I’m unfortunately writing this PSA out of personal experience. As much as I might have hoped to just have a clean getaway from the 2010’s after all my family and I had been through in this decade, they weren’t done with me yet. Yes, I had a suicidal episode of all things over the Christmas holiday of 2019. What a wonderful way to end 2019 and the entire decade, right? It wasn’t all palm trees and sunshine.

[Note: This is one of those blogs where literally everything ties together. Mental health, physical health and wellness, proper diet and eating right, getting enough exercise, taking proper care of yourself, and then what can happen when you do none of the above and allow for the possibility that your body (and mind) gets into a very serious tailspin. It took me an extra day just to add links to all of the related blogs and add a few photos. Take your time, definitely check out all of the linked and related blogs, and get in touch if you want to talk about anything. Although not present on social media much, I’m always in the background for the testicular cancer and broader AYA cancer communities, and am just a click away. - Steve]

CONTACT ME

For testicular cancer survivors adjusting to their new lives after treatments, many doctors like to think that the other testicle will “pick up the slack” as far as our testosterone levels go, but it’s not nearly that simple, and this has merely been an assumption by many doctors that hasn’t been backed up by any formal data. Hormonal peaks and valleys are common, which I’ve most certainly experienced over the years, along with a general ‘irregularity’. The best way to describe how a man can feel when having a testosterone level dropout, is like Superman without his powers — weak, lethargic, depressed, afraid, directionless, and completely lacking any confidence about anything. Very manly, right? With a single testicle, we’re not like a twin-engined aircraft that can still fly almost as normal with a single engine out. As I wrote in my above blog, for the most part I don’t have any ongoing symptoms of low-testosterone, and my body managed to figure things out after a few years. I’ve decided to forego any testosterone replacement therapy (TRT) so long as I’ve remained asymptomatic, but I’m not always asymptomatic, and the bottom fell out on me over the holidays.

The end of the year, and in particular right around the winter solstice — the shortest day of the year — has always been a problematic time for me. It was on one of the first winter solstices that I experienced after my cancer fight, that I noticed just how out of it I felt, almost as though my body wanted to shut down and hibernate. I was experiencing extreme fatigue and felt very depressed, had zero libido, and noticed around the same time that I didn’t even need to shave along with the loss of some body hair. All of this was a dead giveaway for low-testosterone, which a subsequent visit with an endocrinologist confirmed. I’ve managed to minimize these seasonal hormonal troughs so long as I’ve kept myself in pretty good shape and hit the gym regularly, while also maintaining a reasonable diet.

So of course, I hadn’t been doing any of this lately. A brutal work travel schedule the entire last third of 2019 obliterated any fitness routine I might have attempted, exacerbated my chronic fatigue issues, and my diet regressed as well. In hindsight, it’s almost entirely predictable that something like this was bound to happen, because I’d been doing absolutely nothing that I should have been. And there I was.

A Suicidal Episode at Disney World Due to Seasonal Depression And a Hormonal Dropout

We trekked all the way down to Orlando from our D.C. area home base for a week at Disney World over the holidays. With 5 human beings and a dog and all of the expense and logistical complications that come with flying a family of that size anywhere, we decided to drive in our land yacht all the way down. This saved us a few thousand dollars in airfare and car rentals, which is a big part of why we bought it. We split up the drive over two days, but it’s still a long friggin drive, and I was seriously fatigued from my work schedule in the preceding few months. I couldn’t catch even a single friggin break, because right on cue our alarm system acted up the night before we were leaving, which disrupted my sleep and made things even worse. Our first day at Disney World was Monday, December 23rd 2019, the exact date of the winter solstice, and almost like clockwork I couldn’t have been more out of it.

Here I was at the “happiest place on earth”, and I didn’t want to be there at all. Heavy feelings of depression hit me out of nowhere, I wanted out but felt trapped, and that’s when the suicidal thoughts hit me. None of it made any sense to me. Why on Earth was I having such godawful thoughts over Christmas, with my family, in the warmth of Florida, and out of the cold, miserable, and swampy sh*t hole of D.C. while at Disney World of all places? I was afraid and confused and definitely feeling very lost.

