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Joel Gratcyk remembers the moment he finally broke down.
He pulled over to the side of the road, tears streaming down his face. Becoming a father should have been one of the happiest moments of his life. Instead, he fell into deep sorrow as his young son sat in the back seat.
It was all too much. The stress, the lack of sleep, the nagging worry that he wasn’t being a good parent.
“I knew right then that I needed help,” recalled Glatsik, 42. “It was too much for me to handle alone.”
He’s not the only one. A growing body of research suggests that fathers and their female partners may suffer from postpartum depression. Most experts estimate that about 10 percent of fathers will develop the disorder, compared with about 14 percent of mothers.
Now, a new pilot study from the University of Illinois at Chicago suggests that men should be regularly screened for postpartum depression. It’s part of a growing effort to change the conversation about men’s mental health and provide stronger support for the entire family.
“It’s obvious to me that we’ve created these gendered silos of care, which results in fathers being excluded,” said Sam Wainwright, lead author of the study and an assistant professor of internal medicine and pediatrics at the University of Illinois at Chicago.
On the eve of Father’s Day, Glatsik reflected on his sons, now 7 and 11. He hopes that as they grow older, they will feel more comfortable sharing their emotions and being vulnerable.
“Having conversations like this with my sons and seeing them be able to open up about it gives me hope that this conversation can continue to grow,” Glatsik said.
Until recent decades, postpartum depression has been associated with women because of the more pronounced physical and hormonal changes they experience in the postpartum period. Treating this depressive episode, which can last for months, usually requires counseling or antidepressant medication. In August, the FDA also approved a first-of-its-kind oral medication specifically to treat postpartum depression.
But men are far from immune to the emotional stresses of first-time motherhood. Research shows that fathers even experience a drop in testosterone levels after the birth of their children, which is associated with mood changes. Postpartum depression in fathers typically develops three to six months after the birth of their children.
Research shows that postpartum depression in fathers is also a risk factor for reduced quality of family life and impaired family development and relationships.
“A lot of times, fathers are overwhelmed by new experiences,” said Sheehan Fisher, a psychologist at Northwestern Memorial Hospital. “They’re trying to figure out how to adapt, but they don’t know how to be a father.”
The study surveyed 24 new fathers and found that 30% screened positive for PPD. Wainwright suspects that number is higher than average because 87% of participants identified as belonging to a racial or ethnic minority group, which may predispose patients to mental health issues due to institutionalized economic disparities.
Wainwright said regular screening of men at baby checkups could prevent the disease.
“For me, it means taking a stand and telling men, ‘You matter, your health matters,’ and not just because it’s some maternal health goal,” he said.
Previously, Wainwright’s work has focused on women’s health. The UI Two-Generation Clinic, where the study was conducted, provides one-stop postpartum care and pediatric exams for mothers. It primarily serves economically marginalized communities of color.
But clinic staff soon discovered that fathers were being neglected, even though their well-being was critical to the overall health of the family. Typically, the only topic of conversation about fathers during baby checkups was domestic violence, Wainwright said.
“The vast majority of men will do nothing but love their partners and their children, even if they’re not married,” he said. “It’s as if our system believes that men are the root cause of violence, and that’s it.”
The fathers who participated in the study were between one and 15 months postpartum. The researchers screened the fathers using the Edinburgh Postnatal Depression Scale questionnaire, which is the same questionnaire used for the mothers.
Social workers also interviewed the fathers, many of whom were young first-time parents who worried they lacked the skills to properly parent. Most experienced severe sleep deprivation and felt extremely tired. Some said the need to provide financial support conflicted with the desire to meet the growing needs of mother and baby.
“They’re so focused on making sure she’s OK that they actually tend to neglect their own well-being and their own mental health,” Fisher said.
Gratsik, an Arlington Heights resident, didn’t realize that fathers, too, suffer from postpartum depression until his own symptoms set in. It went beyond the “baby blues” — the anxiety can be debilitating at times and last for weeks. Still, like many, he put his wife first because she was dealing with mental health issues herself.
“My focus was trying to help (my wife) and the kids as much as I could,” Glatsik said. “A few months later, as she was doing better and getting back into everything, that’s when I started to kind of break down.”
Finally, he sought professional medical care, began therapy and took antidepressants. His stress levels gradually improved. He added that Gratcyk was only able to get help when he felt validated.
“I started out like a normal guy, saying, ‘I can figure it out, I can take care of myself.’ But that was a mistake,” Glatsik said.
It’s a common phenomenon. Men are often less likely to seek help for mental health issues, said Amanda Atkins, a certified perinatal mental health therapist in Chicago. While she often treats mothers with postpartum depression, fathers with the disorder rarely seek treatment at her clinic. She said the stigma surrounding men’s health can be a deterrent.
“I think men often don’t feel like there’s room for them to feel upset,” Atkins said. “I think that’s why we see men suppressing emotions and saying, ‘I have to be strong.'”
Postpartum depression is also thought to manifest differently in men, who are more likely to be irritable and aggressive. One study found that fathers with depression may be less likely to read to their one-year-old children and more likely to spank them. Experts say the actual number of fathers who suffer from postpartum depression may be higher than 10% because of the different symptoms.
“I think if we as a society could normalize postpartum depression more, we’d be more comfortable with it,” Atkins said.
For Wainwright, the study shows that health care needs to change radically to include fathers in postpartum care. A one-stop system like the Two Generations Clinic could ensure the whole family has adequate support.
Wainwright said the PPD screening was also an opportunity to talk to young men about other aspects of their health. More than half of the participants did not have a primary care physician before the study. However, after the study, two requested mental health services and three established new primary care relationships with their doctors.
“Dads are such an integral part of their kids’ lives, their families’ lives, and they’re so important in their own right. This is a moment where you can connect with them,” Wainwright said.
Glatsik suffered from postpartum depression again when he had his second child, but it was less severe because he was able to manage the symptoms ahead of time. He says his mental health and ability to reflect have improved dramatically over the past decade.
“I’ve gotten a lot better, especially in the last five or six years,” Glatsik said. “I’ve been able to take my medications correctly, get treatment when I need it, and have honest conversations about it. That’s helped me deal with it.”
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