Yes, Dads Get Postpartum Depression Too (with Christopher G. Choukalas, MD)

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INTRO – 0:00

 

BLAIR HODGES: This episode is pretty heavy from a mental health perspective, so listener discretion is advised.

This is Relationscapes, the podcast where we map the landscapes of gender, race, ability, friendship, family, and more so we can better understand ourselves and each other. I'm independent journalist Blair Hodges in Salt Lake City, and our guide in this episode about paternal postnatal depression is physician and author Christopher G. Choukalas.

CHRISTOPHER CHOUKALAS, CLIP: If you go and look up the symptoms of maternal postpartum depression, it is a major depressive episode: sadness, despondency, guilt, shame, sleep, all this down kind of stuff. If you go and look up paternal postnatal depression, first of all, there's nothing in the textbooks about it. So there's no, "Oh, it's this, that, and the other thing."

And nowhere in that do you see sadness, guilt, shame. You see anxiety, you see irritability, you see conflict, you see risk-taking, you see drug-seeking. The symptomatology is totally different.

BLAIR HODGES: When Christopher Choukalas first held his newborn twins in his arms, he didn't feel the joy that many first-time parents expect. Even though he felt strangely disconnected, he still threw himself into meeting their immediate needs, obsessively managing their schedule and optimizing every second. But the more he tried to control, the more he spiraled—intrusive thoughts and rumination, sleeplessness, panic attacks.

Christopher was a doctor, but he'd never even heard of the condition he was experiencing—paternal postnatal depression. He tells the story in his new book, Even the Darkest Night: A Father's Journey of Hope and Healing from Paternal Depression. It's a memoir about fatherhood and a mental health crisis that can be difficult to recognize, even when you're a physician yourself.

Christopher Choukalas joins us to talk about what it took to find his way through it, right now.

 

No Hallmark Moment – 02:15

 

BLAIR HODGES: Dr. Christopher Choukalas, welcome to Relationscapes.

CHRISTOPHER CHOUKALAS: Blair, thank you. It's great to be here.

BLAIR HODGES: It's great to have another fellow dad on the show. I am a father of two, and most of the guests I talk about parenting with are women. I assume you noticed that as you're looking at other books by parents. Is that your experience as well?

CHRISTOPHER CHOUKALAS: Certainly the preponderance is women. Certainly the books that are about perinatal mental health are almost all by women.

BLAIR HODGES: Right. This is the only book I've seen that talks directly about paternal depression. And I think it's extra valuable because you come from a medical background and the background of being a father. Those two things combined, I think, heighten this memoir a little bit.

CHRISTOPHER CHOUKALAS: I think so. First, in a very practical way, as my agent and publisher said, if I was just some guy off the street writing about this, they probably wouldn't have picked it up. Being a physician not only provides some credibility around the things that I might say, but there's also this ironic angle where, as a physician, I should have been better at identifying that something was wrong with me.

And I'll go one further. I also have a master's degree in counseling psychology. So I was steeped in the symptom lists and the diagnostic criteria and the identification of people who might have depression or anxiety. And even still, it eluded me for months that I might actually have something.

BLAIR HODGES: It actually doesn't surprise me very much because I was diagnosed with depression when I was young, and I've experienced depression and anxiety throughout my life. Even having known the symptoms and known what it's like, I've found that I don't always realize when I'm in a depressed place. It comes and goes. So I don't realize that something's been harder or worse for a time until I'm coming out of it.

CHRISTOPHER CHOUKALAS: Oh, interesting.

BLAIR HODGES: And then I'm like, "Oh gosh, I've been in a depressed place for the past little while here."

CHRISTOPHER CHOUKALAS: It's almost like where you don't realize it's night until the sun comes up, and you're like, "Oh yeah, okay." Interesting.

BLAIR HODGES: Yeah. So it makes sense to me. I want to go to the delivery itself. You take us there in the memoir. And a lot of people will have a story, if they're in the delivery room, they'll remember that moment when they first get handed their child and look in their face for the first time.

It's usually this really moving story. So you take us there, and I want you to read from your account of what that experience was like for you.

CHRISTOPHER CHOUKALAS: So to set the stage, here we are in the operating room. I'm an anesthesiologist who spends his life in the operating room with patients, and I'm the one doing stuff to people. But here I am, not in my hospital scrubs. I've got the bunny suit on. And anybody who's been a dad in that situation, they give you this white jacket and thing to put on to cover you up, and you're sitting there in this chair like a dope, and all this stuff's happening around you.

And so there we were. I'm sitting there. Someone handed me the babies, two of them. They were twins. Were they crying, squirming? I couldn't for the life of me tell you. They were red or pink, I guess, and warm with smushed faces. And they were wrapped in those multicolored baby blankets that somehow seemed to be the same at every hospital.

They didn't move a lot, or maybe they couldn't, burrito-wrapped as they were in what I later learned was a swaddle. One of them—we didn't have names yet, but it was Baby A, the first one to come out—had a red, blotchy, heart-shaped mark on her forehead. Just a stork bite, the nurse was quick to say, as if calling it a stork bite instead of using the medical term would be the least bit reassuring to someone like me.

But I hadn't noticed the mark. I couldn't have noticed. It was all such a blur, a swirl of confusion. But for me at that point, it was all cognitive, not feeling. Not yet, anyway. What should a man feel when holding his twin daughters for the first time? How had my own father, absent most of my life, felt when I was born?

How should he have felt? Full of pride? Joyful? Relieved? Or terrified? Had he felt that instant bond, that hallmark emotion where everything clicks into place the second a parent lays eyes on their newborn? Whatever it was I was supposed to feel, I didn't feel it. Those first moments are lost to me. The emotions, if I had any, were ephemeral, either because of all that swirled around me or because this was the beginning of all that would soon swirl within me.

 

A Traumatic Delivery – 06:37

 

BLAIR HODGES: I wondered if this experience that you had, which was pretty different from mine, was also tied up in the trauma of your wife's delivery, because there was a lot of trauma surrounding this. So when they handed you the babies, you had already been through a lot.

For me, the delivery seemed to go pretty much like what you'd expect. And I remember seeing my first child's head, and I remember seeing the little curly hair. I'd seen them come out, and I remember all of this like it's burned in my memory, looking at my child and feeling this really powerful love. And you're describing how you're almost void of feeling at this moment, right?

CHRISTOPHER CHOUKALAS: It was a job to do, right? To hold them. It wasn't like I was feeling some connection with them. I think that's what they want, and that's why they bring them over to you. But I was subsumed, I guess, by a couple of things. Just being overwhelmed by the act of holding them, but also with what was going on around us and what was starting to become apparent the longer that I held them.

BLAIR HODGES: You actually had experience. You saw stuff happening during the delivery that you have seen cause death.

CHRISTOPHER CHOUKALAS: Oh, absolutely. So as I'm holding these babies, I'm looking at Lindsay, and she's sort of gray and sweaty and asleep. Her eyes are closed. And I'm trying to introduce her to these babies. She didn't want to know the gender. So we went into this not knowing if they were boys or girls or what they would be.

