:format(webp)/cdn.vox-cdn.com/uploads/chorus_image/image/56976507/GettyImages_55905772.0.jpg)
One afternoon while I was picking up two of my kids from summer day camp, my thoughts drifted toward how my wife and I would manage their school routine come September. We had an 8-year-old and a 5-year-old, and a new baby — and the stresses of parenting were intensifying by the day.
That's when my internal voice interrupted to say, "What do you care? You'll be dead by then." I had a specific end in mind: a simple step off my apartment building roof.
I had been clinically depressed before, and I go through cyclical emotional troughs, but this was new. I now lived every day with a dull ache radiating throughout my body, a lack of motivation, and a desire to do myself harm. At times, I wanted to relieve my own suffering. At others, I wanted to punish myself.
That was about four months ago, the day I accepted that my mind was ill and that I needed help.
There were many reasons I was dangerously depressed. But one contributor I’d never considered was male postpartum depression, which, according to some studies, potentially afflicts up to a quarter of new fathers.
Male postpartum depression is not widely understood. One reason is that the obvious physical and emotional toll on women both during and after pregnancy leaves little room for sympathy for “lazy dads” struggling with the anxieties of new parenthood. More generally, societal norms of masculinity can frame sadness, especially in the absence of a “rational” cause, as weakness.
I myself thought succumbing to mental illness was a form of weakness. I now know that this is toxic macho nonsense. What was weak was denying my illness.
Our beautiful child was born. Then the hopeless feeling hit me.
Five months ago, my wife gave birth to our third child, who was (and remains) healthy and thriving. When my two other children were born, I had gone back to work no more than two days later, but this time I was on paternity leave. I was thrilled to have five whole weeks in which we could focus on how to be a family of five. Once my leave was up, I would be headed to a brand new job I was excited about.
Ten days of postpartum bliss was all we were afforded before my new job offer was rescinded with vague and conflicting explanations as to why. My mutually agreed-to paternity leave was unquestionably a factor, but it didn’t change the facts on the ground. The responsible preparations we had made were now a memory, and the terror and uncertainty of unemployment was reality.
Things hit a breaking point when, of all things, I got the flu. Lethargy is normal when fighting off a nasty bug, but this was different. I not only wanted to go to sleep by 8 o’clock, I wanted to sleep all day, every day. This continued for months, long after I had recovered from my illness. This was not me — I’m usually the type of person who tries to squeeze 36 hours into a given day. I was in constant physical pain, had difficulty breathing, lacked energy and ambition, and pretty much felt like bawling in the fetal position or beating the walls with my fists all the time.
As all parents know, the chores and duties that young children require leave little time for illness. But my patience for kids just being kids had evaporated. I would lose my temper, shouting at my children for minor transgressions. My wife would try to help me relax, taking all three kids out for hours so I could read or watch baseball. But mostly I just stared at the walls, and resented everyone when they came home.
I knew I was being a shit, and I hated myself for it, but I also saw no way out of this hole. I just wanted the pain, the self-loathing, the suffocation to end. That's when the edge of my roof seemed like a good place to be.
When people say depression is a liar, that's what they're talking about. Suicide started to sound to me like the equivalent of an antibiotic — it'll knock out the illness. Fortunately, I retained enough of my mental capacities to spot the lie.
I told my wife I would seek help, immediately.
Diagnosing the problem
It's not easy to ask for help, and it can be just as hard to find it.
We searched for psychiatrists, psychologists, and therapists who would take our insurance. There weren't many, and even fewer who were accepting new patients. Of those, finding one who was the right fit was tough. (One psychiatrist in particular seemed to think acting like an insult comic was the way to help a suicidal person stave off oblivion.)
Unexpectedly, it was a general practitioner who gave me the first tools I used to save my own life. He explained that chemical depression following a severe flu is common. Your body has expended so many resources fighting the virus that the brain's dopamine levels can crash.
As one psychiatrist I spoke to told me, it was very likely I was suffering from a confluence of depressions, including post-trauma, post-influenza, and, to my surprise, postpartum depression. I did some research on my own and found that postpartum depression in men was not unusual, even if it wasn't widely understood. Why would it be? Men didn't go through wild hormonal changes for nine months! Men didn't carry and deliver a 9-pound life form. But men, like women, deal with the psychological pressure of keeping a soft-skulled new human alive while not sleeping. Sometimes, as in my case, you already have little kids, each of whom is a full-time job.
