Author Archives: allevin18

Guest Post: PTSD & Cancer

The following is a Guest Post from a fellow advocate of mine. Bob McEachern is an advocate for Follicular Lymphoma. You can find much more of his writing on his own very popular blog “Lympho Bob”. In this post, he describes how one going through cancer may likely face symptoms of Post Traumatic Stress Disorder (PTSD). This topic interested me greatly, as I have met advocates of many different chronic illnesses and have often wondered how receiving the diagnosis of a chronic illness and living with a chronic illness may impact one’s mental health. I now have a first-hand description.

 

 

PTSD and Cancer

Recently, a friend posted a link on Twitter. Like me, she’s a cancer survivor – breast cancer for her, Follicular Lymphoma for me.

The link was for a study of Post-Traumatic Stress Syndrome (PTSD) in cancer patients. The researchers began with a simple assumption – that a cancer diagnosis is a traumatic event (I’d say that’s a good assumption). They interviewed patients when they were diagnosed (their exposure to the trauma), and then again at 6 months and at 4 years after diagnosis. The interviews focused on their possible PTSD-related symptoms – intense fear, horror, or helplessness at diagnosis, and then later re-experiencing the event by avoiding it, or feeling numb or detached, for example.

They found that, 6 months after diagnosis, about 20% of cancer patients experienced some form of PTSD. That’s more than 3 times the rate of PTSD in the general population.

The PTSD rate was in line with the general population at 4 years, but there are plenty of cancer patients who relive their experience, even years later.

My own diagnosis was as traumatic as many others. I was 40 years old, the healthiest I had ever been, and had three young children, aged 10, 8, and 6. After the diagnosis, I spent a week doing blood tests, a PET scan, and a bone marrow biopsy, trying to figure out what I was dealing with.

After all that, I went to see a Lymphoma specialist at a nearby research hospital. For the first time, in the waiting room, I was surrounded by other cancer patients, and my reality started to creep in. I picked up a brochure and saw the 5- and 10-year survival rates for Follicular Lymphoma. It was all overwhelming. I spent the next two weeks breaking into tears every half hour or so, wondering, Will that be me? Will I be a statistic? And wondering what would happen to my kids. It was the darkest time of my life.

Fast forward 9 years. My wife needed some testing done at the same hospital. We went up to the second floor of one of the building, and as she was checking in, I got a strange sense that I’d been there before. The building is kind of pyramid-shaped, with one wall completely made of glass windows. In the middle of the waiting area, there was a large planter full of ferns.

I knew those windows. I knew that planter. This was the waiting room that I had been in before.

As my wife sat in the nearly empty waiting room to be called in, I looked around for a directory, to see if this was actually the Hematology section, and not the specialty she was being tested for. Before she got called in, I told her that I thought this was the same room.

She went in for the tests, so I sat by myself in that waiting room, for the 3 hours or so that the tests took. I had brought a book with me, but I couldn’t focus on it. I got up and walked around, still wondering if this was the same room. Sure enough, I found a bronze plaque that had something to do with an important donor and Hematology. This was the place. I also found a big Andy Warhol-type print of a local personality, his face repeated like Marilyn Monroe’s, hanging on the wall. This personality had blood cancer, too. It’s funny — one memory of that bad day was seeing him in the hallway, when he must have had an appointment. This was most definitely the old Hematology department (which I later realized had moved to a new cancer building).

Lots of feelings came flooding back to me. It’s a strange sensation, reliving something so vividly, nine years later.

I don’t know if what I felt would be classified as Subsyndromal PTSD, as the researchers in the cancer study call it. But it’s easy for me to believe that cancer patients can experience those symptoms, even years after they were diagnosed.

One fascinating finding from the PTSD-Cancer research that really stood out for me: patients with all types of cancer experience PTSD at 6 months at a rate higher than the general population, except one: breast cancer patients.

The researchers think that this is the case because breast cancer patients have so many more support resources available to them than patients of other cancers.

Another conclusion from the researchers that stood out: many cancer patients who do experience PTSD symptoms have the belief that going it alone is a sign of strength, and they should just gut it out when they have emotional problems.

It’s not an easy leap to put those two things together. Breast cancer patients (about 99% of them are women) have more support resources, but are also more likely to use them. In general, men are less likely to seek out help.