And she still didn't want to know. So I remember saying, "Lindsay, here are the gir—I mean, the babies." Nothing.

CHRISTOPHER CHOUKALAS: And I'm looking up at the monitor, and I'm seeing these numbers flashing. The blood pressure, it's 60 over 30. And in my mind, I'm trying to reconcile, "Oh, well, sometimes the anesthesia dose can make the blood pressure go down. I'm sure it's fine, whatever, who cares?" Because everything's just business as usual, as far as I can tell.

And this goes on for several minutes. Pretty soon I realize somebody's over here putting another IV into Lindsay's hand. I look back, and I see on top of the anesthesia workstation there are empty syringes of all of the drugs that they use to make the blood pressure go up. And yet the number is still flashing 60 over 30.

So that's when I stand up, I look over the drapes, and I see that Lindsay's having a uterine bleed. And that is to say, the uterus normally would contract due to the hormones that are released after the babies come out. Hers wasn't contracting, and so it just bleeds and bleeds and bleeds and bleeds.

And there's a bunch of stuff that you do to try to prevent that. They were doing all the stuff. There was another surgeon scrubbing in to help. The anesthesiologist had help. They were giving all this stuff. And pretty soon I start to tune into the fact that they're calling for the blood bank, they're calling for the uncross-matched blood, they're calling for the machine that can pump gallons of warmed blood into the patient to basically rescue somebody who's dying.

And that was my introduction to parenthood.

 

Panic! at the Hospital – 09:36

 

BLAIR HODGES: So that was scary enough. Fortunately, your wife was okay, and you tried to carry on from that point. In fact, we can go to about six months after your twins were born. You were back at work as an ICU physician and an anesthesiologist, and this was an intense time anyway because the COVID pandemic was going on.

CHRISTOPHER CHOUKALAS: Oh yeah.

BLAIR HODGES: And so you're at work already under all the stress. You're a new parent. You just saw your wife go through something traumatic, and suddenly one day you saw a yellow napkin. And of all things, seeing that napkin launched this full-blown panic attack. Talk about that.

CHRISTOPHER CHOUKALAS: Well, it happened a little bit sooner than that because I'd actually gone back to work in the ICU early because of need. So I was on five months of paternity leave, but a month or a couple months in, they're like, "Listen, we really need somebody for this week. Everybody's out. Everyone's sick with COVID. Can you do this week?"

And so I was only about a month or six weeks into parenthood. I'm like, "Sure, I'll come back and do this week," because they need me.

And I remember a patient's meal tray being brought into their ICU room, and it had this bright yellow napkin on it. It was the same napkin color from the Women's and Children's Hospital when we were in the hospital for seven weeks.

And I just had this flashback. I stopped cold, thinking about all of the things that these people in the ICU go through: the confusion, the mixed messages, the pain, the uncertainty, the fear, just the uncomfortableness and inconvenience of being here, having something that they don't know is going to get better. That's what we had. That's what we felt.

And I immediately had this moment of kinship with all these people that were suffering so. And it wasn't the first time that I had empathy for my patients, but it was the first time I really felt it. It was the first time that what these people were going through was really inside me, and I just couldn't take it.

BLAIR HODGES: Was it the classic stuff? Shortness of breath, panic, like the walls are closing in? You felt it in the body?

CHRISTOPHER CHOUKALAS: Oh, I was sweating. I had to walk out. I don't know if that was my first panic attack, and I definitely had panic attacks later, but it was this visceral emotional response. It's almost like you want to just vomit all this stuff out. You're like, "Oh, I've been holding this stuff in, and I can finally recognize it and feel it."

And I just got to get it out of me because I know what it's like to be in that room as the patient and not the doctor. And I can't take it.

BLAIR HODGES: Right. And this could interfere with your work, too, because already you were feeling the effects of paternal postnatal depression, which we'll talk about in a minute. But also work was an opportunity to get away from that for a minute. You could go to work and be your work self and connect that way.

Now, suddenly at work, you're having these issues. So where can you go?

CHRISTOPHER CHOUKALAS: You're touching on the whole thing here. First of all, as an anesthesiologist, doctors define their identity by their work. And for me, sure, being an intensive care doctor meant that I stood up straight. I had the starched white coat on. People believed me. They listened to me.

I led a whole team of students and other doctors and pharmacists and physical therapists, and they were looking to me. I was special, and I was important, and I was smart, and I was brave.

And this was the first time in 10 or 12 years of doing this where I thought, not so much, "Oh, I don't really know how to do this," or "I'm not strong enough to do it," but, "Is it good for me? Should I still be doing it?"

And I'll tell you, the answer was eventually no.

BLAIR HODGES: I can only imagine what that would be like. Your worlds are colliding here. What's happening at home, what's happening at work, the kind of panic you're feeling, the kind of disconnect and depression that you're starting to feel.

And like you said, these symptoms were starting to come on and maybe if you had been hearing a patient describe it, you might have already started to recognize what was going on, but you weren't yet ready to see it.

 

Did He Even Want to Be a Dad? – 13:49

 

BLAIR HODGES: We can rewind the tape a bit and go back to the decision to even have children. You describe it as something you weren't particularly excited about. You weren't against it, but your wife Lindsay really wanted this. And so you're already starting off from a position where you don't feel that same drive to have children to begin with.

And then the cost that it took to get there. You had to do IVF, so it was a lot, not just in terms of money, but in terms of emotion and effort and everything you went through, when you were already a little bit like, "Hmm, kids, maybe, I don't know."

CHRISTOPHER CHOUKALAS: Well, you're totally right. I had been in and out of enough relationships that I knew weren't going to go the distance. And when I met Lindsay, it was like this light switch went off. Everybody has a different version of this, but I just knew.

And it wasn't so much that I was like, "Okay, well, I'm going to say yes to whatever because I know I need to hold onto this person." But there's a certain amount of, "Oh, do you like to hike? Sure, I like to hike. Do you want kids? Oh, of course I want to have kids."

Because you want to—it's like, be yourself, but not all at once, not right away.

BLAIR HODGES: Yeah. And plus there's all these chemicals going on in our brains that make us like early love.

CHRISTOPHER CHOUKALAS: One hundred percent. And so in my mind I'm like, "Oh, that's years down the road." So I can just say yes to everything. But it wasn't something that preoccupied my dreams, to be like, "I can't wait to throw the football around."

And in retrospect, I would've denied this at the time, up and down, but it turns out my own upbringing was not a straightforward one either. I didn't have really any kind of relationship with my father. And my own mother, due to a whole host of circumstances, we probably didn't have the nurturing, positive connection that we sort of look to today as the thing that really builds people up and lets them be emotionally stable and productive people.

So there were all these things stacked against me from the get-go. I don't think I realized all that at the time, but all of that, I think, played into my own sense of what being a parent might be like and did I want that?

So no, I didn't particularly want that. But I knew Lindsay did, and I knew I wanted Lindsay. So, hey, we're going to go for it.

