05/20/2019 By Justin Birckbichler
On my testicular cancer awareness blog, A Ballsy Sense of Tumor, I have written extensively what it’s like to experience depression as a cancer survivor. I eventually recognized the signs, asked for help, and went on antidepressants. While I am happy to say they are definitely working, I only knew to ask for them since this wasn’t my first time battling depression.
I’ve alluded to this in past writings, but I fought with clinical depression during my sophomore and junior years in high school. However, I’ve never written a full account of this trying time, and in the wake of the unfortunate events with Anthony Bourdain, Kate Spade, and countless others throughout the past decade, I’m ready to take that leap in hopes of letting someone else know to ask for help.
For context, I grew up in an upper-middle-class family. I am the oldest of three kids and my parents are still together. I was in the gifted program since third grade, participated in a number of sports, and school came rather easy to me. In essence, I was the definition of privilege and from the outside, I had no “reason” to be unhappy.
It started slowly enough. Around the start of sophomore year, I realized I was increasingly feeling sad and hopeless. Nothing seemed to bring me joy and I always managed to find the negative in every situation. I couldn’t figure out why this was happening, but I felt too ashamed to open up, since I had a pretty good life. However, there was a lot of pain inside that I just didn’t know how to manage.
I turned to self-harm to try to let out some of this pain. This is the first time I am publicly admitting this, and before this writing, less than five people in the world knew I did this. I didn’t want to cut myself since that would leave marks, which would make it hard to keep under wraps. I had done a stunt previously where I sprayed Axe body spray on my hand and lit it on fire. It didn’t cause pain if you did it as a stunt, but if you let it burn long enough, it hurt like hell. I did this a handful of times. It didn’t seem to help, yet it became a habit.
I suppose I subconsciously wanted to let some of this struggle out. I remember one day I put up an “Away Message” on AOL Instant Messenger that was beyond the scope of the normal, teenage angst. When I returned, one of my friends (who I later found out had depression himself) had said, “Um, Justin, you might be depressed.” Even though I was self-harming from time to time, I didn’t believe that I could be depressed. Again — I had a good life; what right did I have to be depressed?
At some point, this internal pain began to be too much. I began thinking that I just didn’t want to live anymore since it was too hard, even though nothing external was “wrong.” I started experiencing thoughts of suicide.
While I never actually attempted it, I had concrete plans on how I would do it. It’s still hard to walk past the area in my parents’ home where I was planning to do it. My little sister is what ended up saving my life. She looks up to me and I didn’t want to let her down. My love for her was stronger than my hate for myself.
Reaching this point was a pivotal moment. I finally admitted something was wrong and I needed help. Yet, I didn’t know how to ask. I decided to stop wearing a mask of being ok on the outside. I moved a little slower. Sighed a little bit more. Smiled less. One day, I flopped down dramatically on the couch and my mom finally asked if I wanted to talk to a therapist. Even though I was most likely weeks away from taking my own life, I couldn’t directly ask.
I agreed to get help and began seeing a therapist. I continued harming myself throughout the first few sessions and thoughts of suicide still lingered. Eventually, I admitted both of these to the therapist and we decided to start me on a course of antidepressants.
Initially, my dosage was wrong and I experienced a panic attack not too long after beginning them. I freaked out because my mom told me to go to bed and I wasn’t ready yet. I locked myself in my room and began hyperventilating. My dad literally kicked down my door and carried me outside to get fresh air. I calmed down, the doctors adjusted my meds, and the meds took hold. I continued going to the therapist and this one-two punch of medication and therapy helped raise me out of depression.
I don’t remember exactly when I got off of the medication, but it was an uneventful process. I did not slip back into depression and had no problems coming off of them.
While this experience was probably the hardest in my life, and that’s saying a lot since I faced testicular cancer at 25, it ended up helping me recognize the symptoms early on during my survivorship phase of cancer.
I know that having depression at a young age puts me at risk for a recurrence later in life, and this study from 2017 that said about 20% of cancer survivors experience PTSD symptoms within six months of diagnosis. The CDC also reports that cancer survivors take anxiety and depression medication at almost twice the rate of the general population. Basically, it was a perfect storm of risk factors and I’m glad I knew these figures.
