How Suicidal Feelings Manifest in Young Men—Including Myself

Depression and anxiety have been parts of my life for at least a decade. They ebb and flow. Sometimes one will be more prominent than the other, while other times they’ll both be quite high. Sometimes, both feel manageable.

I began taking Prozac (fluoxetine) in 2018, when I was 19 years old, and was on the antidepressant for three years. I’m not currently taking any medication for my mental health, but I am going to therapy twice a month, something that’s been a great help. I find that unloading on someone for an hour once every couple of weeks makes my mind feel a lot lighter. And as I’m talking through things, sometimes I’ll come to solutions myself, or suddenly a worry won’t seem quite so serious once I’ve said it out loud.

While it was a period of particularly low mental health that culminated in me taking medication, I didn’t make any serious suicide attempts. It was more that I didn’t feel bothered about whether I’d live or die. I’d take more risks. I began smoking regularly—previously, I only smoked on occasion because I was worried about the potential health effects, but the risks weren’t something that bothered me much anymore.

Even with something as simple as crossing the road, I might have moved in a slightly slower fashion, or taken less care in terms of healthy eating and getting enough exercise, something that I know definitely helps my mental health.

I couldn’t really see an end point at which I’d feel better again. It was between my first and second years of university, and every day was the same. I’d wake up, make a coffee, and then more often than not, stay in bed re-watching a sitcom I’d seen myriad times before. It was a sort of limbo. I wasn’t making plans to end my life, but I didn’t feel as though I was really living my life either.

I found that getting my doctor to prescribe me antidepressants was difficult, too. Getting help as a young person was difficult, with waiting lists for therapy and what seemed to be a reluctance to put people on medication. There were a lot of “here’s a website to look at” or “have you tried going for a run?”.

When talking to my doctor, it was difficult to get the balance right between making it clear that I really needed help and wasn’t doing well at all, and not giving the impression that I was actively suicidal.

Fortunately, my antidepressants did help. Sure, there were side effects, and it wasn’t always easy to deal with the overall lack of emotion, but it got me through a difficult time that coincided with getting my degree and finishing university.

Sometimes, even now, life gets tricky. I’ll have a fleeting thought cross my mind that suicide would be a way out. But it’s not a thought that remains for very long. For a long time, it’s been a sort of coping mechanism—knowing that there’s a get-out clause of sorts—but that’s something I’m working hard at unlearning.

I’m not alone in my feelings, and there’s even a name for it: passive suicidal ideation. In short, it’s when somebody thinks about death, or even wishes for death, without actively making any plans to end their life.

Somebody with passive suicidal ideation might have thoughts of wishing that they were never born, that their family or friends would be better off without them, or even that the vehicle they’re in crashes, even if they wouldn’t actively cause an accident themselves. It differs from active suicidal ideation, in that people with the former aren’t actively planning to end their lives. However, passive suicidal ideation can become active over time.

It can be helpful to think of suicidal thoughts as existing along a spectrum. For some people, they’ll be passive. For others, they’ll be active. For some, it might be a combination of the two, or they might move from passive to active.

According to the American Foundation for Suicide Prevention, suicide is the 12th leading cause of death in the U.S., with 1.2 million suicide attempts across 2020. In the same year, men died by suicide 3.88 times more than women.1 This doesn’t necessarily mean that men are more suicidal, but can mean that men more often choose more lethal methods of suicide.

In England, where I’m from, 795 men in my age group (20–24) died by suicide across 2019, 2020, and 2021. While we might not be the age group most affected by suicide overall, this does mean that roughly 1 in a little over 2000 men aged 20–24 die by suicide in England. In short, it’s the biggest cause of death in people under 35 in the U.K.

Let’s face it, it’s not the easiest of times for young people. The Mental Health Million Project’s Mental Health Report suggests that the mental health of young people both in the U.S. and across the world is declining. They mention social media as a factor, but it’s not the only one. Somebody born in the 1990s has lived through the global financial crisis of 2007–08, one of the biggest global pandemics ever, and major political upheaval. It’s understandable that the mental health of young people as a collective might not be fantastic.

And for young men in particular, it can be difficult to reach out.2 Men can be socialized into a mindset of self-reliance or might feel as though they have to be strong for others around them—whether for their partners, children, family members, or other loved ones. They might feel ashamed, or try to ignore how they feel—both of which have the potential to be more damaging than seeking help.3

And then when men do reach out, is there any guarantee that they’ll get help? Even if you’re dealing with the most well-meaning professionals, there can be lengthy waiting lists or costs associated with treatment. In the U.K., different treatments aren’t always equally available across the country, so the help you get might depend on where you live. Perhaps, for this reason, passive suicidal ideation can serve almost as a release, or a distraction, rather than getting serious help. But this can be dangerous.

I’m in a position of relative privilege. While I struggle with my mental health, and might always do so, I have a supportive family and some great friends, and I’m in a financial position where I can pay for therapy; I’m no longer at the behest of waiting lists. Yet, I still don’t find it easy.

It’s a difficult time for many people, regardless of age and gender. But for young men like me, it can be hard to reach out and get help with suicidal feelings and thoughts, even if we’re not necessarily planning to act on them. I’m glad I did; it might have saved my life.