BLAIR HODGES: And you weren't against it either. Some people have a strong feeling, as you said, that they're just like, "That is not my thing," and they know it. And that's not where you were.

CHRISTOPHER CHOUKALAS: No.

BLAIR HODGES: What's interesting to me is that people diverge if they had a harder upbringing or they didn't have that family that was kind of the ideal. Everybody's got problems in their families, but some families are good, and you want to replicate that. You look forward to doing that yourself.

Other people who have a really hard upbringing are like, "I'm not even going to try. I don't want that, actually." And then there's other people who are like, "I want to do it because I want to do it right." And it sounds like you were somewhere where you're just like, "Yeah, that's a possibility."

CHRISTOPHER CHOUKALAS: Well, I was in denial for years about the impact that my upbringing had on me. When you grow up with a father who's absent, people, of course, ask you, "Oh, that must be so hard." And as a solid, earnest, stoic Midwesterner who graduated high school, went to college, got these degrees and has things, you think, "I was fine. He was kind of a jerk anyway. I was better off without him. It didn't affect me."

BLAIR HODGES: And you succeeded.

CHRISTOPHER CHOUKALAS: And you succeeded. And so when that's your narrative, of course you don't think that has any role in whether you want kids or not. So it wasn't like, "Oh, it was bad, I'm going to do it better," or, "It was bad, I don't want to do it." It was like, "I was fine, I did fine, and I'll just do the same."

I'll muscle through that like everything else.

 

When Anxiety Looks Like Control – 17:33

 

BLAIR HODGES: So you end up having the kids. Now paternal postnatal depression is coming on. In your case, it wasn't where you just totally disconnected and stepped out of it, which happens sometimes. Some men, when they're experiencing this, will just disconnect and lean on their wife to do all the work.

You seemed kind of the opposite of this, where you were controlling the schedule, the baby schedule, and monitoring everything. Talk about what your parenting looked like, because to me it didn't fit the stereotype of someone who gets depressed and just completely checks out.

CHRISTOPHER CHOUKALAS: Well, it's funny you mentioned that. I've been spending a little bit of time on some of the Reddit dad subforums, and the number of people who leave within the first six or eight weeks of having a kid has been shocking to me.

And I think it's all this thing that you're saying. They're depressed, they're anxious, they don't know how to handle these feelings, and they bolt. And you're right, that was not me. In part, I suppose it would be easy to look at my dad leaving and say, "Well, I just didn't want to repeat that."

But to be honest, it was never a conscious decision. I was in it. I was on duty, and I was going to see this through. And the way that I controlled the anxious feelings was to routinize everything. I felt as though if the girls weren't sleeping, I couldn't breathe.

Every cycle of nap and wake and feed and play and nap and wake and feed. And you do this five times a day when they're little. And it's like, if they don't get nap number one, the whole rest of the day is going to be a nightmare.

BLAIR HODGES: Domino effect.

CHRISTOPHER CHOUKALAS: And so I read the books and I read the blogs, and I was like, "Okay, we've got to get this down to the minute and turn the knob a little bit this way. And if that didn't work, then the next time we've got to turn the knob that way." And so it was this kind of militant helicoptering of that routine.

And Lindsay didn't really see it that way. I mean, here was someone whose whole conception was medicalized, whose whole pregnancy was medicalized, whose delivery turned into this ICU stay, major surgery, and she almost died. She just wanted to enjoy her kids. She just wanted to enjoy being a mom.

And so to have me be like, "Listen, we're out on this beautiful walk, and the sun is shining and this and that, but their nap is in half an hour. And so if we don't go home now, we're not going to get home in time to do the feeding, to change the diaper, to get them in the crib by the right time. And then the wheels are going to come off."

BLAIR HODGES: Yeah.

CHRISTOPHER CHOUKALAS: So it became this daily act of me needling her to follow the rules so that I could not be crazy. And her resistance to that only drove me further.

BLAIR HODGES: Right. And again, that wouldn't read to me like experiencing depression, but you were having these feelings.

CHRISTOPHER CHOUKALAS: That's right.

BLAIR HODGES: Sometimes even dark feelings.

CHRISTOPHER CHOUKALAS: Well, and I think the reason why you don't necessarily think of depression in this way is because if you go and look up the symptoms of maternal postpartum depression, it is a major depressive episode within the first six, eight, ten weeks of delivering the baby. And then you go and look up major depressive episode, and it's sadness, despondency, guilt, shame, energy issues, sleep, weight changes, all this down kind of stuff.

Okay, if you go and look up paternal postnatal depression, first of all, there's nothing in the textbooks about it. So there's no, "Oh, it's this, that, and the other thing." But you do see symptom lists, and nowhere in that do you see sadness, guilt, shame. You see anxiety, you see irritability, you see conflict, you see risk-taking, you see drug-seeking.

And so it gets called postnatal depression or postpartum depression, but I think that's just a way to relate it to the thing that the mom experienced, almost for name recognition. But the symptomatology is totally different.

BLAIR HODGES: Yeah. It's a mental health episode that surrounds the introduction of a new kid into your life, basically. So that makes sense that they would borrow some language.

CHRISTOPHER CHOUKALAS: That's right.

 

The Disturbing Intrusive Thoughts – 21:37

 

BLAIR HODGES: And when I mentioned things got kind of dark, was it the garage that you would go into? I don't want to say that you were always hovering. You also did try to find moments to be alone and try to center yourself.

But those moments got dark sometimes, in fact, to the point of even imagining them dying.

CHRISTOPHER CHOUKALAS: Oh yeah. Frequently.

BLAIR HODGES: Talk about what that was like. Right now, by the time this comes out, the trial will probably be over, but Lindsay Clancy's in the news right now for postpartum psychosis.

CHRISTOPHER CHOUKALAS: I saw that.

BLAIR HODGES: Yeah, the really tragic thing. She took the lives of her babies. I personally believe we're dealing with postpartum psychosis there. You didn't necessarily experience that, with hallucinations or anything like that, but there were intrusive thoughts. And your intrusive thoughts would be around, "How could this all stop?" Including death.

CHRISTOPHER CHOUKALAS: Yes. How can I get out of this? How can I make this go away?

And I would have these moments where Lindsay and the girls would be somewhere in the car, up at her mom's. We lived in the city at the time, and her mom lived about a half hour north. She'd go up there for a day or an overnight if I was working or whatever. Or even if she was just out with her sister, whatever it happened to be.

And I'd call or text, and I wouldn't hear from them. And my very first thought was, "Well, they must have died in a car crash. And now I'm free."

BLAIR HODGES: Wow.

CHRISTOPHER CHOUKALAS: And it even went as far as to be like, I would analyze it. "Well, but what if just Lindsay died and I'm left with the girls? Or what if just one of them died? Or what if both of them died, but now I'm dealing with Lindsay's grief? No, it has to be all of them."

And it was so ugly and so heinous, but yet I couldn't not have that be the first thought when she wouldn't pick up the phone.

