This article presents biological meta-theory that is intended to serve as a shared key to progress in psychiatry and suicidology. It argues that diverse forms of psychopathology, widely believed to cause suicide, may instead manifest the organism’s last-ditch efforts to avoid that lethal outcome. The analysis elaborates on the pain-brain theory, which views suicide as a costly by-product of human sapience, with the cost managed by serial lines of evolved anti-suicide defenses. The last of these, emergency interventions that function to block the enacting of suicidal ideas, are hypothesized to display in an array of psychiatric phenomena, including mood disorders, substance and behavioral addictions, and psychoses.The etiology of psychiatric syndromes is explained in three parts. First, psychopathology associates with suicidal ideation because the two outcomes share a causal root: the individual’s experience of chronic psychological pain (psychache), subject to a threshold of intellectual maturation. An evolved system utilizes these inputs to evaluate the risk of suicide and to release commensurately severe countermeasures, which manifest non-specifically as psychopathology. Second, the configuration of symptoms is determined by other aspects of individual differences: reflecting contextual needs, individualized blends of motivational and/or cognitive modifications seek to make lethal escape unnecessary and/or impracticable. Third, psychiatric syndromes can be understood as often-observed, heterogeneous clusters of anti-suicide symptoms, combined with psychache and side effects.The model integrates ultimate and proximate explanation, aligns with the epidemiological record, and yields testable predictions. It offers foundations for advancing research, policy, and clinical practice in suicide prevention and mental health.