Living beings are by their nature actively self-preserving agents. But their ability to make choices includes the ability to make the choice not to be.
Sometimes you feel like you want to reach in with a taloned hand and rip out your own guts. To rend and desecrate your body, to destroy yourself. Not as any form of release but just as violence against onself, the one enemy one can never escape.
The greatest threat is to not recognise this impulse and be surprised by it. The more you deny the forces inside you, the more they control you. Knowing about them might not be enough to control them, but it is a start to rebuild oneself, to make defences, to ensure consistency.