BLAIR HODGES: When did you share those thoughts with her, and how did she digest it?

CHRISTOPHER CHOUKALAS: Well, I shared those thoughts later, after I was already getting some help and feeling a little bit better. And she was sort of nonplussed about it, or pretended to be nonplussed about it. She sort of thought, "Yeah, I bet you felt that way. I'm not surprised."

Because I think she knew. She really bore the brunt of how I was feeling more than anybody. For a long time, she even had the job of keeping that to herself so as to not make us look to the outside world like something was wrong. So I think she probably wasn't surprised. She probably imagined all kinds of terrible things that I might be thinking or feeling or doing.

BLAIR HODGES: And I just want to say, if anybody out there experiences those kinds of thoughts, especially if they think of harming someone, talk to somebody right away. You don't have to protect yourself. This is a mental health issue. Don't question yourself. Go and talk to somebody.

For you, it was more, as you talked about, imagining something happened to them and feeling a possible relief about it.

CHRISTOPHER CHOUKALAS: And to clarify that, people have asked, I never really thought about hurting myself. I never thought about leaving, and I never thought about suicide.

And I later learned—a friend of mine is a proofreader and a copy editor, and I actually hired her to look over one of the drafts of the book. And she got to that part of the story, and she's like, "Oh, this is interesting. This is a common—I don't want to say literary trope—but the whole 'my problem dies in a car accident' is a very typical mechanism for people because it absolves them of the guilt of actually doing something to bring it about."

Because the car accident is nobody's fault. You're just magically free. And she's like, "This doesn't make you a monster. This is a very typical human response to stress."

And I had never heard that before, but I remember reading those comments from her and just breathing this sigh of relief. This is years later, of course.

BLAIR HODGES: Yes, but still, you're processing that stuff even as you're putting the book together.

CHRISTOPHER CHOUKALAS: Oh yeah, absolutely. Absolutely.

 

Finally, a Name for What Was Happening – 25:55

 

BLAIR HODGES: There was a big turning point that happened. You talked about the weight this was putting on Lindsay. So you were really going through it, but obviously that was putting her through it as well. She went out, I think, on a run or something. She was with a friend who's a psychologist and was having a conversation, and then she runs back home with news for you.

CHRISTOPHER CHOUKALAS: Oh yeah. I remember I could hear the foot patter up the stairs, and it was like she was coming home with some gift. Basically, the alternative to me having something was that I was just a terrible partner and a terrible parent, and that was just the straw that she drew.

And so for her to come up with an answer that might mean things could get better was like a revelation to her. But for me, it was just one more thing that was now—one more thing I had to do in addition to corralling the schedule and keeping her on track and managing this and everything. It was one more spinning plate above my head.

BLAIR HODGES: Yeah. You talk about being irritated when she's like, "There's this thing called paternal postnatal depression. Here it is."

CHRISTOPHER CHOUKALAS: That's right. "And it sounds exactly like you."

BLAIR HODGES: It didn't land with you the same as it did with her.

CHRISTOPHER CHOUKALAS: Not right away.

BLAIR HODGES: But pretty soon, you say later that night you were able to sit down and reflect on it. And you kind of brought your medical hat to it and thought about it that way, right?

CHRISTOPHER CHOUKALAS: Well, there were two angles on that. I guess the first was just that I knew I wasn't happy, and I knew enough about psychotherapy to know that at the very least, if I talk to somebody, I'm going to be able to unload and unleash that unhappiness and at least get some air on that.

And that felt really good. That felt like an opportunity to, at the very least, maybe even have an ally in my corner because I felt alone in my quest to control this stuff. And I thought at the very least, maybe I'll have an ally.

And I wasn't coming at this as a man with some stigma against seeing a therapist. I mean, as a trainee in counseling psychology, we all see therapists as a part of that learning. And so I knew that it could feel good to talk to somebody and get some of this out of there. Even if I didn't think I had a problem, I knew I wasn't happy, and I knew I needed to get some of that out.

So we started looking for people. It was early COVID, this would've been January of '21. The vaccines were just coming out. People were still locked up in their houses, and it was a mental health crisis worldwide.

And so just even finding somebody was not that easy. Everybody's schedules were full. They were overwhelmed with all of the depression and sadness and angst that people were feeling around this.

But we found Matthew. And as it happens, my wife's sister found him. My wife's sister is the one who also set us up. So I owe her not just my marriage.

BLAIR HODGES: And she donated the eggs for the—is she the one who donated the eggs for the babies as well?

CHRISTOPHER CHOUKALAS: I'll tell you, man, when you really look—so full picture here. Lindsay's sister is getting married tomorrow as we're recording this, right?

BLAIR HODGES: Oh, wow.

CHRISTOPHER CHOUKALAS: And I owe her my relationship. I owe her my daughters. And I owe her finding this man, this therapist who has been just—I mean, I can't not tear up when I think about what he has meant for me in my quest, not just to get better, but to go beyond what I was before.

And I owe it all to Lindsay's sister, Jenica.

BLAIR HODGES: I mean, that's amazing. And that's amazing to hear that she's getting married, too. Congratulations.

CHRISTOPHER CHOUKALAS: She's getting married.

BLAIR HODGES: That's awesome.

CHRISTOPHER CHOUKALAS: Yeah, thank you.

 

Treating Paternal Postnatal Depression – 30:01

 

BLAIR HODGES: So you started meeting with a therapist. What did treatment look like? And you can speak more broadly, too, because maybe the treatment that you went through doesn't necessarily reflect what everybody would go through.

What kind of treatment options are there when someone realizes— You've already mentioned the symptoms, so now people are going to go get diagnosed. What does the treatment look like?

CHRISTOPHER CHOUKALAS: Great question. So when you think about going to a doctor, you're like, "Well, I have a cold, so I'm going to go to the general doctor, and I have a broken bone, so I'm going to go to the orthopedic doctor, and I have a deviated septum, so I'm going to go to the ear, nose, and throat doctor."

And therapists are a little bit like that, too. There are different orientations of how they might approach a problem. There are therapists that specialize in different kinds of problems, like, "I'm really into treating anxiety," or, "I'm really into treating schizophrenia."

For me, I knew I needed a therapist whose bent was not super cognitive because I'm already super cognitive. And I needed someone who was going to be able to get me onto an emotive plane to really feel and dig into this stuff and not just cogitate over and over in my head.

And so for me, that was a big part of the interview with all these therapists. "What kind of therapy do you do?" "Oh, I'm a cognitive behavioralist." Well, that's not what I need.

BLAIR HODGES: That could make it worse.

CHRISTOPHER CHOUKALAS: That's going to make it worse. And so for me, at first, therapy was a lot of venting, just vomiting these experiences and feelings onto this person. And I could finally say out loud what was going on.

I know that probably for book sales and stuff, it's better for me to say, "Oh, postnatal depression is this distinct entity, and there's this specific treatment. And if you subscribe to my Substack, I'll give you the..." But there isn't really a specific therapy for that. It's like, how do you address depression? How do you address anxiety?

