Three weeks after their son was born, Zach Kissinger, 28, took his wife Emmy out to dinner. But he ended up feeling like he was eating alone. Emmy spent most of the dinner quiet and lost in her thoughts. “I could tell that all she wanted was to go back home to our baby,” he says.

Zach, a small business manager in Iowa, sympathized with his wife, who had gone through a traumatic emergency C-section that left her hyper-attached to their son, Fox. But the baby slept with the couple, leaving little physical contact between Zach and Emmy, as well as sleeplessness over the sleeping arrangement. “I was scared to death that I would roll over him,” Zach says.

When Emmy, 27, started back to work, Zach’s feelings of isolation grew. Stretched between her job as a school therapist and taking care of Fox, Emmy had a full plate. Zach kept his feelings to himself because he didn’t want to cause her any additional stress. He spent seven months not knowing that what he was experiencing was paternal postpartum depression (PPPD).

According to a study by the American Journal of Men’s Health, 13.3 percent of expectant fathers experience elevated levels of depressive symptoms during their partner’s third trimester of pregnancy. As for the postpartum period, estimates of the number of men experiencing PPPD in the first two months after birth varies from 4 to 25 percent, according to one study from 2007.

Symptoms of PPPD are not unlike those of maternal postpartum depression, which includes:

  • frustration or irritability
  • becoming stressed easily
  • feeling discouraged
  • fatigue
  • lack of motivation
  • isolation from family and friends

There are some symptoms that tend to be more common in paternal postpartum depression.

“Men and women may experience their depressive symptoms differently,” says Sheehan Fisher, PhD, perinatal clinical psychologist and assistant professor in the department of psychiatry and behavioral sciences at Northwestern University. “There’s research on the concept of ‘masculine depression’ that suggests men may report and engage in externalizing behaviors, such as aggression, hypersexuality, and substance use [like with alcohol] in response to depression,” he says.

For Zach, his anger grew inside of him, but he never expressed it. He wanted to feel more included in a relationship with Fox, but felt excluded when his son had difficulty bonding with him.

“It made me feel even more lonely,” he says. “I kept quiet and helped with whatever I could.”

It’s not uncommon for men to ignore feelings of sadness, hopelessness, or guilt, says Dr. Sarah Allen, psychologist and director of the Postpartum Depression Alliance of Illinois. “Men may also feel in conflict between how they think a man should be and feel, and how they’re actually feeling,” she says.

“They go into shutdown mode,” adds Kay Matthews, founder of the Shades of Blue Project, whose goal is to help minority women with postpartum depression and anxiety. “Instead of expressing the frustration, they proceed in some form of acting out.”

By bottling up his feelings, Zach says he eventually “crumbled,” leading to an argument where the couple even discussed divorce.

“I was so lonely and I couldn’t take it anymore,” he says.

Emmy says it was a lightbulb moment for her. She realized that her tunnel vision on their son had made it difficult to focus on her husband or even notice what he’d been going through.

Instead of separating, the couple made a commitment to reconnect. Fox is now two years old and Zach says he’s so thankful he had an opportunity to voice his concerns and be met by a partner who was willing to work through it with him.

Recently, Emmy experienced a 16-week miscarriage and, while it was difficult for the couple, Zach says the work they’d done to better communicate made it easier to respond to each other’s emotional needs.

“We’ve found a balance and I’m very close with our son,” he says. “Allowing myself to experience these feelings and talk through it was a big deal for me. In the past, I would’ve been more likely to hold the feelings in, in the hopes of allowing more space for Emmy’s feelings.”

Today, the Kissingers are committed to talking more about the stigma that surrounds mental health. Emmy even has a blog where she shares their experiences.

Experts say the treatment for paternal postpartum depression varies, but they include psychotherapy and prescribing an antidepressant, like an SSRI. Matthews also emphasizes that diet, exercise, and meditation can play a role in alleviating symptoms of depression.

The first step is recognizing that mental illness doesn’t discriminate. Anyone can be affected by depression, including dads.

If you or someone you know is experiencing signs of depression, you can find help. Organizations like the National Alliance on Mental Illness offer support groups, education, and other resources to help treat depression and other mental illnesses. You can also call any of the following organizations for anonymous, confidential help:

  • National Suicide Prevention Lifeline (open 24/7): 1-800-273-8255
  • Samaritans 24-Hour Crisis Hotline (open 24/7, call or text): 1-877-870-4673
  • United Way Crisis Helpline (can help you find a therapist, healthcare, or basic necessities): 1-800-233-4357

Caroline Shannon-Karasik’s writing has been featured in several publications, including: Good Housekeeping, Redbook, Prevention, VegNews, and Kiwi magazines, as well as SheKnows.com and EatClean.com. She’s currently writing a collection of essays. More can be found at carolineshannon.com. You can also tweet her @CSKarasik and follow her on Instagram @CarolineShannonKarasik.