I had to take a break from writing for a while. My self reflection and analysis was bordering on excess. It was beginning to drive me crazy and I was becoming frustrated. It was good that I pushed my thoughts as far as I could go with them. I had never looked at this issue with such depth and clarity. Normally I tried to repress it and deal with the aftermath that it creates when I also become hypersexual.

It is in my nature to take things to the extreme. Somehow the ordinary is never enough. This probably has more to do with bipolar than anything. It could be part of my personality too. Who knows?

Anyway, my family doctor's office finally called back. My family doctor has taken a while to get back to me because he was consulting with a urologist here in town. This instills more confidence for me. I was beginning to have second thoughts about my decision to seek out help from my general practitioner as opposed to a urologist. And I was wrong about my family doctor misunderstanding my desire to not go ALL the way down, but to find a more comfortable hormone level. I made a bad assumption when I heard GnRH agonist. I thought you could only really go all the way down with them, but I guess not.

I had really shutdown considering lowering my testosterone level because I was frustrated and didn't want to think about it for one more second. Did the desire go away? No. It seems to be a constant and follows me around in life like a lost puppy.

The two options he gave me are Synarel (Nafarelin) and Lupron. Both are GnRH agonists. The Synarel is a nasal spray and the Lupron is injected daily subcutaneously (just under the skin). The Lupron also comes in a longer lasting monthly intermuscular injection. But that is out of question for right now. My doctor wants something that can be more quickly adjusted. And that seems reasonable from my perspective.

Price pretty much follows however much you end up using on a daily basis. The retail price of Synarel is VERY pricey. Locally the price could be as much as $1,034/month! That is completely unreasonable unless insurance is going to pay for the vast majority of it. Lupron has a generic available, which I was unaware of until today. It's called leuprolide acetate. Lupron as a daily injection could cost as much as $552/month, but the generic is only $126/month.

If you are searching around for more information, the daily injections come as 14 day kits. The Lupron can be found as Lupron 5mg/ml kit. The Leuprolide acetate can be found as leuprolide acetate kit 1mg/0.2ml .

I still have no idea whether insurance is willing to cover these options under GID. Considering the issues with coverage and potential problems, I'm not willing to try anything other than the leuprolide acetate. It is obviously still expensive, but not ridiculous or unaffordable in my case.

There seems to be little anecdotal experience on the archive with GnRH agonists. I think expense has probably been the primary deterrent to others even considering it.

I'll give my doctor a call back and just see where things go.

Still following your thread. Good luck with the GnRH treatment, and I hope everything goes well for you.

My doctor went ahead and prescribed the leuprolide acetate. Each injection is only 0.2mL and has 1mg of active medicine. That is really REALLY small. What's interesting is that he prescribed .1mg/day which means that I would only take 0.02mL! That is so low in volume the pharmacist has no idea how to accurately measure it out and repackage it. So he is going to call tomorrow and find out if it was a mistake or not. Since they don't have it in stock I won't have it at the earliest until Monday. I'm not in a hurry anyway, so we'll see what happens. The only thing I could see doing is putting it all together. Then diluting it with sterile water and repackaging it, but who knows.

The pharmacist is going to let me know what they find out tomorrow.

I don't recall my friend's condition or actual treatment.

There is something else you might try.

Light therapy.

During the winter lack of natural sunlight can cause some people extremely severe mental upset by amplifying beyond reason our normal every day thoughts, fears, stresses. They are special lights. They may be available locally or you might need to order via internet.

In the mean time, do some play acting and pretend you are someone who is successful with no pressing issues. Just pretend for a little while, once a day, or several times a day. It's amazing sometimes how we can trick ourselves into a new us. It's something like stuttering; if a stuttering person can not hear themselves talking, they do not stutter.

PS: By the by, once I finally achieved a permanent low testosterone level, my constant craving and desire to be castrated has subsided. I now think about life and living and not about being castrated. It can be a long and windy road to get to that point and one must make sure well in advance that the destination is truly what is desired for it is a one way road.

