Willful Sleeplessness

I have been very willful about not going to sleep at all last night, but instead spending the night inventing a steel muzzle for my dog, since the laws here require some kind of muzzle here and my dog has broken muzzles made of leather, light steel, and cloth. So, I'm welding something together that unfortunately looks much like tool of torture, but my intent is simply to keep her from being sacrificed by the police or dog catchers.

Suicidal Sleep and Wakefulness

During certain periods, I think about suicide all day long; I go to sleep ruminating about it, and I awaken ruminating about it, picking up precisely where I left off. I didn't have that experience last night or this morning. And my surfing on the Internet before I slept did not depress me so much that I was angry and wanted to die.

Speaking all of which, I guess I should go and take 100 mg. of sertralina /sertraline (Zoloft) and 100 mg. of carbemazepina /carbemazepine (Tegretol/Tegrex), as my first dosages of these medicines for the day. Did I already take them? I can't remember, but a little bit extra is unlikely to hurt me.

I Slept Soundly Until the Phone Rang

Well, last night(actually at 4 A.M.) I convinced myself to sleep by downing four times the regular quantity of clonazepam. Don't do this at home! That and printing some pages from the New York Times and taking them to bed with me for reading is what allowed me to sleep, and in pretty short order.

In fact, I probably would have slept hours earlier had I just taken the New York Times to bed with me, but a symptom of manic depression and hypomania is the unwillingnesss to sleep, even when we feel tired.

A condition seen on rare occasions is “chronic hypomania,” in which people habitually sleep less than 6 hours a night, are constantly too enthusiastic, too busy, full of plans, and full of restless impulses. Essortment.Com

Early this morning, around 2:00 AM, a man came from the gas station across the street and asked if I was sawing something, because it sounded like perhaps my house was being robbed. In fact, I was sawing off two of the legs of my bed to make them equal to the other two. (All four legs need to be 50 cm (twenty-five inches or so), so that I can store all of my junk beneath the bed.) I guess those count as "restless impulses", since few others can be found sawing off the legs of their beds at 2:00 AM, in a manner that attracts the attention of the neighbors.

This is a longstanding impulse. When I was 19 years old (27 years ago), the neighbors called the police because I was sawing studs to renovate my bathroom at three in the morning. Some things never change and some only change with great difficulty and psychoactive drug intervention.

At nine this morning, the phone rang, and just as well because various people were looking for me, to charge me for my accounts and etc. I don't feel as though I took 8 mg of clonazepam last night, just six hours ago.

Why Hasn't the Clonazepam Put me to Sleep?

Well, it's 3.43 AM and I'm still not asleep, in spite of having taken 2 mg of clonazepam at 10:00 P.M., before I went to my friends house, with my dog, for dinner. I imagined that taking the pill before I went out would give me a chance to come home good and tired and sleep, but I was apparently wrong.

They say that clonazepam can cause "depressed mood, thoughts of suicide or hurting yourself", but I had these before I took clonazepam, and these symptoms don't seem to have gotten any worse, although they sometimes get as bad as they were pre-clonazepam. Drugs.Com

Sometimes, out of frustration with life and a vague desire to hurt myself, I take three or four Clonazepam tablets at a time. But, I've read that some people have taken sixty at a time and lived to tell about it. The risk is of addiction and increased tolerance - risks I can't do much about, and risks that are perhaps not as dangerous as going night after night without adequate sleep.

Less serious clonazepam side effects may include:

• drowsiness, dizziness, spinning sensation;

• memory problems;

• tired feeling, muscle weakness, lack of balance or coordination, [etc.] Drugs.Com
  

I've felt all of these symptoms. Often, we have to climb high hills in this neighborhood, and my friends don't understand why I climb with such torpor. I've read the side effects of these medications to my closest friends, with some success.

It says here that Clonazepam should only be taken for a short time, like nine weeks. "Clonazepam should be used for only a short time. Do not take this medication for longer than 9 weeks without your doctor's advice. " I've been taking it for a year. I'll have to ask my psychiatrist if that's something we should be concerned about. I'm not terribly afraid of becoming addicted to drugs anymore. I figure that the risk of killing myself (or somebody else) without them is a more immediate concern. But, I'll ask my psychiatrist anyway.

Rivotril and "Klonopin" are just other names for Clonazepam, and everyone knows that Klonopin is for kooks beyond redemption. I guess this means I am either a kook beyond redemption, or I've had a prejudice against Klonopin that was unwarranted. Neither would surprise me.

Well, to help me sleep, I tool another six milligrams of clonazepam. It's a desperate act that falls somewhere between medication and a futilely inadequate suicide attempt. I've taken ten before and not fallen asleep, so I know that three won't kill me. All I need to do is get into bed with something to read and I will fall asleep. So, why am I being so resistant, so stubbornly resistant, like a child who fights sleep until it overtakes him like an irresistable tidlewave.

I used to feel anxiety at not sleeping because of my many responsibilities of the following day. Now, I've reordered my life so that the biggest consequence of not sleeping now will be sleeping later, when everyone else is awake, going about their business. Perhaps I should take twelve more clonazepam tablets? Perhaps I should read myself to sleep?

Is My Wife Cheating on Me?

I've moved sixteen hours away by bus to get away from my stepson, because he and I simply don't like each other, and I don't like living with him. In the process, I have had to leave my wife and two stepdaughters behind.

So, when I am away, does my wife go out with other men? There's really no way for me to know, except to ask her and hope she tells the truth.

I chat with other women. If my wife finds another man, I hope she tells me simply, so that I can go on with my life without too much emotional disruption. I can accept it if she needs the comfort and support that I can't give her from so far away. I can accept it if I need a living circumstance that living with my wife cannot provide. I just want to continue to be friends, without rancor, as I am with other ex's.

So, I want her to be honest with me about what's going on, even if I soft-peddle much of my activities so as not to alarm, hurt or anger her, or needlessly arouse her jealousy.