And that's the treatment. And so there are different brands of psychotherapy, and there are some different medication approaches. And I used both.

And I found that a lot of the emotive psychotherapy aspects really helped me feel better and not have the intrusive thoughts and feelings, and just to be more comfortable in my own skin and to grapple with the ways in which my own upbringing was affecting my behavior today.

They always say, "Do the work." And I never really know what that means, but I think it means you're sitting in it, and you're thinking and feeling and being challenged by this other person about it. And to just really live in that set of feelings.

But I still had the real physical sensations of anxiety, the chest pain, the heartbeat stuff, just this gnawing, electrical—

BLAIR HODGES: I feel it in my stomach.

CHRISTOPHER CHOUKALAS: Yeah.

BLAIR HODGES: And also some neuropathy from when I had shingles, too. I'll get tingling in my face and stuff.

CHRISTOPHER CHOUKALAS: Oh, no kidding.

BLAIR HODGES: Yeah. It's like my little Spidey sense of anxiety.

CHRISTOPHER CHOUKALAS: Interesting. Well, I found that getting on the medications is what made that calmer.

BLAIR HODGES: That's good, because then that's not swirling you up more. Because when you start feeling it, then you start thinking it, and it's this really terrible cycle you get yourself wound up in.

CHRISTOPHER CHOUKALAS: One hundred percent. And so there are a couple different classes of antidepressants that people use, and the side effect profiles vary a little bit. And it's not so much like, "Oh, you have anxiety, let's start with this one," or, "You have depression with psychotic features, let's start with that one."

It's like, "Hey, this is the one that most people respond to with the least side effects. We're going to try that. We're going to give it six or eight weeks, and then we'll either go up or down on the dose, or we'll try the next one."

And the one that might work for me might not be the one that works for you. And so a lot of it is trial and error, and that's normal.

 

Why Aren't We Talking About Depressed Dads? – 33:56

 

BLAIR HODGES: You also point out that there still need to be more studies on this stuff. I mean, postpartum depression for women, also, I think we could stand to learn a lot more about it. Paternal postnatal depression, we could stand to learn a lot more.

CHRISTOPHER CHOUKALAS: Oh yeah.

BLAIR HODGES: And this is an irony where it seems like we're maybe an example of where we're less likely to help out men. Medical science tends to favor men a lot, as you probably know. In this case, I feel like men are supposed to be these strong leaders. We're not supposed to have these kinds of issues.

We're not supposed to be emotional or have depression, and men don't talk as often. Men are less likely to talk to each other about it. So the odds are stacked a little bit against men in this case, more than we see in other medical contexts, it feels like.

CHRISTOPHER CHOUKALAS: Well, it's important to be really clear about something. First of all, the point that you made about medical science favoring men is true. So to be honest, it's a little bit dangerous to talk about this stuff at all because you will encounter, and I have encountered, a lot of strong defensive feelings from women who feel like this is not men's space.

They should not be talking about this because any heat that you get, any attention that you get, is just going to draw away from women. And of course I can say, "Oh, it's not a zero-sum game," blah, blah, blah.

But their whole experience from the day they were born is that men are—I totally get it. And so I try to remember, and I try to remind people that it was only 20 years ago that people said the exact same thing to women: "You're crazy, just toughen up, it's all in your head."

And these people that are coming at me, their parents had people coming at them for having these experiences. So on the one level, I need to acknowledge that there's this very real feeling out there that this is not for me to talk about and not for me to experience.

On the other hand, we know, and there's good research on this, that if the dad's not well, the kids aren't well.

BLAIR HODGES: And it hurts mom, too.

CHRISTOPHER CHOUKALAS: It hurts everybody.

And so we really need to be looking at everybody, the whole family, because if any man, if any partner, if any parent, if anyone is down, the whole team is down.

BLAIR HODGES: Yeah. I appreciated the book for that because, to me, it doesn't try to steal this—I know it's weird calling it this—spotlight, but let's just go with that metaphor. Taking the spotlight away, because you recognize that this is an issue that affects women when they're dealing with postpartum depression.

But also, we do need to think about how it affects men. And I think there could be more research into how it could affect nonbinary people or trans folks who have kids.

CHRISTOPHER CHOUKALAS: Right. Because look at adoptive parents. Adoptive parents who don't go through childbirth have postpartum depression. The non-birth parent of either gender.

BLAIR HODGES: Yes.

CHRISTOPHER CHOUKALAS: You might have a couple of two women, and one of them is the one who delivers. The other one can get postpartum depression, too.

BLAIR HODGES: Yes, absolutely.

CHRISTOPHER CHOUKALAS: So it's not as simple as, "Oh, you can't have this because you didn't push the baby out." But I so get it. I so get the angst and just the existential dread that these women feel when I start talking about this. So it's tough.

BLAIR HODGES: Yep. Because it's still underdiscussed for them, too. But you say in terms of prevalence, numbers are imprecise. You can't really nail it down, but there are estimates anywhere between 10 to 20 percent of men might experience paternal postnatal depression.

Again, we're not exactly sure, but that's wrapped up in this conversation about why there might not be as much research done or as many questions about it.

CHRISTOPHER CHOUKALAS: That's right.

BLAIR HODGES: That's why I think this book is really such an important read, because it's one of the few that really go into this. And I think memoir is really powerful. Again, you bring a certain technical expertise to it, but hearing your actual story is really what pulls me in. I can feel it with you.

CHRISTOPHER CHOUKALAS: I really appreciate that.

BLAIR HODGES: And I'll remind people, it's called Even the Darkest Night: A Father's Journey of Hope and Healing from Paternal Depression by Dr. Christopher Choukalas.

And Chris, I want to swerve now a little bit and talk about—let me actually figure out what I want to talk about, because I've got kind of a choose-your-own-adventure going.

CHRISTOPHER CHOUKALAS: I really appreciate those comments about the writing because I've written academic books before, and obviously the tone is really different. And it was really important to me that this be as raw and open as I could make it because it felt like if I didn't put it all on the table, number one, whatever cathartic benefit a person might have from writing about this horrendous experience, if I didn't just get it all out there, that catharsis would be incomplete.

But also, I felt like if I didn't portray the worst version of this, then some other dad's going to come along and read it and say, "Oh, I'm even worse than this guy. I'm still not okay. This guy, it was so bad he wrote about it, but it's not as bad as what I'm feeling." And so he'll think, "I'm really far off."

And I just didn't want people to have that experience because I was trying to hide something or make myself not seem as sick as I really was.

 

EXCERPT: Learning to Let Go at the Zoo – 39:20

 

BLAIR HODGES: I'm glad you mentioned that. It ties into this other part of the book I remember, about the importance of talking to other people about what you're experiencing. This is on page 194. Maybe we can have you read from this part.

You're a little ways into your experience of paternal postnatal depression, and you took a trip to the zoo. You're wrapping your head around it more, and just to set this up, this trip to the zoo was intended to help you let go a little bit, to change from being such a hyper-focused person who really needed to control everything for your kids.

