I agree with Rap - very interesting questions.

I SI, and I have been suicidal. The way I tell the difference is my intent.

For me, there is no answer for your 2nd questions, as my family doesn't know that I have big problems - that I see a shrink and on meds. I have absolutely no support for my mental illnesses - they think I can 'fix' myself and that if I'm depressed or something, it's all my fault. They also believe that I'm wasting the shrink's time and the government's money for seeing shrink.

However, I think that sometimes, the way our loved ones know that we have gone beyond wanting just comfort is to tell them - using words, either verbally or written. They don't read minds, and they don't know the 'signals'.