My Blog Site Meters Are Depressing

Unless I make a grand effort to attract traffic to this and my other blogs, a few visits a day is normal for me. Are people uninterested in what I have to say? Have I become irrelevant and worthless? Nugatory?

I write because I need to express myself, regardless of how many people read what I've written. And yet, I've realized that I check my site meter at this and my other blogs to see if I still mean anything to anyone. And when I discover that my popularity is sinking, that fewer and fewer people are reading my blogs, that's yet another reason for depression.

I'm failing, in a way, because of my success. This interlinked incubator for voices that I have helped create has created so many voices and given them such prominence that mine has become just one of a cacophony. The band has become so large, that my flute is barely heard, and rarely do I set the rhythm with the drums. It's democracy that makes me only as important as my colleagues perceive me to be on any given day.

So, I've stopped making my blog meters an obligatory stop on my daily surfing. If someone reads, fine. If not, I have expressed myself to myself, researched and ordered information in a way that is meaningful to me and, like masturbation, it need not give anyone else an orgasm to have achieved its purpose.

How I Made My Dog's Muzzle for Two Dollars

In this new town in which I live, large dogs like mine have to wear muzzles, by law. I have gone through four muzzles and countless collars for my full-grown German Shepherd, because she simply doesn't like them. She pulls on them until she tears their fiber and/or steel to shreds, or until I lose all desire for walking with her. She bucks like a bronco that can't be broken.

Many people have suggested choker collars, but my dog just pulls until her throat is sore and infected, and needs medication. She gave herself a week-long fever this way, requiring medicines, baths, and respite from all collar use entirely. Store-bought chokers and collars and muzzles simply are to uncomfortable and unsufferrable to work on my German Shepherd.

Yesterday, I bought a six-inch piece of 4-inch diameter PVC pipe (typically used for downspouts and waste pipes, and I drilled some quarter inch holes in it. I threaded it in various ways with 3/16 inch steel cable, covered with plastic (available at most hardware stores, and I put this homemade four dollar muzzle over my dogs mouth, threading the cable through her collar so that she can't remove the muzzle just by pulling on it.

This is the most comfortable muzzle she has had, leaving her nose completely unencumbered and allowing to drink at will, even with the muzzle on. She doesn't seem to resist keeping the muzzle on even in the house, which makes it far easier to me to spontaneously go walking with her, without fighting her over putting a muzzle on.

I think I will paint her muzzle "Publish Post" orange, so that she will be more visible in the night. She likes to walk ten yards ahead of me, so its safer, right, if she's more visible? I might mix yellow and red paint, or I might save myself some trouble and by some orange spray paint at the hardware store.

Explaining Carbemazepine / Tegretol / Tegrex

One of my closest friends in town, (my barber) came over tonight. I decided to explain to him about my mood swings and about the Tegretol I am taking in an effort to get them under control, ie. stop feeling suicidal every night. Since he wants to learn English, I asked him to read the following paragraph from http://www.minddisorders.com/Br-Del/Carbamazepine.html about carbemazepine, to help him to understand my challenge and my situation:

Recommended dosage

When used to treat seizure disorders or psychiatric disease, the recommended initial dosage of carbamazepine is 200 mg two times each day. If needed, the daily dosage may be increased by 200 mg once each week. Total daily dosages should not exceed 1,000 mg in children between the ages of 12 and 15 years. Total daily dosages for adults should not exceed 1,200 mg. Carbamazepine should be taken with meals. http://www.minddisorders.com/Br-Del/Carbamazepine.html

Wow! I have been taking 200 milligrams of carbemazepine a day for over a year, not realizing that this might be a nearly uselessly small dose. I've been taking one sixth of the maximum recommended dosage, and one half of the recommended starting dosage. I should have talked with my psychiatrist about this months ago, but I was afraid that if I divulged the thoughts that were making me uncomfortable then my psychiatrist might think I should be hospitalized. I'd much rather die than be hospitalized again, after a "bad trip" on on the last occasion.

My barber asked me why I was sharing this intimate information with him, but I told him that in any new town one has to take a small few people into one's confidence. I've chosen him, and two other close friends.

He admitted that he had learned a lot of new words in the process. He said that 20% of the words in the text were new for him, so I said that talking with me about my psychiatric situation is a good way for him to further his English learning. He also thanked me for sharing this confidence with him.

Taking More Tegrex / Tegretol / Carbemazepine / Carbemazepina

Having spoken with my psychiatrist, he says it was always his intention that I take more than 50 mg of Tegrex per day, once I got used to the lowest dose. But, I didn't get back to him about it and stayed on the lowest dose for a year. I thought only kooks would need to take more than 50 mg of Tegretol, which shows another bias under which I've been laboring, perhaps at great cost to myself.

Anyway, I'm going to take 150 mg of Tegrex from now on and see what happens.

I have to get up early in the morning to get a consult at the free hospital, and I am still awake at 23:44 P.M. I will have to wait in line for at least an hour. Meanwhile, I may not get much sleep first, because sleepiness has reached me now, but not overtaken me to the extent of forcing me to sleep.

Since I've been seriously considering cutting my head off with a chainsaw, therefore taking more medicine is a relatively conservative approach to my head problems. "If thy head offendeth the, cut it off." I know I read something vaguely like that in the Bible, but then I don't pay the Bible much attention anymore anyway, so there's no point in relying on it for permission to cut my head off.

I could also take more sertralina (Zoloft) since I am only taking 150 mg per day, while 200 is the maximum recommended dosage and I've heard of people taking 275 mg per day without adverse immediate results.

Hypomania and Sleep Medications

Since I was twelve years old, I did not want to sleep at a normal hour. I preferred to play chess until four in the morning and then try to get to junior high school by 6:45 AM, which was essentially a fool's errand. My lateness and torpor and intellectual and emotional absence at school were foreordained by my (not) sleeping patterns. I typically rolled into school around ten AM and then had to ask at the office what my locker number was and what my combination was.

Who can remember such details on so little sleep? Now, I read that it is a typical symptom of hypomania to find it virtually impossible to sleep until one is simply too tired to keep his eyes open any longer. (I well remember slipping off of my chair onto the floor in science class in seventh grade, because at that moment it became impossible to pretend to be awake any longer.