My two experiences, nine years apart, were very different. After diagnosis, when things went dark, I kept everything inside for two weeks. I needed to “be strong.” I remember watching TV with my wife and kids, turning off the lights “so I could see better,” but really trying to hide my tears from them. Things only got better when I finally opened up to my wife. She was and still is my rock. She listened, let me cry, and let me know that whatever happened, we would go through it together. Nine years later, after revisiting the same office and feeling the same feelings, I didn’t make that mistake again. We talked through it all right away.

The researchers conclude that more support for cancer patients’ mental health is needed. Even a doctor taking time to debrief a patient’s emotions, right from diagnosis, can help. A doctor’s willingness to bring up the issue can go a long way toward finding a problem.

And patients need to be willing to seek help. Being silent is not a sign of weakness, they say. In fact, it’s a sign of strength – it takes courage to seek help.

That’s a good reminder for all of us.

 

Reflections from the NAMI National Convention (2018)

During the last week of June 2018, National Alliance on Mental Illness (NAMI) held their annual national convention. This year it was held in New Orleans, Louisiana. There were nearly 1,700 total attendees with representation from every state, including Puerto Rico. Half of the attendees at the convention were first-timers. The theme of the convention was, “Live, Learn, Share, Hope”. Each of these themes resonated with me in a different way:

Live:

The theme “Live” makes me think about how I need to live my life to its fullest. The phrase, “Live each day like it’s your last” came to mind. I have become more mindful in the past few years. To some, “mindfulness” may just seem like a buzz word. To me, being mindful and living in the moment is critical in order to be fully present. I now naturally catch myself when my mind is wandering and pull myself back into the present.  This is important because much of our mind wandering has been shown to be negative. One study found approximately 80% of mind wandering to fall into that category. A recent example of mine was when I was playing a board game with three of my kids. I caught myself starting to think about work and things I needed to accomplish around the house. I quickly stopped those thoughts and intentionally focused on my kids and the game we were playing. Of course, everybody’s “fullest” will look different, and that’s okay. Regardless, if we want to live our lives more deeply, learning to be present will always be part of that formula.

Learn:

Much of the NAMI national conference is about learning. I learned about some of the policy and advocacy work that NAMI is doing at the national level. As the nations largest grassroots mental health organization, NAMI has done an extraordinary amount of work in shaping the national public policy in an effort to support both those living with a mental illness and their family members. NAMI has also educated hundreds of thousands of people giving them information and the resources they need in order to support themselves or others.

In addition to learning more about NAMI, I learned about the difficulties and opportunities in mental health research faced by the National Institute of Mental Health (NIMH). I was able to learn more about new medications, new therapies, and how to become a better advocate. I learned more about the unique challenges faced by people of color who are living with a mental illness. The learning opportunities at the convention were endless!

Share:

Sharing is about connecting with others. I was able to connect with so many dynamic, caring people at the convention. People were open to sharing their own personal experiences of living with a mental illness. Others shared  about supporting a loved one with a mental illness. People shared how they advocate for more awareness and better policies around mental illness. Many were there to share their valuable resources. This sharing “culture” was one that allowed for people to connect and learn from one another in a very authentic, caring way.

Hope:

Hope permeated the NAMI convention. Hearing many stories of those living with a mental illness who have made incredible strides, such as Jeff Fink, Lauren Burke, and Lloyd Hale from the movie, “Beyond Silence”. Each of them overcame inconceivable  challenges of living with a mental illness. Learning from others about how they live incredibly meaningful lives full of contentment while managing their mental illness created an immense feeling of hope.

In the end, this convention was both inspiring and educational. It allowed people from all walks of life to connect with one another and to learn from one another. NAMI is an organization that provides a wealth of resources and information to so many. I would urge anybody who has any interest in mental illness to attend a NAMI national, or even state, convention.

Guest Post: Depression–A Cancer Survivor’s Story

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 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 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 a 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 I 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-judgemental. In 2018, 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?

About the Author

Justin High School.jpg

Justin, in his high school days, with his favorite teacher

Justin Birckbichler is a men’s health activist, testicular cancer survivor, and the founder of aBallsySenseofTumor.com. From being diagnosed in November 2016 at the age of 25, to finishing chemo in January 2017, to being cleared in remission in March, he has been passionate about sharing his story to spread awareness about testicular cancer and promote open conversation about men’s health.