So this is a chance for you to go to the zoo, have a day at the zoo, relax, and maybe not be so tied to that schedule.

CHRISTOPHER CHOUKALAS: Yeah.

BLAIR HODGES: So let's hear this excerpt here, because it ties right into what you're saying about the importance of finding catharsis and talking to other people about it.

CHRISTOPHER CHOUKALAS: I remember that day at the zoo, I tried. I really tried. I tried to ignore whether they were eating enough, whether too much time was passing, whether there was or wasn't enough time to try again to see the monkeys, and whether I thought the girls might still nap that day. I tried to focus on their smiles and on their giggles, their requests for more French fries.

I engaged in their excited chatter about the gatitos. In Spanish, the girls' first language, it means kittens. But in this case, they were referring to the 50-pound snow leopards that were very clearly stalking the girls as potential lunch through an inch-thick plate glass window.

This mundane thing, having lunch with my kids at the zoo, was for me something Herculean.

Herculean, not so much because of the effort involved in getting out of the house and navigating the million little things that can beset a trip with toddlers. Herculean, not even so much in terms of the two weeks of planning and preparation leading up to it, but in the larger context of my evolution as a parent, going from someone so defeated and disabled by illness to someone who could manage this thing and look, at least from the outside, like I was doing something routine, something easy, the way all these other parents looked.

But then the obvious point hit me. Maybe we're all just faking it. Maybe parenting is at least a little bit hard for everyone. Like the father I'd met earlier that morning. Maybe more of us are just barely getting by than we could ever know, could ever tell from the outside. Maybe just below the surface, many of us are bursting with emotions we can't quite deal with until someone has the kindness to ask, to share, and to create a space safe enough for us to let it out.

 

What Happens When Men Open Up – 41:44

 

BLAIR HODGES: And that's what happened. When you're in the parking lot before you go into the zoo, you happen to be unloading your car next to this other dad, and he's chatting you up and being like, "Oh, twins, eh?" Because you get this all the time when you've got twins, like, "Oh boy," you know, and—

CHRISTOPHER CHOUKALAS: Double trouble.

BLAIR HODGES: Double trouble. Instead of just doing the usual, like, "Oh, you know it," you actually told him, "Actually, yeah, this is really hard." You kind of surprisingly told him the truth.

CHRISTOPHER CHOUKALAS: That is such a microcosm of my larger experience of talking to men about the book and the feelings and the process. If you stand there and use these words, you are giving another man permission to express their feelings, too. And it's almost like they've just been waiting for somebody to give them permission to let it out.

And so with this guy, I don't know why I said it. I just was like, "No, man, it's really fucking hard. And it took me a year and a half to be able to bring these kids to the zoo by myself. Because I can't function and I can't breathe around my kids."

BLAIR HODGES: And he's standing there. And the amazing thing is, like you said, this gave him permission, too.

CHRISTOPHER CHOUKALAS: And he didn't walk away, and he didn't shy away from it, and he didn't back down from it. He just kind of looked down, shuffled his feet, and he's like, "I mean, that sounds like me."

We didn't call it anything, but, "My wife kept asking me why I was being so short with her all the time. And I didn't know why I was being so short with her. I just didn't have any other emotion other than irritability and conflict."

And again, he didn't use those words, but he kept saying "short with." His wife kept asking why he was so short with her. "I don't know why I was so short with her. I didn't feel like I was short with her, but I just couldn't relax. That's just what would come out."

And there we were, just two dads talking about our feelings at the zoo as the fog is misting down on us. It was wild. It was wild. I had never met this guy.

BLAIR HODGES: I love how you say it's a microcosm because I think that's the power of what the book can do. But I think it invites us to do that in our real lives, too. Reading a book is one thing, but when we can actually talk to people for real.

And it's amazing that that happened in this case with a stranger, because that can happen sometimes. Not always. Sometimes it's a trusted confidant.

CHRISTOPHER CHOUKALAS: Well, maybe it's even easier with a stranger because the stakes are lower, right?

BLAIR HODGES: Right.

CHRISTOPHER CHOUKALAS: It's not your buddy who's like, "What's wrong with this guy? And now I've got to play cards with him."

So I read a lot of scientific literature as a part of writing this book. And you'll get a kick out of this study that came out of Australia. It was basically like the title was, "Men don't talk about their feelings? Well, I think that's bullshit." And we can bleep that out.

And the upshot is, yeah, guys want to talk about their feelings. But what the researchers gleaned from all this was that they'll talk about their feelings, but only if they're not looking at each other, right? They have to be both facing away from each other.

BLAIR HODGES: Like if you're at the game, you're watching the game so you can chat openly.

CHRISTOPHER CHOUKALAS: Yes! Or you have to be driving, or you have to be doing some activity that is a more traditional male activity. You have to be jogging together side by side, and you're like, "Oh, I got in a big fight with my wife last night, and I'm not feeling..."

Yes, you'll talk about your feelings, but only under these very specific circumstances. So I got a kick out of that.

BLAIR HODGES: That was funny. And I thought the book did a good job navigating some of these things. I noticed you never used the words "toxic masculinity," and there are different opinions on how to use that term. But I do think in a broad sense, you are dealing with some of the things that men are cultured to do, like the ways that we're expected to be with our emotions or how we're supposed to talk to other people.

Or men aren't usually as affectionate with other men, physically especially, as we might see women, and not to mention, again, trans and nonbinary folks. So I think your book, for anyone who's triggered when they see the words "toxic masculinity," they don't have to worry about coming across that in your book. But I do think you're addressing it here.

CHRISTOPHER CHOUKALAS: Well, it's funny. I didn't grow up with much of a male role model. Of course I had uncles and the fathers of friends and girlfriends and stuff, but that's super different.

I was raised by a single mother. I did chores, I did my own laundry, I ironed my own shirts by the time I was 14. And so I didn't have that beaten into me, but I also did not see some other better example of how to relate to men other than through the usual kind of, "Hey man, how's it going? Let's chug a beer."

And it's kind of funny. I did join a fraternity in college, and to this day, those are still my closest male friends. And we drank plenty of beer and did all the traditional things, but there was a closeness, I think, that has only grown in intimacy over the years.

And for me, that was kind of the first time I felt like a safe space around other men. And that was a real rare bright spot for me in terms of how I related to other guys. And as I say, that's only deepened as we've all aged together.

 

It Changed His Marriage – 47:18

 

BLAIR HODGES: I like how the book explores these different kinds of relationships. It explores your marriage, too, because as we've talked about, this had a huge impact on your marriage.

And I think one of my favorite revelations in the book was when you're thinking about how your obsession over the babies was trying to control everything because they were so unpredictable, and knowing that if one thing went wrong, it could set them off, and that could ruin nap time, which could then ruin the next meal, which could then cascade.

And you suddenly realized that that's actually how Lindsay was experiencing your relationship with you.