So, now I take Clonazepam/Clopam an hour before I think I should go to bed. An hour later, my body calls out for sleep with medicine the way others' bodies call out for sleep without medicine. I become greatful to be going to sleep instead of mortally resistant.

Now, the issue has arisen whether a person who takes so many medications should drive a car and operate heavy machinery. I my case, it was far more dangerous for me to do so without these medications than with them. Should an epileptic drive with or without taking his seizure medication? Optimally, he would not need to drive at all, but it seems to me that since the purpse of the medication is to reduce seizures, it's better to drive having taken the medicine than to drive without it. That's just my opinion. I know I'm a safer driver when I'm not actively suicidal or full of amorphous anxiety and unvented fury.

Sertralina / Zoloft: What About It for Me?

Psychosite says this about Sertralina, also known as Zoloft:

Para que serve ?
Suas principais indicações são para o tratamento da depressão e do transtorno obsessivo-compulsivo.

Como é usado ?
Geralmente da dose de 50mg por dia costuma ser suficiente, menos do que isso não costuma ser usado. Quando necessário a dose diária pode se elevar até 200mg por dia. Como os comprimidos têm 50mg fica fácil fracionar a dose ao longo do dia. Deve-se tomar preferencialmente pela manhã.

Although people in Twelve Step abstinence programs often think they are week if they cannot abstain from street drugs without the use of prescription drugs, I found that my obsession with chasing women was reduced considerably and became more manageable when I began taking anti-depressants. I wouldn't be surprised if the same were true for alcohol and cocaine, since so many drug addicts use to hide feelings of depression.

Likewise, I've just read that Tegrex/carbemazepina can be helpful in reducing the sickening effects of going without alcohol in the first weeks. I used to have prescription drugs. Then, I was humbled by my own sickly mind and I became a real proponent of taking the prescription medication that can help a person feel better and get over the hum of detoxification, be it from women, cocaine, alcohol, betting or cat-fucking.

Sertralina is also known as Zoloft. I never wanted to try this drug in my home country, because (1) my second wife took it and she seemed quite nutty, and (2) the name "Zoloft" turns me off. It sees like it's a drug for particularly nutty people, like Clonopin.

And yet, in Latin American languages "sertralina" sounds benign enough, and it also one eight the price for a monthly supply here compared to the United States. That's worth a try. My doctor here told me that it was a new drug in these parts, but it's been around at least ten years in the United States, since when my ex-wife was taking it.

The Brazilian site Psychosite says that 50 mg per day is a normal starting dosage of Sertralina/Zolof, but that 200 mg per day, preferably taken in the morning, is the upper limit. Since I still feel depressed much of the time, I can't see the harm in trying the upper limit and seeing what it does for me. I tend to be pretty resistant to psychoactive medications (I used to take 80 mg of Prozac per day), so it wouldn't be strange for me to need 200 mg of sertralina/Zoloft to get the desired effect.

However, I don't want to change two medications at once (Sertralina/Zoloft and Tegrex/carbemazepine, because if there are negative side effects I won't know which drug (or combination of drugs caused those side effects), and if I better I won't know precisely why. So, I'll take more Tegrex for a couple of weeks and then try an increased dose of ZZZoloft as well.

If I'm Hypomanic, What Medication Should I be Taking?

It's generally considered a bad idea to increase one's psychoactive medicine threefold without consulting with a doctor. But it's also considered a bad idea to cut one's head off with a chainsaw. Of the two bad ideas, I prefer the former tonight. So, I'm going to start taking 600 mg of Tegretol (carbemazepine/carbemazepina) per day instead of 200 mg, which I consider to be an insufficient dose, and the literature supports this. (Don't do this at home, especially reducing prescribed medication because you feel you don't need it anymore. That's most often typical manic self-delusion and wishful thinking.)

Now, at the About.Com: Bipolar Disorder webpage, there are warning signs for mania, hypomania and suicide, by Kimberly Read. I'll apply these to my self below in the parenthesis, and see how I do, while the warning signs themselves are highlighted in red:

There are a number of warning signs of manic episodes, red flags as many call them, of which we should be aware. By learning these early indicators, red flags will go up before a loved one rockets into a manic spree, before you slide into depression, before a friend actually attempts suicide.

In this article, the first in a four-part series, we look at some of the common red flags for mania and hypomania. Part II looks at depression flags; Part III, the warning flags for Suicide; and Part IV, the early signs of childhood-onset bipolar disorder (COBPD).

These symptoms are organized into broad categories for easier reference; this list of symptoms is gathered from personal experience as well as the resources listed elsewhere on this page.

Increased energy

• Decreased sleep: (I've been sleeping pretty well, since I started taking 2 mg of clonazepam an hour before bedtime. Otherwise, I would stay up reading the newspapers online, or writing, until six in the morning. My wife would call me to bed, but it was no use. Often, I'd go out to an all-night restaurant or take my dog for a long (two-hour) walk on the beach. During my second marriage, I used to leave the house at 1 AM and then walk seventeen miles until the sun came up.)
  
• Little fatigue: (I feel very often fatigued since I began taking the 2 mg of Clopam (clonazepam) before bed, along with 200 mg.of carbemazepine (Tegrex) as a mood stabilizer, and 150 mg of sertralina (Zoloft) per day. If you've had the experience of using up 2,800 minutes of cellphone time in one month, you might consider a little bit of sleepiness to be a welcomed respite, as I do, mentally and financially.
  
• An increase in activities: I've been called a whirlwind and had established residences in three countries over the course of six weeks. Let's leave it at that.
  
• Restlessness: I've come to the conclusion that sometimes the only alternative to losing my mind is traveling, regardless of the cost and consequences. For me, seeing something new and encountering and coping with new circumstances and people works like electric shock therapy works for others. It distracts me from the immediate past and helps me get involved with the present, at least for a time.
  
• Is having been married three times a symptom of restlessness or simply of poor decision-making?
  