In addition to his work through ABSOT, Justin’s writing has appeared in Cure Magazine, I Had Cancer, The Mighty, The Good Men Project, Stupid Cancer, and more. His work with awareness of men’s health has been featured by Healthline, Ball Boys, and various other organizations. 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. He was also one of the selected attendees of HealtheVoices18.

Justin also serves as a member of the Strategic Advisory Board for the Cancer Knowledge Network and as a board member of the Young Adult Cancer Survivor Advisory Board for Lacuna Loft.

Outside of the “cancer world,” Justin is a teacher, amateur chef, technology aficionado and avid reader. He lives in Fredericksburg, VA with his wife, cat, and dog.

Connect with him on Instagram (@aballsysenseoftumor), on Twitter (@absotTC), on Facebook (Facebook.com/aballsysenseoftumor), on YouTube, or via email (justin@aballsysenseoftumor.com).

A Mental Health Survey for Public School Educators

I have felt quite strongly that there is a great need for more mental health support for educators. When I started to research the topic, I was surprised to see that not only was the profession of teacher/educator not on any of the top ten lists for jobs with the highest suicide rate, but they weren’t even in the top twenty (CBS News: These Jobs Have the Highest Rates of Suicide).

I researched further and found several articles that described the mental health needs of educators in England. This only strengthened my belief that England is much further ahead in the world of advocacy around mental health. The recent Project Eighty Four is just one example in which Calm brought the topic of male suicide to the rooftops (quite literally)!

I decided to put together a survey of my own to prove a hypothesis that I had developed: I believe there is a very high number of educators who are struggling with their mental health. I believe that, particularly in the urban settings, many staff members are dealing with students who are going in and out of complex trauma on a daily basis. This includes the type of trauma in these young people’s lives that I cannot even begin to fathom. The fact that many of them have even made it to school is mind-boggling. Even students who are not going in and out of trauma are, often times these days, facing mental health challenges as seen by the data. In 2016, suicide was the second leading cause of death for groups aged 10-14 and 15-24 (https://www.nimh.nih.gov/health/statistics/suicide.shtml). Many of our students cannot get the medication they need because of various reasons, including a lack of insurance. Others are on month-long waiting lists to get a proper assessment or to find a bed in a facility because they are suicidal. Yet, with all of these challenges, we expect our students to show up to our schools, sit in their chairs quietly, and perform well on our standardized tests (or we could have detrimental repercussions from the federal government, such as the loss of public funds). There’s a shortage of school social workers and school counselors. Not only does this create an unrealistic student to social worker/school counselor ratio adding to their stress, but it also puts classroom teachers in the situation of having to ‘play’ counselor or social worker. Many times our school nurses are dealing more with psychosomatic symptoms than anything actually physical. Building administrators are faced with deciding on consequences for students who they know are facing incredible life challenges. They are also dealing with parents or guardians who are often times dealing with their own life struggles and mental health difficulties.

So, this brings me back to my survey. I created a survey to send to public school educators (staff of any positions in a public school system in the United States). Just prior to making my very brief, confidential survey of eight questions public, I bumped into another survey that had revolved around the mental health of educators: the 2017 Educator Quality of Work Life Survey. This was a 30-question survey conducted by the American Federation of Teachers (AFT) and the Badass Teachers Association (BATs). Some of the key findings that stood out to me from their survey results were:

  • Teachers reported having poor mental health for 11 or more days per month at twice the rate of the general U.S. workforce. They also reported lower-than-rec-ommended levels of health outcomes and sleep per night.
  • In response to the question “How often is work stressful?” nearly a quarter of respondents said “always”.
  • Educators and school staff find their work “always” or “often” stressful 61 percent of the time, significantly higher than workers in the general population, who report
    that work is “always” or “often”stressful only 30 percent of the time.
  • Educators are much more likely to be bullied, harassed and threatened at work than other workers.
    • 43 percent of respondents in the public survey group reported they had been bullied, harassed or threatened in the last year.
  • Teachers and school staff are significantly more stressed than other U.S. workers:
    • Respondents to the public survey reported an…average of 12 days in the last 30 that their mental health was not good
    • 21 percent of educators in the random sample characterized their mental health as not good for 11 or more days in the last 30, significantly higher than U.S. workers generally, less than 10 percent of whom reported poor mental health for 11 or more days in the past month, according to national data from 2014.
  • Educators’ physical health is more likely to suffer than other U.S. workers

My first thought was that since a survey had been recently completed, perhaps there is no need for my survey. However, after further reflection, I decided that the fact that the AFT and BATs had such a survey was acknowledgement that perhaps my theory had some validity. In addition to that, my survey is quite different. None of the eight questions that I ask were a part of their survey and my questions, I believe, are much more direct in getting to the mental health of educators.