This time, I asked for help and antidepressants. I’m happy to say I am still on the meds and not feeling effects of depression. Experiencing the episode in high school helped me advocate for myself earlier before it got worse.
In addition to being a testicular cancer survivor, I am a fourth-grade teacher. I noticed one of my students seemed very upset, distant, and prone to tears. I requested a conference with his parents to discuss these episodes and tried to recommend they take him for further evaluation. They told me that they give him everything they wanted, love him unconditionally, and he has no reason to be sad. In a moment of “I’m not sure I should do this,” I shared that what I had experienced (leaving out the self-harm and thoughts of suicide parts) since I had “no reason to be sad” too. I saw something change in their eyes and I hope it may have paid off.
You can’t always tell if someone is experiencing depression from the outside. Like I said, I had a prime life and no real reason to be upset. Depression is a chemical imbalance in your brain and it’s always influenced by external factors. Asking if a person is feeling okay won’t always work, either. They might not even be aware of their own feelings or may hide it out of a certain feeling of stigma. My best advice is to be there for that individual and to be non-judgmental. In 2019, we should be treating mental health as a serious issue and stop the stigma surrounding it.
I hope by sharing my story, even one person realizes that it’s okay to ask for help and doesn’t feel they need to suffer in silence. I compare taking care of mental health to needing chemo for cancer or a cast for a broken arm. No one would blink twice about treating either of those conditions, but why does society not have the same attitude towards mental health?
Help is available from anywhere in the United States via Crisis Text Line (text HOME to 741741) or the National Suicide Prevention Lifeline at (800) 273-8255. Either service is free, confidential, and available 24 hours a day, seven days a week.
You can’t always tell if someone is experiencing depression from the outside.
Justin, in his high school days, with his favorite teacher.
About the Author
Justin Birckbichler is a men’s health advocate, testicular cancer survivor, and the founder of aBallsySenseofTumor.com. In November 2016, he was diagnosed with stage II testicular cancer at the age of 25. Throughout his diagnosis, surgery, chemotherapy, and being cleared in remission in March 2017, he has been passionate about sharing his story to spread awareness about testicular cancer, promote open conversation about men’s health, and talk about the unspoken realities of being a cancer survivor.
He works as the Operations Associate at Savvy Cooperative, the first and only patient-owned co-op that empowers people to use their health experiences to inform new products and services through surveys, interviews, product testing and more.
In 2017, ABSOT won an award for the Best Advocacy and Awareness Cancer Blog in 2017, and Justin was recognized as one of 15 People Who Raised Cancer Awareness in 2017. Additionally, Justin was selected as the winner of the Hilarious Patient Leader Category in the 2018 WEGO Health Awards. In 2019, Justin was recognized as one of “40 Under 40 in Cancer.” ABSOT was chosen as one of Healthline’s Best Men’s Health Blogs for 2020 and Justin was also named as one of Cancer Health 25: Change Makers in the same year.
Notably in 2019, Justin delivered a TEDx talk, entitled “Carpe Scrotiem: Why Men Must Start Discussing Their Health”
His work with men’s health awareness has been featured by over 60 different companies and organizations, including British GQ, Livestrong, Healthline, The Mayo Clinic, The Movember Foundation, National Foundation for Cancer Research, and various other groups. In addition to his work through ABSOT, Justin has written over 160 articles, appearing in Cure Magazine, I Had Cancer, The Mighty, The Good Men Project, Stupid Cancer, and more.
Justin Birckbichler also serves as an advisor to Blue Note Therapeutics, and has had roles as a member of the Patient & Caregiver Advocate Board for Cancer University, on the 2020 HealtheVoices Advisory Board, the Board of Trustees of Our Odyssey, Young Adult Cancer Survivor Advisory Board for Lacuna Loft, and on the 2019 WEGO Health Patient Leader Advisory Board.
Outside of the “cancer world,” Justin amateur chef, technology aficionado, and avid reader. He lives in Fredericksburg, VA with his brother and sister kittens, Downey and Pepper. In his free time, he enjoys reading, cooking, writing, exercising, and watching movies.