There is a disturbing trend taking place in therapy offices, intimate gatherings, private conversations with trusted individuals, and among teens and young adults. This trend is hidden in plain sight and yet I haven’t yet read much about it. Is it new? Is it just too disturbing? Or, is everyone looking in all the wrong places when discussing the COVID-19 pandemic, masks, politics, and social unrest? Perhaps we are not looking more deeply into the mental health consequences of COVID-19. We know there is more reported depression, anxiety, substance abuse and dependence, and a mountain of loneliness. There are more relational issues and parents are struggling with children and the dilemma of what will happen when school begins, if it does, in the fall. People have become afraid of one another. Indeed, Americans are suffering from Pandemic Shock, which may be a new variant of PTSD. It certainly appears to have all the signs and symptoms.
As we look at and attempt to support people and their mental health needs at the time of this pandemic the issue of suicide has emerged in an odd manner. I say odd because it is a different take. Let me explain.
A number of people including clients, friends, associates, and more socially distant acquaintances have mentioned the C Word. COVID. They say they actually wish they would contract COVID-19. Initially I was a bit shocked, but this was quickly followed with the scientist in me the wanted to hear and understand more about what was being shared.
What is passive suicide? Passive suicide is when a person has thoughts of death or dying but generally has no plan and doesn’t plan to take any action toward ending their life. Or, passive suicide is when people think they would be better off dead. We also hear people saying they don’t really feel invested much in life. The twist here with Pandemic Shock is hearing people say they do not plan on taking any action to prevent harm to self.
Passive suicide is reported more often among middle age and elderly populations. In a 2019 study by Dong and Gonzalez they found 10-13% of adults fifty years of age or older had passive suicide ideation. Ideation refers to ideas or thoughts of. In middle or older age groups suicide rates are higher and passive suicide ideation, which is a Red Flag, is also higher.
Passive suicide can be not putting on a seatbelt. It can be driving too fast and simply not caring. It can be drinking and driving fast and not caring. It involves taking risks. It encompasses a reference point of ‘I don’t care’ or ‘Who cares.’ Passive suicide might even apply to not wearing a mask or otherwise exposing oneself to the COVID virus unnecessarily. It likely isn’t socially correct to say, “I think I will expose myself to the virus and hopefully get it and die.” That statement is a bit edgy. But, if one says they are not wearing a mask because the virus isn’t real, or everyone is making too much of it, or even that mask wearing is evidence of cowardice or of a political position you gain latitude and permission.
The people I hear speaking about COVID-19 and ‘who cares’ all have clinical depression. It fits. We talk about it. We attempt to stay on task and work through this in therapy. But what about all the people who are not seeing counselors?
We don’t want to make the mistake of assuming everyone is talking about the same thing. A person who is suicidal and passively suicidal can hide in plain sight. They can hide under the cry of politics, to mask or not to mask, or other position taking that has some social acceptability. They don’t have to feel strange or left out, which may be an underlying aspect to the passive suicide composite within. They can be a part of something bigger and if they die from COVID-19, one woman said, “It would be an acceptable way to die. Think of it. ‘She died of COVID. Poor Kathy.’ Better that as a legacy than Kathy killed herself.”
Think about your positions. Think about what friends and family are saying. It is likely you are all on the same page. But what if you’re not. If you have a friend, co-worker, family member, or loved one who has any history of depression or other mental health concern, it is important to listen carefully and not assume you and this other person are really speaking about the same thing. Suicide risk comes in many forms. Passive suicide is real and it is a red flag. Passive suicide hides in plain sight.
If you are depressed or suicidal or you know of someone who may be please seek help from your local guidance center, local counselors, your primary care provider, the emergency department of your hospital, or call one of the numerous local or national hotlines for helps.
Stay safe. Be well. Pay attention.
Nanette Burton Mongelluzzo, PhD