Speech Disruptions

• Rapid, pressured speech: Sometimes I NEED to talk to someone. I used to talk to suicide hotlines for hours. But no one said my speech was "rapid" or "pressured". I merely felt pressure to continue speaking for fear of what I might think and do when I was alone again.
  
• Incoherent speech (generally not present in hypomania)
  
• Clang associations: the association of words based on their sound
  (For example, my ex-husband once carried on for some time about vacancies, vagrancies and bacon seeds.)

Impaired Judgment

• Lack of insight: Do three marriages show lack of insight?
  
• Inappropriate humor: I often laugh at movies while others are in shock, cowering beneath their seats. This really ruined a first date one time, and makes people think I'm insane, which I just might be. Once, I was laughing and jovial when my friends visited me in a mental institution after a suicide attempt. When they left, I cried on the floor of my cell. (OK, that's an exaggeration. It was simply a hospital room with no "sharps".)
  
• Inappropriate behaviors: Would coming on to every woman I know count as an inappropriate behavior? That's what I did before I started taking this cocktail of medicines that I'm taking now. For example, I was going out with a girl who was a twin and I asked her if they wouldn't both like to have sex with me at the same time. That was perceived as "inappropriate", and caused some very hurt feelings.
  
• Impulsive behaviors: Would telling the customer service woman at the telephone company to suck my dick (in the presence of my fiancée and her mother) count as an impulsive behavior? Would driving 105 miles per hour in the breakdown lane count as an impulsive behavior? Would utterly destroying an isolation room in a mental hospital count as an "impulsive behavior". I wouldn't have done it if I had foreseen the results.
  
• Financial extravagance: I used my mother's credit card without her permission to purchase tennis lessons. Is that financial extravagance or merely an overwhelming desire to stay fit?
  
• Grandiose thinking: Hmmm. You never know what's grandiose until you try and fail or succeed.

Increased or Decreased Sexuality

• May include inappropriate or sexual behavior: Would asking a cousin twice my age to have sex with me count as "inappropriate sexual behavior"? Would sex with same-sex strangers count? Mores are changing so quickly in this area.
  

Changes in Thought Patterns

• Distractibility: It's very hard to distract me. Once I get my mind focused on something, it becomes an obsession until it is complete.
  
• Creative thinking: Yes. I have my own word in Wikipedia.
  
• Flight of ideas: Yes. I don't have the flight of ideas typical of flagrant manic depression, especially having experienced such behavior at first hand in my brother and cousin.
• Disorientation: It's been a while since I felt truly disoriented. I think I was traveling in South America at Christmastime, and couldn't figure out what the hell I was doing there and why. So, I bought a plane ticket and traveled somewhere else, where I still felt disoriented. That might be considered symptomatic of "disorientation". But, that was almost thirty years ago!
  
• Disjointed thinking:
  
• Racing thoughts

Changes in Mood

• Irritability: Does breaking the sink with a chair count as irritability?
  
• Excitability: I'm pretty calm, except when I believe that the world is coming to an end and I might as well kill myself.
  
• Hostility: My ex-girlfriend says that just before I admitted myself to a hospital, I smashed a number of objects in the house and then left the house with a sledge hammer, promising to do something significant to somebody with it. While I was too tired to remember that very well (it was about three in the morning), I do well remember jumping onto the hood of a car at a traffic light and ripping the windshield whiper off, because the driver stopped abruptly next to my leg.
  
• Feelings of exhilaration

Changes in Perceptions

• Inflated self-esteem
  
• Hallucinations (not present in hypomania)
  
• Delusions (not present in hypomania)
  
• Paranoia (generally not severe in hypomania)
  
• Increased religious activities: Would driving three hours per day to sing in three different choirs at my church count as "increased religious activity"? Would it matter if I drove to choir rehearsal at 100 miles per hour?
  

Hypomania also differs from bipolar mania in that the symptoms are generally less severe so that they do not cause significant impairment of daily activities. There are no psychotic features present in hypomania: I'm not aware of any psychotic features in myself, so hypomania seems a more appropriate diagnosis, although a battery of psychiatrists has disagreed with me. Medications aimed at "simple" mania don't work for me, which might be dispositive, and anti-depressants DO work for me, which might also be dispositive.

More often than not, those who are close to us will notice our little red flags long before we will. If someone you love is waving flags, express concern. And if someone you love expresses concern, listen. My friends notice changes in me, but they have no knowledge of the information above. Some of them urge me to try to become independent of the medicine I'm taking, but I compare it to insulin and I ask them if insulin dependent people should try to ween themselves off of it?

Whenever I raise these issues with my brother, he is so desperately uncomfortable that he just wants me to shut up. Maybe it's because my uncle and my brother had manic depression and he's afraid his own children might be next. Or maybe he's just shallow, superficial and petrified. Maybe he simply doesn't care? In any case, I've stopped talking with him, since my every feeling and perception is a landmine for him.

Having known a number of people who were manic depressive, including the psychotic features, I don't think I'm manic depressive. I think I'm hypo-manic. So, what does that mean in terms of developing and effective medication regime that can keep me from rapid cycling from happy to despondent in the course of twelve or fewer hours? That's the question.

Carbemazepine (Tegrex, Tegretol) and Me

I've been taking carbemazepine for a year, although I've had mild to moderate symptoms of manic depressive disorder (everything but psychosis) since I was a teenager. And yet, when I began taking carbemazepine, I only spoke with a doctor whom I trusted once and began taking one 200 mg tablet per day, in the morning, often without eating any breakfast first.

Now, because I often start the day feeling encouraged and singing and end the day feeling despondent, morbid and preferably dead, I am considering taking more carbemazepine. And as I read literature on the Internet, this seems like a perfectly reasonable idea. For example, an article entitled "CARBAMAZEPINE THERAPY: What is Manic Depression?", says:

How should carbamazepine be taken? Carbamazepine is usually taken in divided doses over the course of the day usually 3 or 4 times daily. To minimize side effects most doctors will gradually increase the dose until the desired effect is achieved. Later the dose may again be adjusted with the goal of finding the 'minimal effective dose' i.e. the least amount of drug needed to obtain the desired side effect. Many people prefer to take their medication with meals, which not only help them remember to take it, but also helps to avoid nausea that may occur if it is taken on an empty stomach. CARBAMAZEPINE THERAPY: What is Manic Depression?

