Dark waters

They found him in the river. The river kills a few handfuls of people each year, what fraction by their own hand, I don't know. I don't know if he took his own life either, but I have my suspicions. Young male, seemingly happy, his last trip a bike ride late at night to hang out near a music festival he didn't have tickets for, his last words a text message to his girlfriend. Good luck with your midterm. I have my suspicions.

My suicidal fantasies typically revolved around firearms. Handguns, usually. Point blank, to the side of the head, elaborate visualization of the effects of muzzle blast, the striking contrast of crimson blood and tissues on the flat gray winter snows. A rather gruesome way to go, I guess, particularly for the poor suckers who have to clean up after you, but you wouldn't care anymore, you'd be dead after all, and suicide is so painfully selfish anyway the details don't matter. I don't own any firearms, avoid contact with them, wouldn't know how to start if I wanted to. It'd scare me to want to. I'm not that stupid.

I've thought about the river, too. It'd be easy, accessible. Find a nice spot on a high bridge and jump. Masculine enough -- male suicides succeed more often than female, because of the methods selected. I once knew the classification system of attempts, read the back of the Merck manual, but not anymore. The only time I scared myself (in recent years anyway) was with the river. Thinking about jumping is one thing. Thinking about which bridge, though, which spot, which side. Don't go there. I stopped that train of thought, I don't want to die yet.

When I was young, late in high school I'd go for long walks late at night. Parents don't worry about boys, I guess. Or maybe they do, but let them wander anyway. We lived near the beach, sometimes I'd go look at the ocean. Walk in the park above the pier. Mostly I was alone with my thoughts. Rarely I'd get approached, offered things. Need some bud? Want a ride in my van? No thanks. I wanted to be alone with my thoughts.

I'd walk on the sand, look out at the waves. Dark, softly crashing, white caps glowing in the moon. Wondering how far I'd get, if I just started swimming.

The conciseness of tragedy

My wife talks about the necessity of fiction for explaining things: there are some feelings which require an entire novel to evoke. And it's true, I think we all know what she's talking about, there are places that you cannot go without taking the journey to get there.

Sometimes, though, something very brief can evoke an entire novel's worth of emotion. She read me a recipe quoted by Caitlin Flanagan, from some 1950's thing which went approximately like this: "hack a chicken into pieces, dump paprika on it, throw it into medium hot oil for as long as it takes to smoke a cigarette, staring sullenly at the sink". An entire English Lit course right there, although I've reproduced it badly.

Another one, a Slashdot comment, went like this:

My boyfriend suffered a stroke which crippled his short-term memory. For example, one time ...

Very factual, just the basic background to get out of the way, before telling the funny story. But there's an entire novel's worth packed in there too. What must it be like to lose the man you love? What does this mean for the life you'd been planning to have together? Or not lose him entirely, just he's utterly changed? What will his life be like now? Yours? In some ways, worse than having him die, some unkind aunt would no doubt claim. Would you leave him? But very romantic, to stick around... not that he remembers it for more than 30 seconds. A whole novel's worth, packed in tightly, by someone for whom the story is old, tired, the interest worn out through repetition a thousand times. By someone who's moved on, emotionally, made their peace and said goodbye? Perhaps. But still, that word boyfriend, present tense, not ex, not former lover, but boyfriend. A complete tragedy, written small.

A third, even shorter. Posters suddenly appeared everywhere on campus recently: "MISSING", and a picture of a happy looking male student, plus details. Missing person reports are almost always bad news, but adult men aren't usually the focus. Clearly possessed of a loving (and well-organized) set of family, friends and girlfriend, he just didn't show up one evening. You know to hope for the best, even for a stranger you've never met, but you also know to assume the worst, even for happy looking bright young men with a full future in front on them. The posters all disappeared yesterday, just as suddenly, their very absence communicating the end of the tragic story. He's no longer missing.

A cure for love

--Doctor, doctor, give me the news // I've got a bad case of lovin' you

--Let's try Paxil 20mg qd, expect possible nausea, somnolence, asthenia, abnormal ejaculation, and sweating, call the receptionist to report any suicidal thoughts, come back in a month and let me know how you're doing. Next!

I'm reading "Why we love", by Helen Fisher, a fascinating book on the chemistry of romantic love. The author is an anthropologist who's done a variety of studies on the nature of love, including some very interesting fMRI work on the brains of undergraduates in love. Interspersed with zillions of quotes from the romantic literature, she reviews what's known about the chemical and neural circuitry of love. There are three principal molecular actors:

• dopamine, associated with focussed attention and goal directed behavior, exhilaration, hyperactivity, mania -- it's involved with all chemical addictions;
  
• norepinephrine, which is closely related to and has roughly similar effects to dopamine
  
• serotonin, whose levels are reduced in love, just as in individuals with obsessive-compulsive disorder (OCD).
  

These three are interlinked: dopamine and epinephrine in positive feedback, and repressing serotonin levels. Identifying the individual chemicals giving particular responses helps us understand the individual aspects of an experience which, without the molecular basis, would be an indivisible whole.

This is fascinating stuff, explaining the eternal mysteries, all that. But the pharmacologist in me (doesn't everyone have an inner pharmacologist?) wants to apply this knowledge. Love potions are the historical goal, and perhaps the second half of the book might give ideas as to how to create love. Easier might be easing the pangs of love once it's started. Love isn't all good, in fact, when unreciprocated or the circumstances aren't right, it's just pain. It'd be nice to be able to turn it off, when desired. Fortunately, for the lowered-serotonin obsessive thought patterns, there's an entire class of drugs, the selective serotonin reuptake inhibitors (SSRIs). Although licensed for use against defined accepted illnesses such as depression, anxiety, OCD, etc., they might well work fine against pathological love. I don't know if serotonin feeds back into the dopamine/norepinephrine cycle, to stop the root cause, or if an SSRI would just allow you to concentrate on other things, but it seems clear to me that it would be helpful. Prescribing a drug "off-label" for a new indication is very common and entirely acceptable, if the physician thinks it would help the patient.

If you don't like physicians and well-tested, commercially pure drugs, you still aren't out of luck. There are a wide variety of things sold in health food stores, some of which are known to have antidepressant or SSRI like properties. St. John's Wort extracts have had the most clinical testing, but there are others as well (5-HT, eg). The traditional salve for a broken heart is alcohol, but experimenting with something with a little better biochemical basis seems like a good idea.

In fact, it's such an obvious idea, that I wonder if it hasn't been done already. Certainly there've been points in my life when I could've used something.

-- No pill's gonna cure my ill // I've got a bad case of lovin' you


-- Give it a month. We'll see.