It’s Not Just a Bad Mood: Let’s Talk About Passive Suicidal Ideation This September

Canva Pro Image 

by Jessica Garrett, Ph.D., LP, NCSP 

September is Suicide Awareness Month, and while the conversation often focuses on crisis plans and active intent, there’s a quieter, more pervasive struggle I see far too often in my practice: passive suicidal ideation.  It’s not about planning. It’s about a deep, bone-weary exhaustion with life itself. I once had a patient put it more clearly than any textbook ever could: “If I could just flip a switch and turn it all off, I would. But I’m  not, like, actively suicidal or anything.” That sentiment – the wish to just not be here anymore, to disappear without a trace, to have it all just stop – is incredibly common. And it’s dangerous to ignore. 

This Isn’t a Niche Problem. It’s an Epidemic of Exhaustion. 

If you think this is rare, think again. A recent, sobering KFF/CNN poll found that a staggering 90% of adults in the U.S. believe we’re in a mental health crisis. The data paints a grim picture of a nation drowning in stress, anxiety, and profound loneliness. This is the fertile ground where passive ideation takes root. It’s the logical, albeit terrifying, endpoint of feeling chronically overwhelmed and disconnected. This crisis is particularly acute right now, especially for our youth. It’s not just a feeling; it’s a well-documented pattern.  Studies, including research published in the Journal of the American Academy of Child and Adolescent  Psychiatry, have identified a heartbreaking trend: suicide rates for teens and young adults consistently peak in the fall. The unstructured freedom of summer is replaced by rigid schedules, academic pressure, and the need to navigate complex social hierarchies. For any teen, this is a heavy lift. For a neurodivergent brain already struggling with regulation and executive function, this transition isn’t just stressful; it’s a full-blown assault. 

The Snowball Effect: How Executive Dysfunction Fuels Hopelessness 

In my work with neurodivergent families, I often talk about the “snowball effect.” It starts small. For someone with unrecognized or untreated ADHD, their brain is already working overtime. They are  “dysexecutive” – meaning the brain’s management system that handles planning, organizing, and initiating tasks is impaired. It’s not a matter of willpower; the engine simply won’t turn over. This makes even simple tasks feel monumental. The laundry piles up. Emails go unanswered. Bills are forgotten. Each uncompleted task adds a layer of shame and failure. This feeds depression, which in turn further depletes executive functioning. Now, not only is it hard to start tasks, but you also lack the motivation and energy. You know you should go for a walk, stop doomscrolling, touch grass, call a friend, or cook a meal – the very things that could help – but the chasm between knowing and doing feels impossibly wide. The snowball gets bigger and faster, gathering more shame, more isolation, and more hopelessness until you’re buried. The desire to just “turn it all off” isn’t a flaw; it’s a sign of a nervous system that has been in an unwinnable battle for far too long. 

The Research is Clear: Neurodivergence is a Major Risk Factor 

And the research confirms just how brutal that battle can be. This isn’t just a theory; it’s a statistical reality backed by a growing body of devastating research. A landmark 2019 study published in JAMA Psychiatry found that adults with ADHD have a significantly higher risk of suicide attempts. For the autistic community, the numbers are even more stark. Research from Sweden’s Karolinska Institutet revealed that autistic adults without a co-occurring intellectual disability are nearly ten times more likely to die by suicide than the general population. 

Let that sink in. Ten times. This risk isn’t abstract. It’s the direct result of a lifetime spent navigating a world not built for your brain. It’s the exhaustion of social camouflaging – the constant, high-effort performance  of appearing “normal.” It’s the intense, gut-wrenching pain of Rejection Sensitive Dysphoria (RSD) in  ADHD, where perceived criticism feels like a catastrophic wound. It’s the emotional dysregulation that makes feelings of hopelessness feel absolute and eternal. For both teens and adults, this leads to a profound 

sense of alienation. When you feel fundamentally different from everyone around you, loneliness becomes a constant companion. Passive suicidal ideation, then, becomes the brain’s desperate cry for a ceasefire—a break from the relentless performance and the overwhelming emotional static. 

What to Look For in Your Loved Ones (and Yourself) 

This snowball effect often hides in plain sight. It sounds and looks like: 

– “I’m just so tired of everything.” 

– “I wish I could just go to sleep and not wake up.” 

– “It wouldn’t matter if I wasn’t here.” 

– Joking about disappearing or dying. 

– A noticeable withdrawal from people and activities they once enjoyed. 

– A significant drop in executive functioning: mail piling up, hygiene declining, missing appointments. 

A Note for Parents: Navigating the Pushback 

It’s one of the hardest things in the world to watch your child struggle and have them push you away when you try to help. In teens, depression and passive ideation often look like anger, defiance, or extreme irritability. They shut the door, put in their earbuds, and live behind a screen. 