Do I look suicidal here? Fooled you! Not literally right in this very moment, but around this time is when it was hitting.

I think I must have felt it coming somehow, because I decided to go totally ‘dark’ once again. I logged out of all social media accounts, never looked at the news, and didn’t even put up any Merry Christmas or Happy New Year greetings on social for family or friends. When you’re having really awful thoughts like these, do you really need to be reading about all of the twisted sh*t going on in the world, or seeing yet another friend blowing a gasket over the latest thing they’re outraged about in the news, which probably isn’t even true? I just focused on staying in the moment with my family, put all external worries and concerns out of my mind, and luckily whatever spell this was faded by the middle of Christmas Day.

It saddens me that I have a bit of experience with suicidal episodes, but it can most certainly come with the territory of being a cancer survivor, and really speaks volumes about just how badly hormones being out of whack can mess with your head. The first time I’d ever been suicidal in my life was just short of two years after my cancer diagnosis, when PTSD was ravaging me from the inside out and burning my mind to the ground. It was the same feelings of feeling trapped with no way out, and just wanting to end it all as a means of escaping the pain that you can feel from PTSD. I was terrified of my body and couldn’t bear to live another moment in it, but how do you escape your own body? Well…

Don’t do it.

National Suicide Prevention Lifeline: 1-800-273-8255

Call the above number any time in the U.S. Reach out for help. Call a friend. You can even try the GRTY Health Chatbot. You can CONTACT ME and I’m happy to talk people through these situations, but I can’t guarantee I’ll be immediately available. Things will get better. Everybody is entitled to a “bad day”, especially as cancer survivors. The next one will be better, I promise. Believe in yourself, don’t give up, and keep getting back up. You will find ways to make it through whatever’s been haunting you, just as I and many others have.

At Disney, I took a deep breathe, told myself that this wasn’t what I wanted and had no idea where these thoughts were coming from, and just fully immersed myself in the moment, enjoying each and every second with my family at Disney. I didn’t give myself time to think or my mind the ability to wander, and that’s what turning off you phone, social media, the news, and all of those other distractions is all about. When you’re immersed in these external things, you’re not in your moment; you’re in someone else’s, and potentially someone else’s pain and misery, which there’s been no shortage of on the Internet! Stay in the moment — your moment. How “clean” is your social media feed? How clean is the news? Everybody’s experiences are likely to be a bit different, but I personally can’t go on social media or read the news without wanting to throw up. This is why when I’m feeling vulnerable or have dark thoughts going through my mind, I just switch all of this garbage off. At Disney where you pay by the minute, running around like crazy and hitting 20,000 steps per day probably did a lot to jerk my body out of whatever hormonal slump I was in, and I perked right back up.

Different Causes Require Different Responses

Of course, nobody wants to keep feeling this way. It can be tough to decipher where deeply depressive states or suicidal thoughts are coming from. I’ve been in depressive states because young adult cancer is a terrible life situation to have to deal with and adapt to, having nothing to do with hormones at all. Cancer sucks and there is no easy cancer, period. PTSD after cancer definitely caused some suicidal thoughts, but I’ve also had them from other seemingly impossible and completely unfair situations that life has thrown at us as well. The 2010’s were a rough decade for my family in far more ways than just cancer. It can be tough to know what to do, as each cause requires a different response.

Related Blog: PTSD After Cancer

There’s plenty of reasons to be justifiably upset, depressed, or distressed as cancer survivors, which could possibly lead to suicidal thoughts. Life doesn’t tend to let up after cancer either, and the rest of the world doesn’t care that we had cancer, either. The point is, don’t discount or forget about hormones and their potential to wreak havoc on our minds when they’re out of whack. Plenty of my other blogs might help you to work through many of the other sources of pain and distress after cancer, but keep testosterone levels on your radar screens, especially if something seemingly comes out of nowhere and you’re not even sure why you’re feeling the way you are.

