In current usage, any disastrous situation. The balls referred to are NOT testicles. The term dates from the days of wooden sailing ships when the existence of a shipboard disaster, such as plague, lack of food or water, mutiny, etc. was communicated to the outside world by hoisting large-ish, brightly painted wooden balls up into the rigging. Balls of different colors represented different disasters and therefore served as either requests for assistance or warnings to stay clear.
When someone says they are going "Balls Up" , they are going go all out & when do whatever they do without given a fuck! Like getting "turnt up" or someone going "Balls to the wall", EXCEPT this is going to be harder than those, no matter what!!
SOO...if you start your night off "going BALLS UP" you know you're already going right but NEVER go "Balls to the wall" (ouch, sounds painful)
"I'm going to go BALLS UP tonight & hopefully I can end up BALLS DEEP & not BALLS SMUSHED TO A WALL orrr BALLS FLAT .. Cause you got too smashed!! WHATEVER you do, don't Be a little bitch & go no balls out ...because then really YOU'RE JUST a pussy ass bitch with NO BALLS AT ALL.. BAHAHAHA! MIC DROP..DUECE!