I think that for some people, it can get better, even if it doesn't feel like it now. That's why I think it's good to exhaust every other option first, before deciding to ctb.
Sometimes, there's a fixable explanation behind the urges, like a hormone imbalance or even vitamin deficiency. Low vitamin D levels actually do make you suicidal and depressed, and so do low thyroid hormones (I know both from experience). And those are totally curable.
But sometimes it's not a correctable situation. People do have chronic or terminal illnesses that won't get better, and there are bad situations that just get worse. Trauma, physical conditions... A lot of things just won't get better.
Anyway, I've been trying everything I possibly can to make sure I can't fix this, because I really wish it didn't have to end this way. But sadly, nothing has worked and I'm just spiraling deeper. It's nearing the end for me. At least I know it's not an impulsive decision. Sometimes, I break down and want to act right away, but I resist the urges because I know I need to be clearheaded when I actually do it. And there are things I want to wrap up first.