In the end, once the need is made more apparent, my goal is to advocate for a much better system of support for educators. I believe that districts can do much more than simply hand a brochure to a struggling staff member and offer a few sessions of free, confidential counseling. United States public school educators are dealing with an incredible amount of stress in what is arguably one of the most important roles in our country. We can do better…we must do better… to support them!

If you are a public school educator in the United States, please consider taking this very brief (eight question), anonymous, completely confidential survey regarding Mental Health.

As always, comments to this post (and all others) are welcomed and encouraged! Thank you!

Guest Post: Progress with Prozac

The following is a piece written by fellow advocate, Justin Birckbichler. I had the privilege of meeting Justin recently at an incredible conference for online advocates of chronic illnesses, HealtheVoices. The conference was sponsored by Janssen, the pharmaceutical division of Johnson and Johnson, as a way for them to give back to the communities for whom they serve. Justin advocates for testicular cancer. He is an incredible advocate who is knowledgeable, funny, supportive, and caring. He helped me further the work of my own advocacy, as well. Justin also happens to be a teacher!

Read more about Justin at the bottom of this post.

Please note: if you are a man, please consider taking his very short survey for his research on the topic of testicular cancer. A link for the survey is included in his bio.

For now, enjoy this intriguing piece of writing:

Progress with Prozac 

Around the five month mark post chemo, I realized something was not quite right. It wasn’t my new fascination with discussing balls at every opportunity; it was more than that – my mood was not what it should have been. At first, I thought it was just the stress of returning to work and transitioning back to being a normal person instead of a cancer patient.

Upon closer inspection, I realized I was still feeling down, but it was summer, so the job reason didn’t make sense. If you’re not at regular reader of A Ballsy Sense of Tumor, I am a teacher, and teachers don’t work in the summer – that’s the main reason we chose this, duh. (If you’re my principal and you’re reading this, please understand that this is a joke.)

However, a new school year began, and I noticed that I was feeling off and just not as enthusiastic as I once was about teaching. It wasn’t that I hated my job; it was that something internally wasn’t quite right, and it was having an impact on my ability to teach to the best of my abilities. My students were still learning, growing, and seemingly enjoying themselves, so they didn’t appear to notice my internal struggle. Nor did my administrators, who are awesome and amazingly supportive of me, or my co-workers, who are also pretty great and put up with endless ball puns during team meetings. Regrettably, we don’t teach about spheres during the geometry unit.

In addition to feeling slightly off at work, I also realized I was feeling irritable and was much quicker to get angry at home. In October, I experienced a full on panic attack while watching an episode of Stranger Things on Netflix on the eve of my orchiectomyversary. Overall, hobbies like reading and cooking didn’t bring me as much pleasure as they once did, and I just felt generally pretty flat.

As I’ve alluded to numerous times through my writing on ABSOT, I battled with depression in high school. However, since my only job at that point in my life was to be a student (and school had never been a struggle for me, since I was in the gifted program), it didn’t have an impact on my “job.” It dawned on me that I was now feeling some of the same effects I did back them.

Knowing that having depression at a young age puts me at risk for a recurrence later in life, I decided to look into research about cancer survivors and PTSD/depression to fully understand just how stacked the cards were against me. It didn’t bode well when I first typed “cancer survivors and…” into Google, and “PTSD” and “depression” popped up as the first two suggested results (followed by “alcohol”).

As I researched more, I found 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.

After finding this information, I decided to ask for help, specifically in the form of antidepressants at my follow up visit in December. Dr. Maurer agreed to prescribe them, and I thought it would be all pretty rainbows and fluffy unicorns immediately.

However, about four weeks later, I felt no different. I knew antidepressants could take up to six weeks to show major changes, but I wasn’t feeling even slightly better. Perhaps I even felt worse, as I had these “happy pills” and I still felt down. Maybe something was just wrong with me – beyond the missing testicle.