Hi nullorchis,

What you are referring to is called seasonal affective disorder. It is abbreviated as SAD. It is a form of depression brought on by changes in exposure to light. Depression can certainly bring on a form of rumination for some people, but that is not my problem. I have had plenty of depression in my life and it isn't something that I'm currently suffering from. Actually it has been quite a while since I've had to deal with it for any long period of time. Light therapy can be helpful for those with seasonal affective disorder during the winter months.

My core problem with mood is having bipolar. It is a complicated beast especially since I don't tolerate the medication for it. No amount of pretending makes it better. Self awareness if my primary weapon against it. Ignoring it tends to be disastrous.

What you are suggesting is a form of "pull yourself up by the bootstraps." It doesn't tend to work for many people.

I'm glad that you feel much better adjusted after castration.

My local pharmacy called me today to let me know what was going on with the prescription for leuprolide acetate. My doctor had made a mistake in the decimal place. I hope that doesn't happen to others! That could be a bad thing for other kinds of medicine, especially if they went the other way and it was for too much! Anyway, now that that is cleared up, they were unable to find another pharmacy in town that carries the leuprolide acetate. I'm not surprised, very few people take this medication. They were also unable to contact the manufacture today. They will try again next week. Unfortunately, they didn't seem very confident on fulfilling this prescription quickly. They said they will try every week to get it in. I take it that it will take on the order of a month or more to get it. I will be surprised if it comes in any quicker. LoL. I'm patient, so it isn't that big of deal.

guy26 (imported) wrote: Sun Feb 06, 2011 2:21 pm Today I have been having self doubts about my core identity. I'm not entirely for sure why. I find it more distressing that I can't be happy with who I am. It seems like such a simple task in life and one that would grow easier, not harder over time.

Humans are designed to be dissatisfied. This is due to evolution. From an evolutionary point of view, the most successful being is one that expands its territory and most inventive. If you think about it, the reason you explore new territory is because you are dissatisfied with where you are. And the reason you invent things is because you are dissatisfied with what you have.

We (especially West Coast North Americans) are the descendents of explorers who descended from explorers who descended from explorers. For example, my family came to North America in the 1600s and then kept moving around -- to Mid-West, then Gold Rush, then Mexico, then Canada, then California again. This means my family has been perennially dissatisfied, and it is in my genes.

I'm sure there have been many content individuals, but they have been overrun by the dissatisfied explorers with technology.

Anyway, my point is that it is our human nature to be dissatisfied. Even the people who are rich, famous and able to bang any chick they want seem to still be greedy and power hungry. Look at Gaddafi trying to hold power, or Charlie Sheen and his current break-down.

So it is not happiness that you need to seek, but rather what Buddhists call "equinamity". Basically, it means that you have perspective and accept the dissatisfaction and the suffering of life. You instead just become interested in the process of life, and you are able to observe yourself through all your travails.

Your quest for "happiness" is not as easy as you think it is -- as evidenced by your difficulty in achieving it. Just stop seeking happiness, and instead get interested in life in all its ups and downs.

guy26 (imported) wrote: Sun Feb 06, 2011 2:21 pm You could suggest that I'm having pity for myself and asking, "why me?" Maybe that's the case, but it seems deeper than that.

You've hit the nail on the head. Our fundamental dissatisfaction manifests itself as self-pity. It is "deep" and also silly. Stop feeling sorry for yourself and replace the self-pity with pure interest in awareness.

guy26 (imported) wrote: Sun Feb 06, 2011 2:21 pm For a long time I have felt that my self identity shifts just slightly from time to time.

Don't worry about that. Just watch it with interest and let your "identity" flow and evolve naturally.

Sorry for getting all philosophical, but it seemed that your posts are reaching out for some deeper answer.

Anyway, my point is that you're going in the wrong direction worrying about "happiness" and "identity". Instead, you're an ever-changing awareness that is fundamentally dissatisfied but is still on an amazing, interesting journey.

Don't apologize SplitDik. I appreciate the thoughtful and philosophical reply. It means a lot to me that you would take the time to think so deeply about my situation. Your response is entirely relevant to my situation and it is something that I need to give more thought to.

