Suicide is an escape reflex. Thoughts of suicide are the real problem. In suicidality, there is a perpetuation of thoughts of suicide that may or may not lead to the actual attempting of taking one’s own life. Much like the difference between clinical depression and that kind that everyone else feels. According to the DSM IV TR, for depression to be noted as a disorder, there must be depressive symptoms daily for over two weeks. Suicidality is comparable in that it must be chronic thoughts of suicide, not just an impulsive desire to escape. For example, people with bipolar disorder are more likely to commit suicide because they go from one extreme pole (mania) to another extreme (depression). After having experienced such an extreme “high,” any kind of low will be grounds for killing themselves. This is then suicide as an escape reflex. One who has suicidality will be more likely to wonder what their funeral would be like or be more than curious about running the next red light. However, they won’t. Instead they are tortured by these thoughts. Like a time-bomb, stress will become too great and they will likely take steps to carry out killing themselves. This is not without seeking an escape from this intensified torture. That is the irony in suicidality; their escape reflex before attempting suicide will be trying to live, contrary to suicide being an escape reflex.
However, there are circumstances where accidental death may occur. In these cases in particular, an individual engages in a knowingly reckless activity and the outcome just happens to be the cause of their demise (see Darwin Awards, 1,000 Ways to Die, etc.) Under these circumstances, would that individual be considered as having suicidality? I am thinking no, but perhaps it depends on the context of that situation. As an example, consider some of the stories of the recipients of the medal of honor. These individuals put their lives in danger for the good of their country/squad/etc. Equally, we can look at the radical Islamic group Al-Qaeda and their support for martyrs to commit suicide in the name of Allah. Or even Christians who die for their beliefs. What drives a person to knowingly engage in something that can, and sometimes does, lead to their demise?
I know there is an aspect of a “rush” or a feeling of exhilaration when jumping off of a cliff into water below but what I am curious about is if that same person tends towards a personality trait or something…being impulsive does not mean suicidal. Being diagnosed with Suicidality does not mean suicidal, either. But, impulsion and Suicidality are not exactly telling of each other; it does not matter. Impulsion comes out of positive reinforcement.
As someone does something risky (cliff jumping example), what happens is glucocorticoids are released, stimulating the adrenal glands above the kidneys. As this occurs, one can experience a response we know as “fight-or-flight.” One who experiences this response followed by a rewarding stimuli (landing in water, surviving, etc) then could cause a release of endorphines which stimulate the production of dopamine, thus, reinforcing the impulsive behavior (someone do an experiment on this!!). This could then lead to an association that danger = pleasure in the individual’s mind. Everything will be okay throughout this process because I am safe and nothing can go wrong. I have done this so many times before. As the mind generalizes the above two statements to other scenarios, we can see a development of impulsivity (think little Albert and the white rabbit). This is the difference from Suicidality; where the presence of an ambivalent escape response is evident in one, a tendency towards risky behavior is present in the other.
Therefore, suicide, contextually, is an escape response. On one hand, suicide is escaping from stressful or negative situations which could either have been chronic or recent. On the other hand, accidental deaths where the individual has killed them self arises out of the positive association between risky behavior and pleasure.