Not sure how they could describe suicidality more clearly. Speaking as someone who has also experienced it due to chronic health conditions that had gotten particularly bad for a while.
While mine were not health-related they (the stressors) were equally as bad and ran on for years; I am naturally an optimistic person and have no addictions, and I live healthily; even so, the only reason I didn't take my life was because my religion expressly forbids it (doomed to Eternity if).
It might start off with self-sabotage and end up in suicidal thoughts-- but also, maybe self-sabotage is yet another way to cope with extreme stress?
Given that Poe had chronic stressors (financial, for one), maybe his drinking and self-sabotage were the kind of responses his brain would generate. Even though he himself calls them "perversity", it doesn't negate the fact that he was experiencing severe brain damage due to the constant stress.
The TFA also elevates Freud into the discussion, but most if not all of Freudian ideas have been empirically refuted (thanks to the new advances).