This is really interesting and eloquently written. I just finished reading a book called "The Suicidal Mind" by Edwin Shneidman. He wrote that people become suicidal because of a psychic ache, from thwarted psychological needs. You write that when you are suicidal you want to die, and I was wondering if you have identified the why behind it. Sometimes I have the feeling that everything in life is meaningless and trite and the feeling is, "Why bother? People's little bursts of happiness are short-lived and shallow. This is what I would call my own version of existential angst morphing into suicidal mind. But I have never made any attempts and frankly it seems like it is actually rather difficult and complex to orchestrate a successful suicide. To attempt it and botch it and end up worse off than before seems to me a true nightmare.

So I have never made a "plan" although I have contacted others to let them know how I am feeling. At this time I have an appointment in a month with a psychiatrist because my primary care doctor did not seem to be responding to my emails that my agitated depression was increasing alarmingly. I am proud of myself that I started to reach out for help, even if this is often a frustrating process. It kind of broke the little bubble I was living in, and I think that is what causes suicidal ideation to move towards planning, although I don't know this for sure.

I can relate to what you wrote about wanting to die because of wanting to end pain. I am sorry you deal with chronic pain. I would not be a very strong person if I had to deal with that. I am in awe of people who battle chronic pain, terminal illness etc. However, I do deal with mental pain. I think I have dealt with it my whole life. I usually get through periods of intense mental pain with a variety of things such as medication, therapy, and mainly waiting it out. My experience with mental pain fits your "wanting to die to escape pain" model to a tee.

I am happy you brought up about the alcohol. Some people have pointed out to me that alcohol is a central nervous depressant and therefore does not really contribute to depression. I am not even certain if alcohol goes directly to the brain. I mean, does it pass brain barriers? (Okay, I just looked it up...and it does go directly to the brain because the brain is part of the central nervous system. I was talking to someone recently who kept saying that the brain wasn't part of the central nervous system, so it got me confused.)

I know one thing...I am battling a virulent period of depression right now, and abstaining from alcohol helps. Also, sugar, junk food and the like.

Addiction is a whole other kettle of fish. This person could experience his depression getting worse after stopping alcohol because than the personal issues the alcohol use were masking are now unmasked and are there to deal with.

Bezodiazepines are now being prescribed to people who are in alcohol withdrawal. Don't know if that is a good idea, but it is a new treatment out there...