Much of my off-and-on depression over the years has been situational based from serially bad and traumatic situations that my family and I have been forced to bear going far beyond just cancer, and not because of chemical imbalances, hormones, or other things. But testosterone dropouts like these from cancer can still rear their ugly head even 9 years out, if I’ve been doing a terrible job of taking care of myself, as had been the case over the last few months of 2019.

What I’m Doing Now

I can blame a grueling work schedule all I want, being 50% travel and hardly being home, and then having to work two full-time jobs at my full time job, too. None of that helped, but did I ever hit the hotel gym while on business travel? I did exactly one time, the entire year. Did I maintain healthy eating habits, or did I allow myself to completely fall off the bus on that too? Did I make an effort to get back into the gym when I was home? Not really. I just kinda gave up for awhile and hoped for the best, and ended up with the worst. No, my work schedule wasn’t forgiving at all, but I also wasn’t doing jack shit for myself, and paid a terrible price.

The moral of my story is that if I had even been attempting to do what I know I need to do to take care of myself, this most certainly wouldn’t have happened. I need to do a much better and more consistent job of taking proper care of myself, and can’t allow anything to get in the way of that. I’m doing the same things now that I’ve known I’ve needed to do all along, which is to get my ass into the gym at least a few times per week, clean up my diet and lay off of all of the caffeine and ‘boba’ and other garbage, and make sure I’m getting enough rest, and I already feel a zillion times better. It’s one thing to just expect to feel a bit of seasonal depression, a semi-predictable hormonal dropout, and feeling totally wasted for a few days, but it’s something entirely different when it devolves into suicidal thoughts to go along with it.

Read the above blog published almost exactly a year ago where I said the same goddamned thing. Too bad I didn’t listen to myself! Maybe this suicidal episode is the wake-up call and motivation that I need to finally start taking consistently good care of myself, and to stop making excuses.

Rescued By Disney World Again

Disney was, of course, fantastic. The new Star Wars Galaxy’s Edge attraction at Hollywood Studios which had literally just opened two weeks before was amazing, and the new rides were mind blowing and unlike anything you’ve ever been on before. We all had a great time even if I was shaken up a bit, and now I can say with authority that Disney has rescued me from some truly awful things not once but twice.

Related Blogs: Overcoming Post-Cancer Depression

The first time I went to Disney World with my family in April of 2013, I was just a few months out of the first time I had been suicidal due to heavy PTSD for over a month. While my suicidal thoughts have never been anything more than brief moments, it’s enough to leave a mark on you, and the depression can linger. Here I was just over two years out from my cancer diagnosis thinking I should have been through it all, only to realize that I was merely at the start of a far greater challenge adapting mentally. I also felt like if something was going to happen to me, it was going to happen sooner rather than later, and that I just needed to truly live every moment that I had. Most testicular cancer recurrences occur within two years from the end of treatments for non-seminoma patients (5 years for pure seminoma), and towards the end of this window is definitely a very nerve-wracking time.

That week at Disney back in 2013 was truly magical in that I didn’t think of cancer even once, never had a single depressive thought, and just cherished every magical moment with my family. Here I was feeling so lost and directionless, but Disney taught me exactly what I needed to do. Just live and enjoy every moment of your life, and never let a second of it go to waste.

And then here I was again nearly 9 years out from my cancer diagnosis, in the midst of something awful once again due to a perfect storm of internal and external factors, combined with the winter solstice and a testosterone level dropout. Disney World and in particular the new Star Wars Galaxy’s Edge attraction was so amazing that I literally didn’t have time to be depressed or anything else, but instead found myself in awe. And then the fast pace of Disney (paying by the minute!!) snapped my body out of whatever physiological or hormonal slump it was in.

The depressive and suicidal thoughts vanished at Disney, just like the money in our wallets!

Magic!!! (LOL!)