Since I've only been taking one 200 mg tablet per day, I'm going to increase that (Yes, "I") to 400 mg and see what happens. I'm going to contact a psychiatrist to confirm this decision, but not one who lives close to me. If they find out that I'm actively considering suicide much of the time, then they might want to put me in a hospital (and I might want to go at first), only to find myself locked up and unable to get out without someone else's permission.

Actually, I am at high risk for suicidal behavior according to standard criteria, because I have recently moved away from my wife and the town where I lived for four years; I have an anemic social system where I now live; I have acute financial troubles and worries; and I have a history of suicidal behavior and gestures, as well as hospitalizations. What's more, I have talked about suicide with virtually everyone I know (I asked my barber to slit my throat with his straight razor).

The only missing ingredient seems to be drug and alcohol use, which would at once potentiate the other drugs I'm taking (make them stronger as potential poisons), remove my inhibitions and judgment, and make me more likely to engage in risk-taking behavior. If I really wanted to die, I would have to start drinking (grain?) alcohol in large quantities, along with much larger doses of the other medications I'm taking.

And all of that still might not work. It might only land me in a mental hospital where I would have fewer choices than I have now. That's why I've decided that if I'm going to kill myself, I'm going to behead myself.

Since I don't have a history of beheading myself and I do have a history of trying various medications to make me feel better, it seems more in keeping with my past behavior to just try more carbemazepine and see how it works.

Oh, one more thing: I don't drive anymore because my anger made it dangerous to do so. But, I'm sure it would be less dangerous to drive while taking this mind confusing drug then to drive like a maniac without it.

Tegrex Takes My Fury Away

It's been roughly a year since I first wrote that Tegrex Makes Me Sleepy, Gives Me Torpor. A year into using Tegrex (carbemazepine), (if it still makes me sleepy and gives me torpor), I don't notice it anymore.

What I have noticed is that the fury that I once felt, the extreme lack of patience and desire to smash something or tell someone to go fuck himself, is gone. Pervasive anger is often a part of untreated depression (or whatever my problem is, at least for me), yet the Tegrex has treated the anger part of my "depression" successfully.

I still have angry thoughts. Over the past week, and periodically since I was seventeen years old, I have been thinking about creating a guillotine of one kind or another (note the one I found to symbolize my mood when I started this blog a year ago) and the idea of cutting my head off is just as present today as it was a year ago.

Lately, having bought a welding machine, and with an account at a store that sells gas-powered chain saws, I've been fantasizing about building a chainsaw-powered guillotine. Actually, I've been fantasizing about this since I was about seventeen years old. Did I say that already?

I would have build a guillotine in my mother's back yard, but I think the neighbors would have seen it, and that would have let loose a cascade of unpredictable consequences, none of which involved me dying in peace on my guillotine.

So, you might say that I'm still furious inside, but without the compulsion to act it out. That makes life more manageable, since in the period before I started taking Tegrex I bashed a marble kitchen sink into five pieces with a wooden chair, for an example. That sort of release felt good and necessary and justified in the moment, but left me with expensive troubles to resolve.

Now, I am investigating the possibility of taking more Tegrex. When I talked to a state psychiatrist and told him that I was only taking 200 milligrams per day (of a potential 1,600 mg maximum dosage), he was notably surprised. "You're not taking 1,600 milligrams?" he asked with shock? But, he was trained back in the 1950's, when psychiatrists considered that an effective dose had been reached when the negative side effects became apparent. More recently, psychiatrists and psychologists believe an effective dose has been reached when the negative affect and behavior goes away, even if the patient doesn't have e.g. facial ticks and obvious torpor caused by the medication.

Now, I'm reading online the patient insert for carbemazepine (which does not come with the medicine when it is provided for free by the Government pharmacy) and the insert says:

The initial dose of 200 to 400 mg per day, should be increased slowly until the achievement of analgesia (in general, 200 mg, 3 to 4 times daily). Then gradually reduce the dosage to the lowest level of maintenance possible. Neurolab

So, I'm only taking the minimum recommended dosage and 25% of the maximum recommended dosage of this medication. Maybe I should take more? Lately I feel great in the morning, singing on the way to wherever I'm going, and by ten o'clock at night I want to walk in front of a semi-trailer. I'm fantasizing about ways to kill myself. These are mood swings that occur on a very rapid basis, like the "rapid cycling" kind of bipolar disorder.

The page says further,

Acute mania and maintenance treatment of bipolar affective disorders: The dose range is 400 to 1,600 mg a day, and the usual dose is 400 to 600 mg a day, in 2 to 3 divided doses. Neurolab

So, I'm taking merely half to a third of the "usual dose", and I'm taking it once a day, in the morning, instead of spreading two or three times as much medicine out over the full day.

I'm going to contact my psychiatrist and propose that I take more, and see what he thinks. Meanwhile, I'm just going to take more on my own and see what happens.

Is it True that "Depression is a Choice"?

If my depression is a choice, then I must choose to be depressed for two weeks and then to NOT be depressed for two other weeks, intermittently. I don't think that makes a lot of sense.

Public records of insanity

I have often wondered why human beings should have to wait for courts or psychiatrists to declare them insane or infirm, when they may be perfectly capable of making this declaration to the public on their own, for mosts practical intents and purposes. Public declarations of insanity, such as those that individuals can make on the Internet, may serve as a record for family, friends and others of an individual "lost his marbles" and how they got them back, should that happen.

My psychologist suggests that I stop writing in my suicide blog. "You don't know what effect what you say will have on others," she says. But, the idea that my thoughts of suicide can convince others to commit suicide seems to ignore a simple fact: it's people's own depression, conflicts, disappointments and "tristezas" that make them suicidal, not someone elses. A person who does not share any of these characteristic symptoms will find this journal wholly irrelevant, unless she has a family member, friend or client who shares these symptoms. In that case, these reflections may be useful to someone.

