He's griefing upon his killings. But he also felt good since he loathed Alex, he doesn't want to deal with his existence. He believes that by killing him, he need not deal with him any longer. So, in my understandings, the last scene is unfolding his nature of trying to swallow his sorrows and accept everything that was done. Although I don't think he will kill himself—maybe he regrets it and is trying to endorse the fact that his loved one is dead, and that he had committed homicide.
Although I'm a little late, I think it's just back to the beginning. Do you remember how Clark mentioned that all murderers said that they were all miserable or were "falsely" happy? When the inspector asks Clark if he's okay, he responds "it was for revenge" with a smile and with that kind of response, you'd assume that yes, he's okay but no, the ending shows us that no he isn't and that he's pathetic.
I liked the little "teasing" (about how the fish he took because of the doc were still alive even if he wasn't there to take care of them but his dear friend he tried so hard to save was already dead with only his finger remaining) and also, like Alex said, Clark is stubborn, even until the end, he tells him he hated him and that he didn't love him (that scene kinda reminds me the first murder), Alex was falsely happy with his delusions and Clark was kinda right, as if to prove his point from the beginning...
But I don't think he would kill himself, well we dunno, to me, it seems like Clark still had lingering feelings towards doc (more so than friendship) so he could kill himself out of remorse and guilt but I believe he wouldn't since it isn't his "style", we already saw that even when he was intimate with doc, he had trouble confiding in him, he seems the type to only keep things to himself and go on like everything's fine.

Can someone explain me the ending? Like what're your thoughts? Did Clark killed himself?