What to look for in your teen: 

– Irritability that looks like disrespect. A short fuse and constant arguments can be a mask for deep pain. 

– A drop in executive functioning. Their room is a disaster, they’ve stopped showering regularly, and their grades are slipping. This isn’t laziness; it’s a sign of being overwhelmed. 

– Abandoning things they once loved. They quit the soccer team, stop playing their guitar, or no longer hang out with their core group of friends. 

– Increased isolation. They spend all their time alone in their room, often online. 

How to help when they won’t let you in: Your job isn’t to fix it; it’s to be a stable, loving presence in the storm. 

– Use “shoulder-to-shoulder” time. Don’t force intense, face-to-face conversations. Talk while you’re driving, doing dishes, or walking the dog. The lack of direct eye contact can make it easier for them to open up. 

– Observe, don’t accuse. Instead of, “Why is your room such a mess?” try, “I’ve noticed it seems hard to keep things organized lately. It looks like you’re feeling overwhelmed.” 

– Be their external executive function. For a neurodivergent teen, this is crucial. Don’t just tell them to do their homework. Sit with them. Say, “Let’s just find the assignment together. That’s all we  have to do right now.” You are lending them your brain’s prefrontal cortex when theirs is offline. 

– Hold boundaries with love. It’s okay to say, “I love you too much to pretend I’m not worried. We  are going to see a therapist together because your well-being is not negotiable.” You are the parent.  You can, and should, insist on professional help. 

– Validate their reality. One of the most powerful things you can say is, “It makes sense that you’re exhausted. Your brain is working so hard just to get through the day.” This is the antidote to shame. 

What to Do: Rebooting the System When You Have Nothing Left 

As someone who has navigated my own struggles with depression and executive dysfunction, I know that  “just reach out” can feel like being asked to climb a mountain. When your activation energy is at zero, the goal is to stop the snowball’s momentum. 

Here are concrete strategies:

– The 5-Second Rule (for your body, not your food). The moment you have an impulse to do  something—get water, step outside—physically move within five seconds. Don’t think. Just move.  Put your feet on the floor. The goal isn’t to complete a task; it’s to break the inertia. 

– Externalize Your Brain. Your internal manager is offline. Outsource it. Use timers for everything.  Set an alarm for 10 minutes to stand outside. Use a sticky note on the mirror that says, “Brush  teeth.” Let technology or paper be your brain for a while. 

– Task Pairing. Pair something you have to do with something that provides even a flicker of  dopamine. Listen to a specific podcast only when you take a walk. Watch your favorite comfort  show only when you’re folding laundry. 

– Focus on Sensation, Not Accomplishment. The goal isn’t to “feel better.” It’s just to feel something  else. Splash cold water on your face. Touch grass: step outside without shoes and feel the ground.  Hold an ice cube. Eat a sour candy. These tiny sensory inputs can briefly interrupt the feedback  loop of hopelessness. 

The First Step Back: The Power of an Accurate Diagnosis 

Here’s the thing about the snowball: you can’t stop it if you don’t know what started it. Getting an accurate  diagnosis and understanding that the root may be ADHD, depression, or both is often the most critical first  step. It’s not about getting a label; it’s about getting a roadmap. It reframes the narrative from “I’m a failure”  to “My brain works differently and now I have the tools to work with it.” 

And here is the most important part: just as these symptoms build on each other, they also recede together.  When you start treating the ADHD, your executive functions improve. It becomes a little easier to start a  task. Completing that task provides a small hit of dopamine and reduces the shame. With less shame, the  depression lifts slightly. With a lighter mood, you have more energy to try the next thing. The snowball can  melt. There is hope. 

If thoughts become more intense or you feel you are in immediate danger, do not wait. – Call or text the 988 Suicide & Crisis Lifeline. 

– Text HOME to 741741 to connect with the Crisis Text Line. 

– Go to your nearest emergency room. 

This September, let’s broaden the conversation. Let’s acknowledge the quiet desperation of wanting to  disappear and treat it with the seriousness it deserves. Checking in with someone, and truly listening, is one  of the most powerful things you can do. 

Dr. Jessica Garrett is a clinical and school psychologist, mother, wife, and the Director of the Center for  Psychological Assessment at Birmingham Maple Clinic in Troy, Michigan where she has been practicing for over 10 years. With a background that includes classroom teaching, school psychology, and  university instruction, she works alongside neurodivergent individuals and families to help them  navigate life’s challenges with warmth, humor, and a human touch. Dr. Garrett is often described as  down-to-earth and approachable and she aims to make even the toughest conversations feel comfortable  and manageable. She regularly contributes to discussions on mental health and education in the media  and believes that real change happens when people feel truly seen and heard.