My Most Pervasive Globalized Thoughts of Self-Hate and Suicide

My psychologist insists that my depression originates in my globalized thoughts, such as the thought that "I have myself" - a thought that makes me feel angry, sad and desperate - all of which thoughts lead to the still more globalized thought that "I wish I were dead."

In fact, my most pervasive globalized thoughts are that "I hate myself" and "I wish I were dead," precisely in that order. But, just as we can learn something by abandoning the word "racist" and identifying specific ideational, emotional and physical behavior patterns that are color-aroused and dysfunctional, in others and in ourselves, so I can learn something about myself when I say, "I hate myself when . . . " and "I wish I were dead when . . ."

I hate myself when I look at seven hundred women walking along the street before and beside me and I am compelled to accept that I cannot have one or all of them. And then I wish I were dead.

I hate myself when I think of things I would need to do, in addition to what I am already doing, to make a go of it, and I realize that I am not willing to do those things. And then I feel trapped in my own unwillingness and I wish I were dead.

Parenthetically, I feel desperate when I realize that the United States may well be on the verge of electing its first woman or Black president - a lifelong goal of mine to see that happen - and yet, in my private depressions, I feel so overwhelmed with my own grief that I wish I were dead, regardless of whether I live to see my aspirations all of the social and political changes I hoped for are on the verge of being realized and I feel so bad that I don't want to live to see the changes come to fruition.

I hate myself when when I leave a woman who loves me and I find myself alone.

Parenthetically, my psychologist insists that my depression originates in my globalized thoughts, such as the thought that "I have myself" - a thought that makes me feel angry, sad and desperate - all of which thoughts lead to the still more globalized thought that "I wish I were dead."

I hate myself when I suspect that my friends and the public are ignoring my blog.

I hate myself when I think I am inconsequential, but I don't stop hating myself when everything tells me that I am making a big difference. That is a symptom of depression.

Dreams from my Immolation

I dreamed that all of my new white clothes, including my shorts that I bought in São Paulo, had blue in on them, so I looked unsuccessfully for a place to soak them in water. They were probably ruined.

I dreamed that the floor of my home was covered with water, but the doorway was higher than the rest of the house, so I would have to push the water out splash by splash. As I began to push the water out, pieces of the brown rug began to rip off and come out with the water.

I dreamed that someone wanted me to show them how to install a fiberglass tub, just as I had done at my mother's house. I reluctantly agreed to show them, even though I didn't want to just as I reluctantly agree to certain things in the present with respect to my step-son, even though I don't want to.

I dreamed I was in a van that flipped over, leaving me face on the ground inside of the van, looking outward and wondering how I would get out of this mess before another vehicle crashed into the van in the middle of this busy intersection?

I Wished I Was Dead Again

Even when things are going well in my life in outward respects, still the fantasy of suicide is my first thought as I climb into bed each afternoon for a nap, and each night for three hours of sleep. And then I dream of my mother and our arguments.

I dreamed that I was looking for a place for myself in the world, fantasizing about calling people at random just before Christmas and asking for donations to "Eunice F." Hahaha . . . . I dreamed my mother told me that the school in which I was teaching - the same at which she was a professor - thought it better that I leave as soon as possible.

I dreamed my mother angrily demanded that I stop screaming at her when I got angry and throwing things around the house. I said to her, "You're screaming at me," which was an easier answer, since I could not agree to stop screaming at her and throwing things around the house.

I dreamed I had nowhere to live in a big town, so as I road through a neighborhood of beautiful homes I imagined asking some of the homeowners if they didn't have a room they'd like to rent. The homes, although immaculate, were on a steep hill, and I wondered if it would be possible to exit their driveways when the snow began to fall?

I dreamed of my brother . . .

During the day, I live partially in the present. At night, when I am asleep, I live mostly in the distant past. I dream in English, of English-speaking persons, although I haven't lived in an English-speaking country for over seven years. I dream of people past rather than present - of the worst conflicts and fears . . .

If I were dead, when I am dead, I hope I will stop dreaming, because my sleeping moments in life are worse than my waking moments by far. And yet I sleep a third of my days away, like a daily appointment with the torture doctor.

If I hung myself from the door frame, then I dreams would go away. If I constructed a large rectangular box with a huge blade at the end, I could crawl into the box while it stood upright, so that only my head protruded from the box, right where the blade would catch my neck as the box fell over and hit the floor.

Sometimes, I dream of suicide during the day as well. When I see enormous two-story tour buses speeding down the road, I imagine running and standing in from of them, being struck and dying. As I swim out to see at the beach, I am torn between fear of drowning and the desire to continue swimming until the shore is a distant memory.

ACarnaval Night in Bahia, Brazil

Last night, with a young male friend of the United States, I went to an big all-night Carnaval celebration in a little town half an hour from here. During the bus ride, four tall and leggy transvestites taunted the Brazilian men on the bus, saying that although the men claimed to be heterosexual, yet the transvestites could sense, “I know you want me!”

The kidding was all in good fun and one man even seemed about to unbutton his fly for some action, until one of the transvestites taunted a man who wasn’t able to take the challenge to his heterosexuality playfully. He slapped the transvestite, and her feelings were clearly hurt, but she played it off gamely. She apologized for any feelings hurt as we got off the bus and everyone went into the party, bleached blonde and red-headed transvestites, and heteros of ever hue.

As we walked into the town square, my very forward friend locked eyes with a buxom mocha colored girl of about eighteen years old, whose smile was as brilliant as the lumen on a lighthouse. Passing one another, they turned to lock eyes again, the buxom beauty now sharing some words with a girlfriend before returning to meet my pal halfway. They exchanged some words I couldn’t hear and then their lips locked together in a passionate kiss during which she lifted his hand to rest flatly upon the top of upper breast.