CHRISTOPHER CHOUKALAS: Yes. Yes. That's a great pickup on your part because I don't know if I really beat that into the reader, but there was a point at which it became clear that, yeah, I'm stepping on eggshells around the girls, and she's stepping on eggshells around me because she doesn't know what's going to set me off.

BLAIR HODGES: It seems like she really did believe in you throughout this process. I mean, it was really hard for her, but it seems like she was really there for you. And it doesn't always turn out that way.

CHRISTOPHER CHOUKALAS: No. I have been asked so many times when I go out and talk about the book, "Why do you think she stayed?"

And actually, at the launch event, she was there. You know how this goes, a bookstore hosts a thing, and you go and there's a bunch of people. And we had a really terrific turnout. It was a really beautiful event for me to get to talk in front of all these people, some of whom I knew and have known for a long time, and just kind of be out there.

But of course, Lindsay is in the audience, too. And when that question comes around, everybody turned around to her, like, "Well, Chris, you don't answer this. What is it, Lindsay? Why did you stay? I mean, you had a couple bucks in your pocket. You could have. You didn't have to live like this."

And I think she had been through a lot of her own challenges in her life. The model that her parents set for her was that sometimes marriage is really hard, not just for months, but for years. She had a job with a startup that was extraordinarily stressful, but she knew if she could wait it out, there'd be kind of a reward at the end.

And so just the act of going to work every day for those years was such a burden to her. And I think growing up Catholic also gives you a sense of service and commitment and seeing things through. And I think, to her credit, those things really became a part of her.

And so she thought, "I just need to see this through."

But none of this works without her. None of this works without her. The hard times at the beginning never get better without her. The life that we have now in terms of the ease and comfort and the fun things we get to do, the way that she makes me feel like I can do anything, from getting better to writing this book to any of this stuff.

It all comes from her belief in me. And I just wouldn't be anywhere without that.

BLAIR HODGES: I love that. And I know that it doesn't always work out that way. And sometimes it probably shouldn't work out that way if someone needs to take greater care of themselves and the change isn't coming. There are different roads that everybody can go on. So I don't think everybody's going to wind up in the same place.

But I think seeing where you both wound up is really helpful to me. It's gratifying to know that she had the strength to work together with you and that you had the ability to make those changes. And for people who don't have that same experience, obviously our hearts are out to them as well.

But when it works out, it's so nice. It's so nice when it happens.

CHRISTOPHER CHOUKALAS: And I didn't know that it would. I mean, I knew that I would get better, I guess, but I don't think it was always super obvious that our relationship was going to make it in a way that was beyond just kind of grinding it out and living together as parents.

The fact that we have been able to come together and find love and joy and passion and intimacy, that's not a guarantee. And that part has been the really beautiful surprise.

 

It Changed His Professional Life – 51:37

 

BLAIR HODGES: Well, not only had your marriage changed because of this, but maybe take a second to talk about how your professional life changed. This changed your professional life, too.

CHRISTOPHER CHOUKALAS: It's funny, I didn't think there was anything wrong with my work. I didn't think there was anything wrong with my career. But when I made the decision to leave the intensive care unit, when I made the decision to leave academic medicine and join this community practice up here in the suburbs, all evolving while I am improving as a parent and a partner, I find that because I feel like enough, I can relate to my patients in a much more wholesome and honest and earnest way.

And I'll give you an example. All of my patients now have my phone number. The idea that somebody would need something from me that I couldn't provide was such a stressor. I never would give my patients my phone number before. I didn't want, "Oh, what if they call me? What if they need something?"

But now it's like, I see these people at the grocery store. These people are in my community. And Lindsay has pointed this out, too. She has never seen me happier at work.

It's the way that I now get to relate to other people, from the patients to the doctors to the nurses, the other people. I just feel so much more open and available because I'm not afraid that they might need something from me that I can't provide, because now I can provide it.

BLAIR HODGES: Yeah. It was really cool seeing you go from a doctor who was just like, "I just want to get this done in the ICU, and then we're done. We don't need to really even think about each other as people. I'm just fixing the car," kind of thing, to actually connecting with the patients as humans.

That's a big difference.

CHRISTOPHER CHOUKALAS: It feels totally different.

 

A Million Reasons Not to Write This Book – 53:21

 

BLAIR HODGES: Before we get to regrets, challenges, and surprises, I wanted to spend a second talking about what it was like to write this book. Because I think it was maybe in your acknowledgments somewhere in the book, you pointed out that you actually had a million reasons not to write this book.

You don't list them in the book. I wondered what a few of those reasons were, and what got you to push through those?

CHRISTOPHER CHOUKALAS: Well, I think that not a lot of people would want this kind of detail about their family out there.

BLAIR HODGES: Yeah, it's very candid.

CHRISTOPHER CHOUKALAS: You could fear that people might think you're a wimp or you're soft, or not everybody would want other people to know that they suffered a mental health crisis. Not everyone would want people to know that your marriage was struggling. And not everybody would want their kids to eventually be aware that you suffered this way, because what guilt might they take on as a part of that?

And then there's this stuff about my parents. My dad's not in my life, but my mom was until she passed away unexpectedly just a couple of months back.

And there's some stuff in there that's maybe not super flattering about how she was able to come as a parent. And I think that I worried a lot, I stressed a lot about what it was going to be like to have her read how I felt about my upbringing.

And so it would've been easier just to shrink away and not put myself out there. But at the end of the day, it was going to come out one way. I mean, this stuff was in me, and it just had to come out.

And I don't know, man, it's like life. It just didn't work to keep this all to myself, to keep this gem of information, this gem of possibility, this nugget of something that could make people live a richer life. It just didn't work not to share it.

BLAIR HODGES: And you talked about how it became more worth it the more you went on, too. The experience of writing the book seemed to have made it more worth it, even.

CHRISTOPHER CHOUKALAS: Oh yeah. The way that I would write about certain things changed over time. You know how this works. You write a draft, and then you change it, and months go by, and you come back to it.

And there's this question that keeps coming up: Was it worth it? Not was getting help worth it, because getting help is hard and all this.

But would you go back and just undo the whole having kids part to begin with and just keep living your life the way that it was, which seemed perfectly adequate at the time?

And when I first started writing about that, it was like, "I don't know, man. This has been a really shitty couple of years. I don't know. I don't know."

And each time I would come at that part, a few months later, a few months later, a few months later, it was like, "I don't know. I don't recognize this guy. Of course, of course I'm better off for having gone through this."

So it was really cool to see how the act of writing it and just coming back to it created a certain clarity for me around how much I had grown as a part of all this.

BLAIR HODGES: And people will grow just from reading it, too.

CHRISTOPHER CHOUKALAS: Well, I hope so.

BLAIR HODGES: The book is called Even the Darkest Night: A Father's Journey of Hope and Healing from Paternal Depression by Dr. Christopher Choukalas. And Chris is an anesthesiologist in community practice now. He's also a professor in the Department of Anesthesia and Perioperative Care at the University of California, San Francisco. He now lives in California with his wife and his daughters.

