“Oh man, how’d you do it?  Skiing?” They ask when you tell people you broke your leg.  They’ll want the war story and the high-fives.  “I’m so sorry; how can I help,” they ask when you tell them your body is sick, like with cancer.

But what about when your heart is sick?  What do they say then?  Or do they look away, look down, shuffle their feet, and change the subject?  There are few words that can ease the pain of being so despondent you can’t get out of your car and into the house, or the stabbing jolts of electricity that fill your chest all night long, making any sleep, any relief from it all, impossible, or when you realize that caring for desperately dying patients in the COVID ICU during the worst days of the pandemic is light years easier than sitting with your own daughters.

I felt all of those things.

In August, 2020, my wife, Lindsey, gave birth to twin daughters, and I fell apart.  For months, I thought two things: one, this is just how fatherhood is, and two, I am a terrible father and husband.  It was nearly a year before we learned about paternal post-natal depression (PPND)*, and maybe that’s why I felt so awful and afraid for so long.

But perhaps I’ve been lucky; when I told my circle of people that men can have postpartum depression, that I had it, and that this is what it was like, they met me with understanding and support.  And when I’d talk to other parents, I felt seen; I was told “I think I had that,” or “This sounds like my husband” more times than I can count.

I wrote a book, Even the Darkest Night, about my experiences, and soon everyone will know some of the darkest and most intimate details of the last several years of my life.  In it, you’ll see what it felt like to be afraid to be alone with my girls, what anxiety felt like every minute of every day, and how father’s postpartum depression differs from that of mothers; think less crying, more anger, irritability, and risk-taking.

There will be trouble, I know.  People will say I’m weak, or whiny, or worse.  People will tell me this is a woman’s disease and to sit down; “This is not your space” they will say.  I’m certain they will, because some already have.

But I am equally certain people will see themselves in my words.  The new father who can’t figure out why he’s so angry and irritable.  The exasperated new mother who lays awake at night wondering why her spouse isn’t connecting with their baby, or with her.  These people will hear the name for what they’re going through and that spark might just be the beginning of recovery.

For me, as a physician, having a name for what I was feeling gave me the hope that it could be treated, that I could get better.  And I did.  Therapy and, eventually, medication, were my lifelines, but they were not easy ones.  Turning a lens inward in therapy is hard work, and I’m blessed to have found a therapist who is both skilled and supportive.  There was satisfying catharsis, yes, but also sessions of guided introspection and coming to grips with the ways in which my own upbringing left me less than whole.  Connecting this to how I was unprepared to meet the needs in my newborns that went unmet in my own life was excruciating.

To say therapy is “a lot of talking” misses that the “talking” is focused on bringing forward some deep, dark memories from the years that built me.  And after years of casual denial, I finally had to admit that my father’s abandoning my brother and me was not neutral, that it hurt me, and that I was not yet over it.

But I did get over it, in time, and with help.  For me, the biggest impact was therapy, and a close second was opening up to other people, usually other fathers, about what I had been going through.  Hearing that others had struggled, even if not in the same way, was healing.  So too were those first few conversations with dads after I was feeling better, when instead of needing a shoulder, I could be one.  This personal and interpersonal work led the charge, but the role of antidepressants in my journey needs to be acknowledged, as well.  My thoughts and feelings were becoming safer, but it wasn’t until starting medication that the physical symptoms, those stabbing jolts of anxiety, the pains in my chest, and the irregular heartbeats, began to subside.

Given what I’ve been through, I would share just two pieces of advice: the first is if you’re a new father and you’re not feeling like yourself, if you feel constantly in conflict with your spouse, drinking more than you should, or going back to cigarettes or other drugs, yeah, maybe new fatherhood is just hard.  Or maybe it’s paternal post-natal depression.  Reach out.  Ask questions.  Find help.  Remote psychotherapy has put counseling within reach even for busy parents, and it is worth the time and effort.  The second piece is that if you’re a new father and you ARE loving it and doing great, reach out to someone in your circle and check on them.  Ask questions, and listen, really listen, to the answers.  And remember that PPND exists; it might just be the thing that spurs them to see someone.

To say life is better now is both true and woefully inadequate.  I love my girls and I love my life.  It is the joy that I feel now, after all I’d endured, that drove me to tell my story.  Shining a light on PPND, showing men why they might be suffering and how to get help, can save millions of men countless months of suffering and failing to bond with their children.  The time for me to Step Up and talk about this is now, so that others won’t have to suffer like I did.

Chris Choukalas
Marin County, California, United States
@christopherchoukalasmd

Christopher G. Choukalas, MD, MS, is a physician in community practice in Marin County, California, where he lives with his wife and twin daughters, who are now nearing 6 years old.  He is the author of Even the Darkest Night, a first-of-its-kind memoir on paternal post-natal depression, out June 2^nd on Harmony Rodale Convergent.

* The terms “postnatal depression” (PND) and “postpartum depression” (PPD) are often used interchangeably. When referring to fathers specifically, you may see terms such as “male postnatal depression” or “paternal postnatal depression”.