I’ve learned to be open with my health and feelings, so at my med check up with NP Sullivan, I basically said, “Hey, I don’t think these are working.” Since I am obviously super medically qualified (read as: not qualified at all), I supported my theorem by saying I was on the same dosage I was in high school, and High School Justin was about fifty pounds lighter and ten years younger (and had a terrible taste in hairstyles and girls, but that’s a different story for another day).

NP Sullivan actually agreed with me and decided to increase my dosage. I wish I could say that this was the end of my frustration, but it wasn’t.

However, this new struggle wasn’t internal – it was externally driven towards insurance companies and American healthcare in general. If you’re an international reader (and I know you’re out there, since according to Blogger’s data I have readers on every continent, except Antarctica, which is a shame since it’s cold as ball(s) there), appreciate it if you have a better healthcare system.

When Dr. Maurer first prescribed the pills in December, my prescription was denied, since the pharmacy needed to get “pre-authorization” because apparently, a doctor’s orders aren’t enough. This wouldn’t have been a huge deal, but I was going out of town for a week and wanted to start the pills immediately. Out of desperation, I ended up paying out of pocket for that first fill. About two weeks after starting the pills, the pre-authorization came through, just in time for my dosage increase.

And just in time for another claim denial. Apparently, my original pre-auth covered me only for the original dose. The fact that insurance claims can be denied through an automated system by non-medical professionals is ridiculous to me. Insurance companies, do better.

Long story short, the insurance claim handlers at Dr. Maurer’s office are awesome, and I got pre-authorized for the new dose. (Maybe my mini-rant on Instagram story helped too!) This new pre-auth lasts for a year, and hopefully, I won’t need any more increases.

To be honest, I don’t think I will need it. I’m not really sure when I noticed that I was feeling better, but when I wrote my “12 Months Later” post in late-January, things were definitely looking up. I was getting more into the swing of lesson planning and teaching, minor things didn’t bother me as much, and I didn’t find myself complaining as often. I wish I could say that colors were suddenly more vivid, but I’m colorblind and colors don’t ever look bright.

It’s now the end of February, and I feel so much better than I did in September. (Side note – I really feel like Christopher Nolan with the amount of time jumps in this post. My bad.) While I would never say I hated work, I definitely have a better attitude when I walk through the doors of Room 31. Exercise, writing, reading, and cooking have become more enjoyable again. While writing this post, I realized that this one has a better feel and tone, as compared to some of the posts I wrote between September to January, even though it’s about depression, I feel more like myself on a day-to-day basis. I haven’t resumed any sort of formal therapy program, but I know that is definitely recommended while on these pills. It’s on my to-do list to look into in the future.

My biggest takeaway from this all is to ask for help if you feel you need it. There seems to be such a stigma around mental health and this post is an effort to be open and transparent to help dispel it. Sometimes, mental health isn’t even viewed as a necessary thing to take care of or treat as a serious matter. We treat our bodies and help them to heal when we are sick or injured; why should our mental health and brains be different?

The debacle with the insurance company and preauthorization helps to underscore this issue. When I had “probable strep” in January, although the test came back negative, the company had no problem approving amoxicillin, even though it probably wasn’t necessary. Any other prescription for my myriad of side effects during chemo was filled without an issue. But needing antidepressants? I had to jump through hoops to get those.

I recently saw a Tweet that said, “Depressed people don’t need Prozac. They need running shoes and fresh air.”

That’s a damaging narrative. I tried that, and continue to exercise, but it wasn’t that simple for me. If that’s your opinion, fine. Go run or whatever else works for you. But don’t shame other people for trying what might work for them. Just as I’m not going to fault you for trying homeopathic medicine, don’t go throwing crystals at me for what I’ve chosen. Positive thinking just isn’t enough sometimes.

I hope that this dosage continues to keep my mood elevated and on the upswing. I have no idea how long I’ll need to be on the antidepressants, but I’m not worried about it. What matters to me is that my emotional healing is beginning to catch up to my physical healing, the disparity between the two being something that has been nagging at me since I was cleared for remission.

However, this is something that I should have seen coming. They removed half of my “lower brain” and left my upper brain fully intact… no wonder it’s taking twice as long to heal!