I have struggled for years on even trying to pin down on what it means to be happy. It is such a simple concept on the surface. My changes in mood have often made me question the very essence of happiness. I tend to cast feelings and emotions into a dichotomy of legitimate and illegitimate feelings. For instance, euphoric mania has to be the most pleasurable and happy moments that I have ever had in life. Nothing else comes measurable close to it, let alone exceeding it. It is well beyond normal and it has nothing to do with reality. I tend to think of it as the essence of happiness and joy. It is a limitless exuberance and energy. For these moments of euphoric mania, I classify them as illegitimate. Ultimately designating feelings as legitimate or illegitimate may serve no other purpose than to better help me respond to the irrational chaos that I feel at times.

My struggles in life have caused me to reject Christianity and a lot of the surrounding philosophy. It doesn't work for me and I find it somewhat destructive for my own situation.

The Buddist perspective has a strong appeal. It sounds somewhat similar to my own self developed philosophy, which also draws upon existentialist thought to a degree. I find that life may have no ultimate meaning, and yet life itself gives rise to meaning.

And yeah, my posts were reaching out for something deeper. My struggle with bipolar and identity has not been an easy one.

As I approach starting a GnRH agonist, I have been questioning my motives even more. And I have been looking even more critically at them. I want to know that I am acting rationally and reasonably. It isn't that this is an undoable proposition. I can quit at any time and as long as I don't go past a certain length of time, the likelihood of permanent changes isn't all that high. I've lowered my testosterone with depo prover twice, so I have an idea of where I'm going. The larger issue is the rapid cycling that I'm risking by going down this road. It is a hell that few understand and I don't really want to invite it back.

For the last few days I have had doubts and wondered whether I have just been making shit up for the last couple of months. My desire to start the GnRH agonist over the last few days has had to do with an uptick in my libido. And this increase is beginning to drive me crazy.

However, I can't really imagine how anyone could make up the amount of crap that I have written about in the last couple of months. I can't imagine how I could come up with that level of detail if it were some kind of self dilution.

I have begun to wonder if the reasons for my drive toward castration is really all that static over time. Maybe sometimes it has a lot more to do with hypersexuality and almost nothing to do with identity issues. And other times it may have a lot to do with identity and almost nothing to do with being uncomfortable with an elevated libido. And if that is the case, it makes me a little uncomfortable with moving forward with it. It seems a little wishy washy even by my own standards. Is either really an invalid reason to change my hormone levels? Maybe. I don't know.

Maybe who I am is in constant flux at a deeper level. Part of it may simply have to do with being bipolar. I can accept that even if it is a little disconcerting. I agree that life is all about the journey. Introspectively, I find my life interesting alright. LoL. I have done and felt many things others around me never have and never will. I don't think this makes me better than them, but it may make my life more rich and ultimately fulfilling before I die.

Do you have a suggestion for what I could read to better understand equanimity?

guy26 you're really psychoanalyzing yourself, which isn't a bad thing, but you can over do it. It's a Freudian method of therapy, maybe you didn't realize it.

http://www.thefreedictionary.com/psychoanalyzing

I've tried to do the same thing for years, but after I was castrated. Castration became such a compulsion for me I couldn't stop myself, I was mentally & emotionally driven to have it done. I never considered myself hypersexual, but I did do a lot of cutting before I was castrated, specifically to my genitals. Did I hate them? No, but I think I was frustrated sexually and cutting gave me some sort of release other than orgasm. I've yet to really understand or know why in my mind I had to be castrated, but I was and I am now a eunuch. Sometimes I think about becoming a nullo but the compulsion to remove my penis isn't near as strong as my compulsion to be castrated. It's been an interesting journey, I think it would make a good movie, but who would make it?

How true Hash,

The drive to be castrated is very strong and it leads to self abuse, it did with me. It was my every thought my life wrapped around the thought of being castrated, when I was walking down the hall after being castrated by Dr Kimmel, I remember well the thought I had, "I am finally complete".

From that day to now, those thought and actions of self abuse or to cut off any other part of my body are gone.

I am finally at peace with myself.

River