They talked and they kissed and exchanged telephone numbers at a capeta (fruit/alcohol juice drink) stand, and then the mocha beauty was gone.

Music filled the space, with a “Brega” (Brazilian pop music) band playing on stage, while thousands on people, from the ages of ten years old to sixty, danced and grinded, laughed and flirted, drank beer and sought partners. Initially, I just watched everyone, remembering that I’m supposed to be depressed. But then I dispensed with all loyalty to depression, loneliness and misery, and I danced and played with everyone else, momentarily freeing my mind from all concern and cogitation.

At some point, after an hour or so, I found myself wanting to go home. At three in the morning, it was long past my bedtime, and I knew I should be at my computer, clacking out another tome on the misery of life or the presidential race seven thousand miles away. Instead of leaving this Carnaval celebration, I decided to pretend that I sitting in my living room, was watching it on television. There I was no longer obliged to dance or engage with others and could just watch the teenagers enjoying themselves, watching this scene on a big screen in surround sound.

Now, my friend had found two more women, one beige with blonde hair and the other mocha again, with bountiful breasts in a revealing yellow bikini top. If my friend was to make his way with the beige girl, I would have to entertain and distract the mocha woman meanwhile. They certainly drank a lot of beer ( I don’t drink at all), but I did my part until some men next to us began a horseplay that easily turns into fighting when men are drunk at four in the morning.

We felt the stink of tear gas, and I was ready to go home, yet my friend and his girl attractions, I now learned, were determined to stay at this party until the sun came up. Who knows what might happen with the girls, the fights, the tear gas . . .

Not me. I’m a married man with a loving wife who needed loving, plus three children and a big dog waiting for me at home.

As I rode back home, chatting in English with an eighteen year-old blonde girl from Germany, I saw just one transvestite, tall and black, with orange hair on her legs.

I could spend more time at Carnaval festivities, particularly if my friend comes with me so that I’m shouldering the immense weight of going alone to enjoy myself. But I do have some qualms:

What if my life passes me by more quickly while I’m out enjoying myself?

What will my wife think if I repeatedly come home at four in the morning?

It’s nine in the morning now. The sun is full up and the dizzying music about sex that is audible from a block away – a staple in Bahia – means that another day has begun.

I Hate Myself Today / Asphyxiation

When I feel depressed, I remember thousands of instances in which I didn't measure up to my or others' expectation, and then I shout inwardly and mumble to myself, "I hate myself." It becomes so bad that my wife and children can hear me saying this, the only saving grace being that my children may not yet know what it means.

I hate myself for the times when I took a risk and it turned out badly, and I hate myself as well for the times when I failed to take a risk and lost an opportunity. I hate myself because people laugh[ed] at me and because I care that people laugh[ed] at me. I hate myself for being depressed and for not being able to find a way out of my depression.

Certainly, I could endeavor to love myself, but the mere thought makes me angry. I tried before, hard, and was unsuccessful, falling backward hard, into worse traps than those I had escaped. FUCK recovery!

I wish I were dead right now, and I revile myself for lacking the coverage to kill myself.

Before I went to sleep last night, I wondered if swallowing large objects would be a reliable way to die? If one didn't die, would the attempt leave any negative after-effects (aside from the terrible experience of not being able to breathe?)

Choking or food asphyxiation hazards include hot dogs, gum drops, nuts, taco chips, steak, or any food that is not chewed sufficiently to be swallowed and hence, becomes lodged in the pharynx, blocking the opening to the esophagus and larynx (11, 78). Even grapes given to very young infants or children have caused a number of fatalities. People must chew food adequately before swallowing.

Old age, poor dentition, and alcohol consumption also contribute to fatal food asphyxiation or choking on food (129). People should not give large pieces of food to children and the elderly, or to any individuals who are incapable of chewing the food before it is swallowed. It is also beneficial to be trained to perform the Heimlich maneuver and Cardio Pulmonary Resuscitation, and to travel with other individuals who are trained in these procedures. Hi-Tm.Com

Another source says,

While reports of suicide by smothering and strangulation are common, suicide by choking is far more rare. In addition to the act being difficult to carry out, suspected cases are not easily distinguished from accidental or homicidal deaths. Here, we present a case of suicide by choking on toilet paper in a patient with a long history of schizophrenia. The case was ruled a suicide based on the patient having been witnessed in a previous unsuccessful attempt of the same act. "Choking on Toilet Paper: An Unusual Case of Suicide and a Review of the Literature on Suicide by Smothering, Strangulation, and Choking," The American Journal of Forensic Medicine and Pathology

A lot of different items can cause asphyxia if swallowed:

Foreign Body Aspiration
Fatal food asphyxia has a number of predisposing
factors that include old age, poor dentition, insuffi-
ciently chewing food, semi-solid diet, alcohol use,
sedative drug use, reduced motor coordination,
dementia, long-term care facility residence, sedative
drug use, and various neurological and other dis-
eases (e.g., Parkinson’s disease).
12,23,84-86
A study of
Chinese adults found foreign body aspiration to be
localized more in the lower airway, resulting from
bone fragments in 49% of cases.
87
Here the mean
age was 60.5 years, with a range from 24-80 years of
age and 81% were male. Another study concluded
that unchewed meat or sausage caused choking in
67% of cases, with breads, cookies, and pastries
12%, fruits or vegetables accounted for another 8%,
cheese and egg products 2%, and the remaining
(2%) known sources were non-food items including
dentures, a hair ornament, and a cork.

Preventing Asphyxiation and Choking Injuries in Manitoba

"Nuclear Beliefs" Go Nuclear

I got an opportunity to talk to my psychologist today. She says that I have "nuclear beliefs," like "I'm too bad to deserve love," "The whole world hates me." "I have no right to have friends, because I'm a terrible person."

I was about eight years old when I decided that it would be better for me if I just spent my whole life in the house and didn't try to make any friends.

Things went terribly wrong with some of my best friendships and I was told that it was because I was very, very bad. So, I decided not to try anymore.

Particularly with women. But also with guys.