About the Author: Justin Birckbichler is a fourth grade teacher, men’s health activist, testicular cancer survivor, and the founder of aBallsySenseofTumor.com. From being diagnosed in November 2016 at the age of 25, to finishing chemo in January 2017, to being cleared in remission in March, he has been passionate about sharing his story to spread awareness and promote open conversation about men’s health. Connect with him on Instagram (@aballsysenseoftumor), on Twitter (@absotTC), on Facebook (Facebook.com/aballsysenseoftumor) or via email (justin@aballsysenseoftumor.com).

Currently, Justin is running a research study based on males of any age who have had a physical exam done by a doctor and their experiences related to testicular exams. I

This six-question survey is brief. All responses are anonymous, and all information is kept completely confidential.

If you’re a male, please visit bit.ly/absotdoctorsurvey to help further the research. If you’re not an owner of testicles yourself, please share the link to help maximize the reach. Thank you in advance!

Shame & Its Connection to the Stigma

As I was recovering from my second major bout of depression, I was introduced to Brene Brown’s well-known TedTalk on shame. It didn’t really make a lot of sense to me at the time. However, looking back on my two bouts of major depression and their lengthy recoveries, it is clear that I had a great deal of shame.

The first experiences I’m reminded of when I think of shame were the times I would go to the local pharmacy to pick up my medications (originally, several). I would wander around the store to make sure that there were no neighbors who I knew that would see me purchasing medications. What would I say if they happened to ask what medications I was getting? How would I respond if they asked me if I was sick? Now, also in hindsight, there was clearly a component of anxiety in play at the time. Anxiety often goes hand-in-hand with depression. That being said, there was clearly a component of shame in taking medications for a mental illness. When I’d return home from the stressful trip to the pharmacy, not only would I immediately throw out the receipt or any other evidence that I was taking an anti-depressant, but I would be sure to first tear it into many pieces. I also quickly hid the medicine in my underwear drawer, just in case someone would come into our master bedroom and see them.

When I first had depression, I would see my family doctor for medications. I remember sitting in the waiting room, wondering what would happen if someone from work  would happen to see me? Would I lie and say that I was there for a physical? I remember jockeying to find a seat in the waiting area that was conspicuous enough spot so that very few people could see me. I’d even hold a magazine near my face, covering it as best possible without being obvious. Focusing more on not being seen than actually reading any of the words on the pages. All of these actions, again, based upon my shame of needing to see a doctor for depression.

I was concerned about having to take too much time off from work in order to make it to my doctor appointments, particularly when I was first diagnosed seeing the doctor frequently. What would the staff at the school I worked at think if I was gone frequently for appointments, coming in late or leaving early? More shame. And once my depression got more severe, I had to starting seeing a psychiatrist. The psychiatrist who I chose to see was at a Behavioral Health clinic. I certainly knew the excuse of being there for a routine physical or a nasty cold wasn’t going to fly had I seen someone I knew. They’d instantly know I was there for some type of behavior health concern. Solely based on my shame of bumping into someone who might recognize me from the large school district I had been working in for many years, I considered changing doctors. In the end, I decided that seeking out a new psychiatrist would be too stressful and not feasible. So I gritted through the experience of sitting in the waiting room for each of my appointments, hoping desperately not to bump into someone I knew or who even looked vaguely familiar.

Early on in my depression, I ordered two books about depression (as shame would prevent me from purchasing these books in person at a bookstore where people may see me making such a purchase). These were incredible books by Matthew Johnstone that do an amazing job of helping others understand what it’s like to live with depression, or to live with a loved one who has depression. I read them, shared one with my wife, and then gently hid them away on the top of a tall bookcase in the basement. Not on the top shelf, but on the top of the bookcase, concerned, due to my shame, that someone who was visiting us at some point in the future might just see the books and ask about them.

When my suicidal thoughts became pervasive and plausible, I had to make the excruciating decision to take time off from work in order to check myself into a partial hospitalization program. Excruciating, as I nervously wondered what the staff who I supervised would say if I was gone for three weeks or more? What would I say when I returned? The shame was powerful. I nearly chose not to take time off and not to receive the help that I needed because of this shame. I had brought my wife and sister to my final appointment to advocate for me, as I did not have much confidence in the psychiatric physician’s assistant who I was seeing. Sure enough, the psychiatric physician’s assistant played into that shame, sharing with me how challenging taking off work may be. I was thankful for bringing my wife and sister who strongly advocated for me to enter a partial hospitalization program. In the end, I believe taking work off and entering such a program actually saved my life!