Cancer Can Affect People For Their Entire Lives

The last thing I want to point out is just how illustrative this episode has been of the fact that AYA (adolescent and young adult) cancers can affect people for their entire lives. If you thought that because I’m 9 years out from my cancer diagnosis that everything is okay, that I’ve been through everything, that it’s all in the distant past, and that everything is fine and good, you’d be wrong. I’d like to think that too, but my young adult cancer experience as a whole is still something that I have to manage, as a whole.

I have to keep myself physically active and exercise regularly, especially in these winter months in order to keep myself ‘perked up’ hormonally. Although it’s a fraction of what it used to be, I still have chronic fatigue issues. I can push it for awhile and far more than I could in the early years, but there’s still a line that once crossed, my body will basically shut down and I can’t really do anything for a day or two. I still have to watch what I eat and eat a well-balanced diet, to help maximize my potential and the energy that my body does have available. I still have neuropathy related pain and shooting nerve pain just about every day. And I can’t have toxic people in my life at all, and my tolerance for BS is basically zero, which is something that many, many cancer survivors will tell you.

If you understand how hard I’ve had to work and fight just to overcome depression, all of the anxiety issues I’ve faced, the PTSD, and the suicidal episodes, then you’d understand why other people causing issues in any way are just a non-starter. It’s an all hands on deck ordeal just to keep my own mind afloat and on an even keel at times, hence not having any tolerance for other people that might rock my boat with their bullshit, whether they realize it or not.

As I write this, there’s someone in my life who’s just had some pathological need to bring up the fact that my childhood best friend commit suicide every time I see them, among other things. The more they brought him up, the more I tried to suppress these painful memories until one time I wasn’t able to do so, and spent the next six months re-grieving this loss, re-experiencing all of the pain, and just being depressed again at the childhood best friend that I lost very early in life. They were finally called out for this behavior and were disinvited from visiting us for the past year for more reasons than that, and not only were they completely unapologetic, but were offended and called me ungrateful and more.

With a history of mental health issues from cancer and a few suicidal episodes myself, do you think this sort of behavior is something that I really need in my life? I should neither have to explain any of this, nor should I have to provide an answer to the above question, and yet I’m having to do so. I haven’t given up on this person yet because of how much I care about them, but I’m close. Some people are just truly unbelievable.

Related Blog: Steve Pake's Top 10 Guide to Surviving a Young Adult Cancer (In particular, read the section on removing toxic elements from your life.)

you have To Cure The Whole Patient

As I wrote in the above blog, “curing cancer” is about a lot more than just eradicating some rogue cells from someone’s body. Cancer becomes as much a disease of our minds in the way it can haunt us, as it is of our bodies. If you want to cure a patient of cancer, that means curing the entire patient and not just removing the rogue cells. Although this episode was merely from a hormonal dropout (and a bit of seasonal depression) and not from some broader core psychological issue, it’s enough to show me that this “disease” is still present, and something that I need to keep managing much better than I had been. I’ve failed plenty of times as a cancer survivor, in understanding what I’d even been through, in managing my body, in managing my mind, and in managing the people around me. It’s important to learn from your mistakes, and so I hope sharing this bit of darkness from my life as a teaching moment can continue to help others that have faced the same.

I hope to never find myself here again in my life, and I hope you don’t either.

Onwards and upwards for 2020!

Steve

Two things before you go. If you’re struggling with any of this and want to talk, please do get in touch. I’m happy to talk with anyone about any of this to help people find their way through the dark times, but if you’re actively contemplating or attempting, please call 1-800-273-TALK (8255) right now, as I can’t guarantee that I’ll be immediately available.

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You’re also more than welcomed to check out all of our fun photos from Disney World below, and we also swung by Kennedy Space Center as well, which was amazing albeit slightly rained out. Despite all of my and our struggles, the point of sharing fun photos of our adventures of the year is to illustrate lives well-lived, and that we’re not just sitting around and sulking and feeling sorry for ourselves. I’m sorry, but fuck that. Life is meant to be lived and enjoyed, despite whatever hardships you might face.

Keep on keeping on!

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