 

Regrets, Challenges, & Surprises – 56:53

 

BLAIR HODGES: Chris, I always like to end with Regrets, Challenges, & Surprises. This is an opportunity for you to talk about this freshly published book. Is there anything you would change about it now that it's out? Sometimes people feel really good about it. They don't need to make any changes. What was most challenging about writing it, or what surprised you the most about writing it?

CHRISTOPHER CHOUKALAS: You know, it sounds kind of trite or logistical, but I wish I could have spent more time writing about the joy that had come. I think deadlines were looming and this and that, and I kind of underdid the parts towards the end where it was just how much I was liking it now.

And I also think that my relationship with Lindsay continued to evolve throughout the course of this. And I think it wasn't really until the book was turned in that we really found each other in a really real and loving and open way. And so it would've been cool if I could have really felt more of that as I was finishing the end of it.

BLAIR HODGES: I mean, I love the part where you say you're walking down the hall and someone sees your work ID or whatever, and they're like, "Who's that guy in that picture?" Because it totally looked like a different person.

CHRISTOPHER CHOUKALAS: It was such a throwaway for this guy. It was such a throwaway for this guy. It was like, "Ah, this doesn't look like you." But it was so rich for me. It was such a moment.

And actually, a couple months ago, I mean, I still work with this guy. A couple months ago, I ran into him and I told him, I guess for the first time, "You probably don't remember this, but we had this thing, and you said this thing. And I just want to tell you what that stirred up in me, what that did for me, and just how I feel about the work that I'm doing now and the people that I'm doing it with."

I'm crying again. And he just looks at me, and he's a 65-year-old guy, and we just hugged.

Right there in the hallway, we just embraced each other, and we just kind of cried. And it's just like, "Hey, man, we're all in this together. I really appreciate you telling me that that's how you felt when I brought that up."

And I was like, "Gene, just saying that to me, just saying what you saw in me changed my life. So thank you."

BLAIR HODGES: I love that it's affecting your day-to-day life, and then also just your life as a dad and your life as a partner. Your kids are about six-ish or so now?

CHRISTOPHER CHOUKALAS: They're going to be six in August.

BLAIR HODGES: Okay, yeah.

CHRISTOPHER CHOUKALAS: And if you can stand it, I hear them kind of pattering around. They probably want to rush in here and get on screen.

BLAIR HODGES: Hey, I wouldn't be opposed to saying hello if they want to come say hi.

CHRISTOPHER CHOUKALAS: Real quick. Hey girls, come into the living room. Say hi to Papa and Blair.

BLAIR HODGES: I'll be like, "Oh, double trouble!" [Laughter] Just kidding.

CHRISTOPHER CHOUKALAS: I know you're so shy. You're so shy.

BLAIR HODGES: I'll just wave to you if you can hear me. Can they hear me? Maybe you'll have to—

CHRISTOPHER CHOUKALAS: They can't because it's on the earphones.

CHILD: Where are the shoes?

BLAIR HODGES: Yeah, I'm waving anyway.

CHRISTOPHER CHOUKALAS: You don't have to.

CHILD: Where are the shoes, Papa?

CHRISTOPHER CHOUKALAS: Oh, they're up in—I don't know. We gotta find them. I better get up.

BLAIR HODGES: Are they going to the rehearsal, too?

CHRISTOPHER CHOUKALAS: So they're the flower girls. This is Isa.

BLAIR HODGES: Oh, hi!

CHRISTOPHER CHOUKALAS: This is Blair. I know we have like five minutes. Don't worry. We'll get going. I thought I put the shoes in the top of one of their closets. If they're not—

LINDSAY CHOUKALAS: I'm too short!

CHRISTOPHER CHOUKALAS: Oh, she's too short! [Laughs]

BLAIR HODGES: Is that Lindsay?

CHRISTOPHER CHOUKALAS: That's Lindsay. Do you want to say hi?

BLAIR HODGES: Yeah.

CHRISTOPHER CHOUKALAS: You can't hear her because it's on—

LINDSAY CHOUKALAS: Hi!

BLAIR HODGES: Hi! Yeah, just tell her that I said hello, and I love the book, and I love her part in it, obviously.

CHRISTOPHER CHOUKALAS: Yeah, I will. I will. So this is Isa and Pia and Lindsay.

BLAIR HODGES: Hello, family.

CHRISTOPHER CHOUKALAS: Okay.

CHILD: Hello? [laughter] 

CHRISTOPHER CHOUKALAS: The video froze, but the audio is still recording.

BLAIR HODGES: Oh, good. Okay, yeah.

CHILD: Hello! Papa, how can we hear you?

CHRISTOPHER CHOUKALAS: I know, because it's right in here. I'm going to go find your shoes, I promise.

CHILD: What do they look like and what color are they?

CHRISTOPHER CHOUKALAS: Are you still there?

BLAIR HODGES: Yep, I'm still here. 

CHRISTOPHER CHOUKALAS: Great. The video is frozen but the audio is great.

BLAIR HODGES: Great.

Okay, bye!

Well, thank you so much, Chris. I just want to congratulate you on the book.

CHRISTOPHER CHOUKALAS: Oh, thank you.

BLAIR HODGES: It's a terrific book, well-written, really engaging, and there's so much necessary and important information in it. I hope it just gets spread far and wide, Chris. I really love this book.

CHRISTOPHER CHOUKALAS: I really appreciate that. Thank you.

 

Outro – 01:01:17

 

BLAIR HODGES: Thanks for joining me on this episode of Relationscapes. At the end of the discussions, I like to recommend a few fellow traveler episodes. These are discussions that intersect with what we talked about in this episode.

So I encourage you to check out my interview with Ayana Lage. It's called "The Postpartum Psychosis Prophecies."

AYANA LAGE, CLIP: I was very aware of the risks of postpartum mental health. I'd heard of postpartum psychosis. It didn't even cross my mind as something that could happen to me, but I'd heard of it. But I think I kind of had this thought of, "I've already been through so much when it comes to pregnancy and fertility and all of this. I deserve to have a good experience, so that's what's going to happen."

BLAIR HODGES: And you can also check out my episode with Teresa Wong. It's called "When It's More Than the Baby Blues."

TERESA WONG, CLIP: I was just so happy to find out that I wasn't alone in this, that other people felt the same way.

BLAIR HODGES: And when you're listening, keep in mind that postpartum depression and postpartum psychosis are not the same thing. Those are two different conditions. And we dig into those in both of those episodes.

If you're enjoying Relationscapes, take a second to rate and review it in Apple Podcasts or leave a rating in Spotify. I want to get the Spotify ratings up. I think we're around 40 or so, but we can do better than that. So if you're listening in Spotify, go rate it. It's super easy.

Another way you can help me grow the show is by recommending it to a friend. So if somebody in your life came to mind while you're listening to this one, text them a link.

You can follow me on Instagram or TikTok for some video of this episode and other bonus stuff. I'm @_relationscapes.

Mates of State provides our theme music. I'm your host, Blair Hodges, an independent journalist in Salt Lake City, and I hope to spend more time with you soon here on Relationscapes.