It was shame that kept me indoors when I took sick time away from work. I knew that it would be better to get outside. I knew I should be helping my family by running errands and driving our kids to activities. I knew that going for walk, getting a bit of exercise and fresh air, rather than isolating myself inside of the house, was important. However, the fear, once again, of bumping into someone I knew and having to explain why I wasn’t at work was terrifying for me. The shame of taking work off for depression was preventing me to do the things I needed to do in order to recover from depression and to help support my family.

What does stigma have to do with this, you may ask? I believe that a strong stigma still exists in much of the US. I believe the shame that many people face in dealing with a mental illness is directly related to this stigma. Because of the stigma, people are often uncomfortable to talk about mental illnesses. People with a mental illness are often judged and/or labeled. A mental illness is just like any other illness and should be treated as such. As many people say, mental illnesses are invisible. Yet, it’s important to understand that they are just as real as any other illness. A mental illness doesn’t make anybody any less intelligent and it certainly doesn’t make them violent, as a fair amount of myths may lead one to believe.

We need to normalize conversations around mental health, just as we have around cancer, diabetes, heart disease, and many other serious illnesses. One way to normalize our conversations is by sharing our stories of mental illness. Sharing our stories helps to educate those who may not understand mental illnesses and to support those who are struggling. The more we talk publicly and openly about mental illness, the more we do away with the stigma and the less shame people living with a mental illness feel.

Shame is powerful. Shame is dangerous. Shame often prevents people from getting the help they need. Shame played a role in me nearly taking my own life. Help normalize the conversations around mental illness, help end the shame!

Please tune in to my podcast, The Depression Files to hear me interview men who have struggled with depression. Inspirational stories of hope and perseverance!

As always, I welcome and encourage comments to this post. Thank you!

 

Guest Post: An Excerpt from Author & Advocate Steve Austin’s Upcoming Book

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Steve Austin was the very first guest I had on my podcast, “The Depression Files”. I had reached out to him after I had learned of his advocacy work and his book, “From Pastor to a Psych Ward”.

Steve is now about to release his fifth book: “Catching Your Breath: The Sacred Journey from Chaos to Calm”. Steve is a skilled writer who gracefully shares his story in the hopes of supporting others.

Please enjoy this excerpt from his upcoming book. If at all possible, please check out his Kickstarter page in order to support the launch of this important book:

When I was just a little boy, our family was vacationing at a motel on the outskirts of Nashville. My dad’s best friend from high school lived in the area, and we always had such a great time with their family. I was standing on the stairs at the shallow end of the pool, mesmerized as I watched my Dad take a deep breath and disappear under the water.  Dad has always been in fantastic shape, and I just knew he could do anything. I stood there, anxiously watching and waiting for him to return from the other side of the pool. It felt like he was down beneath  the surface of those deep waters forever and might never return.


For the first few seconds, it was so cool, but to a kindergartener, staying under past the count of ten seemed either impossible or superhuman. Dad finally returned, and I cheered. “Whoa! Dad! That was awesome! I counted all the way to 100 while you were underwater!” As incredible as it was, I always felt better when my Dad was near me. The water was an uncertain thing to me, and I didn’t like feeling alone.

It’s interesting to note that children can’t hold their breath as long as adults, but the older we become, the longer we teach ourselves to hold it in. The same is true in life. There are many people holding their breath and fears, just waiting to exhale. Every day, we have an opportunity to exhale all the pain, anxiety, anger, and everything else we have been holding on to and breathe-in calm and newness.

When I was much older than the little boy in the shallow end, I became acutely aware of what it feels like to hold your breath so long that the pain and shame feels like drowning. For me, the end of the rope looked like waking up in an ICU room after a serious suicide attempt. This was the point where I started to learn how to breathe again. I’m not a medical professional, I’m just a guy who has survived a shipwreck and found the courage to talk about it. Not everyone has an official mental health diagnosis, but  everyone knows what it’s like to feel completely overwhelmed by life.

Much like the day my Dad returned from the deep end, laid his head against the edge of the pool, and finally exhaled, my journey from chaos to calm started after years of holding my breath. No matter how superhuman someone may seem, we have all been overwhelmed at one time or another, and we are all looking for the safety of the shallow end.

– Excerpt from Steve Austin’s upcoming book, Catching Your Breath. Support the Kickstarter campaign today at kickstartmybook.com and get more details on this powerful new book at catchingyourbreath.com.

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