe.

How to Reduce the Risk of Suicide Attempts

There are lots of things that can function as resilience factors to protect a person from suicidal thoughts. Having a positive relationship with a support system (whether organic or professional) is a great start. Research has shown that owning a pet or practicing a particular religion can also mitigate risk of completing suicidal actions. I tell a lot of my clients with chronic suicidal ideation to treat the thoughts like a stinky rotten egg someone has gifted them. Hold it, acknowledge it, then put it down and move on. Arguing with these thoughts can actually perpetuate them and make them grow. It's like holding the egg as far away from you as you can reach or punching it several times between your hands -- at the end of the day it's still in your hands. You got to learn to redirect your thoughts when suicide crosses the mind.

If I Could Say Just One Thing to Someone Who Is Suicidal

Everything is temporary. I'm glad you're still here.

About the Author

Image of Jordan Dobrowski, LCSW: white woman in mid twenties with a nose ring

Jordan Dobrowski is a Licensed Clinical Social Worker and Certified Psychedelic-Assisted Therapy Provider with experience providing psychotherapy to youth and adults in both English and Spanish. She received her Master’s in Social Work with certificates in Trauma-Informed Care and Culturally Responsive Mental Healthcare for Immigrant Families from the University of Chicago in 2018. She currently teaches with Naropa University and the Integrative Psychiatry Institute in their psychedelic clinical training programs. She is the founder of Willow & Leaf Counseling, and the executive director for Kaleidoscope Psychedelics — an organization working to improve psychedelic therapy access for BIPOC, queer, and neurodivergent folks in Chicago.

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