Maybe if I keep adding stuff to my suicide blog I can roll it all into a book later. Yes, it may even be therapeutic.

At times like this, it seems like I just have constant bad memories and every one of them makes me urgently think, "I hate myself and I wish I were dead!"

The psychologist asked me socratically if I hadn't had times like this in the past and been able to overcome them.

Yeah . . . When I'm crossing the street, I take my time walking almost directly toward the buses instead of getting out of the way.

But, I didn't really want to recover. I wanted to die and get it over with. But I didn't have the courage.

I had a long-ass dream. I was a new teacher at a high school, having coffe in the lunch room, except that I didn't know where anything was and I was afraid to ask anyone, for fear that they would laugh at me.

God Damn, I Feel Shitty!

For the second day in a row, I awoke at 3:00 AM. Couldn't sleep. The first day, I installed an electrical switch in the kitchen, to do something constructive with my insomnia time. Last night was worse. I awoke at three, my wife asleep and insensitive to my aspirations, and I just wanted to die. I began thinking of hanging myself with my think black extension cord, only to reflect on the difficulty of making a proper noose with such a cord, and the near necessity of going to a hardware store and buying a proper hanging rope.

It wouldn't be the first time I've bought such a rope. The first two time were in New Jersey (the rope was in the trunk of my car for a year) and the second time was in Nice, France. The noose sat at the floor of my closet for two years, because it scared my friends if I left it on my bed.

This present depressive episode started on the beach two days ago, when the waiter refused to serve me. I confronted him and demanded a menu, but I never was able to get even a bottle of mineral water, settling instead for fresh coconut water from the ambulatory vendors with the hammer-spike coconut openers.

That's when I started feeling depressed. What is wrong with me that they will no longer serve me at this restaurant? What did I do?

My wife reassures that this is simply who year-round residents like me are treated when the tourist season comes, and restaurant waiters are desperate to make the big dollars from the big spenders when they can. They simply don't want us to take up chairs and waiter time when the tourists have so much more money to spend.

So, maybe this wasn't about me being unworthy. Maybe this was about the ups and downs of the local economy.

Now, I understand. So, when will I feel better? And when will minor disappointments stop sending me into major depressions?

Last night, as I cut onions into little pieces to make a hamburger that was nearly inedible with two hot peppers mixed in, I imagined hacking my fingers of with the steak knife and flushing the fingers down the toilet, so that they couldn't be re-affixed. I didn't do it. I just thought it, as I so often imagine ways to hurt and destroy myself once and for all.

A couple of days ago, in this same bad mood while crossing the street, I walked slowly and silently dared the cars and a bus to hit me. The mirror of a passing car struck my arm, but I wasn't hit by the passenger bus.

Life is so ironic. The terminally ill people who want to live on cannot, and terminally depressed people who want to die instead live on incessantly.

Tegrex Makes Me Sleepy, Gives Me Torpor

I've been taking this mood stabilizer called "Tegrex" that really does help to eliminate the furies in which I broke furniture and told people to go fuck themselves. (When I was on the phone with the telephone company at my ex-fiancée's mother's house, I my fury at the bureaucracy built up until I screamed at the operator in Portuguese, "Suck my dick, just suck my dick!" Since my ex-fiancée and her mother were regular church-goers, they were unaccustomed to such language, particularly when screamed at operators from the telephone company.)

Anyway, Tegrex removes the compulsion to scream that way. I often have insomnia as well, and sometimes can become irritable and disbalanced simply for lack of sleep. Tegrex makes me feel tired, compelling me to take a two-hour nap every afternoon after lunch, like right now. And at night sleep becomes a Tegrex-compelled requirement rather than just a bothersome and voluntary option. Many people lose their minds for lack of sleep, says my psychiatrist, so sleeping is a good idea even for those who would prefer to remain perpetually awake.

Here's an example of why it's important to take psychoactive drugs consistently once they've been prescribed: When I first started taking Tegrex, I had a week of an uncomfortable (but not unbearable ) side effect: torpor. I felt dizzy, like I had gone without food and water for a couple of days. After a week, this side-effect nearly disappeared, except that I got tired every day at noon and had to take a nap.

Well, I ran out of the medication, didn't have a prescription for more, and spent about a week not taking the medication. Now that I've started again, I have the same side-effect (torpor) that I did when I started the first time because, effectively, I'm starting from scratch again. Had I taken the medication consistently, my body would have been accustomed and would never have reverted to its old unaccustomed state.

Hey, You're Handsome!

Is that your photo, Jose? If so, you're a handsome guy! (I've decided to begin expressing what I feel regardless of our society's insistence that we suppress and deny certain feelings and thoughts in order to avoid appearing to be "gay".)

Why, after all, should it be so socially unacceptable for one man to say to another, "I think you're handsome." Will he disagree with me?

Perhaps he will think that I'm "dando uma cantada" (singing to him, like a bird for mating). Well, so what? If he likes the bird and he likes the song, then what's the problem? (I'm a married flightless bird in Brazil, so that limits my interactions anyway.)

Will the world become a worse place if a man knows that I find him handsome. I don't think it'll hurt anyone, really.

I've discussed this with my wife. She's ok with it. She doesn't find it horribly unacceptable or unspeakably terrible that there are some other men whom I find handsome and attractive. She knows that I think one of my best male friends is handsome and attractive. For that matter, she knows that I think a lot of women are attractive. If the attraction to the women doesn't end our relationship, then why should the attraction to the men be any different?

You know what? If I hear a song that I really like, I tell my friends about it. If I eat at restaurant and I'm pleased with the food, then I tell my friends about it. If I think a woman is pretty, or attractively dressed, I tell her. So, from now on, I refuse to abide by the rule that says that I have to pretend to be unaware that there are handsome men in the world. I'm done keeping this awareness to myself. I also refuse to abide my the rule that says that if I find a man attractive, I have to keep that a secret.

There are some men in the world whom I find attractive, typically because their faces seem open, warm and guileless. I think those are very good characteristics in a person, be it a man or a woman. And that's what I find attractive. Those are the men whom I want for friends.