According to the American Medical Association (AMA), male postpartum depression symptoms include anger, mood swings, insomnia, guilt, lack of interest in the children, physical pain, and a feeling of disconnection with the child’s mother. Lack of regular sleep and exercise, and social isolation, don’t help, but there is a biological factor at play too, studies have found.
Male testosterone tends to drop following childbirth. Some evolutionary theorists have suggested that this trait evolved in the animal kingdom to keep males focused on their families during the early life of a child, as it lowers the risk of the males straying. But the hormonal shift can be drastic in some men, greatly increasing the risk for depression. Still, despite an increasing awareness of male postpartum depression, the National Institute of Mental Health’s website describes postpartum depression as an exclusively female mood disorder.
Women are approximately twice as likely as men to be depressed in the first three months after birth, but 12 months after birth the levels of depression are similar. Part of why it is so little understood is because the science regarding male testosterone levels after childbirth is fairly new.
So let's recap. Sleepless nights. Intensely paced stressed days. Possible postpartum depression. Depleted dopamine levels following a severe illness. Oh, yeah, and my career just took a sucker punch to the gut. Learning that there were reasons for my depression that went beyond just surface emotional reactions was both a relief and a source of strength.
How I learned to “embrace the suck”
Among the treatments I flirted with were talk therapy, antidepressants, and group counseling. After I didn’t see any improvement, I decided to eschew therapy and antidepressants for now, though I would give anything and everything a try again if I felt like I was a risk to myself.
I ended up fashioning my own anti-depression strategy, drawing on what I’d learned from my reading and my therapists. I exercised every day. I completely stopped drinking alcohol. I kicked away the crutch to see how everyday life — social awkwardness, boredom, all of it — really felt.
Finally, I decided I would "embrace the suck" — a concept I learned about in a book called Going to Pieces Without Falling Apart, by Buddhist psychiatrist Mark Epstein. In combining Buddhist philosophy with Western psychiatry, Epstein argues that denying the reality of your suffering only creates more suffering, so the healthiest course of action is to just go ahead and face its awfulness.
While only a few months have passed since my lowest point, these simple adjustments are working for me. It’s not that my depression has gone away. It’s that I can manage the ebbs and flows. I don’t rush through a list of life and career tasks that never gets shorter. Instead, I laugh more and goof off with my kids — who won’t be kids for too long — every day.
I don't share my story as some kind of How to Survive Suicidal Depression handbook. My cobbled-together regimen is working for me now, but it may not work forever. It also may not work for everyone experiencing male postpartum depression. Medication and therapy can be necessary, and maybe they'll be necessary for me someday too.
What I do accept about myself is there is a demon in my brain, one that tries to persuade me that slicing my neck with a serrated knife could be a plausible solution for the pain and self-loathing brought on by depression.
While there has been a greater willingness to discuss male postpartum depression, the term itself carries baggage. To some men, a man who claims to have postpartum depression sounds effeminate. To some women, it sounds like a man appropriating a distinctively female kind of psychological trauma. Both unempathetic points of view unwittingly contribute to a culture of macho toxicity that discourages men from addressing mental illnesses.
Wizdom Powell, an associate professor in the University of North Carolina Chapel Hill Department of Health Behavior, has discussed the physiological consequences of “masculinity norms” that make it difficult for men to ask for or receive mental health care. But repressed issues can rebound at later times with greater severity. She suggests that men who rigidly adhere to such hardcore ideas of masculinity may suffer from higher rates of depression.
Not everyone is as lucky as me — with a healthy and supportive family committed to riding out the storm. Whoever you have, lean on them. No one will resent you for asking for help.
Depression nearly killed me, and I don’t think it’s done with me yet. Whenever it returns, I'll have to confront it with all the weapons in my arsenal. Maintaining my mental health will be a process that may well last for the rest of my life. For now, I live one day at a time and embrace the suck.
Anthony L. Fisher is a journalist and filmmaker in New York whose work has also appeared in the Daily Beast, the Week, New York Daily News, and Reason. Fisher wrote and directed the feature film Sidewalk Traffic, available on major video-on-demand platforms. Find him on Twitter @anthonyLfisher.
First Person is Vox's home for compelling, provocative narrative essays. Do you have a story to share? Read our submission guidelines, and pitch us at firstperson@vox.com.
