A reality TV star's decision to talk about his experience as a new dad is shining a light on a lesser-known topic, paternal postpartum depression.
Leroy Garrett, a competitor on "The Challenge: All Stars," told "Good Morning America" in a new interview that when he began struggling after the birth of his first child, he did not even know men could be affected by postpartum depression, a mental health condition that impacts men and women before, during and after pregnancy.
"I really didn't recognize it at first," Garrett said. "I remember my mood would always just be low ... and I had a feeling of just like worthlessness and guilt as well, because I felt like this is supposed to be the happiest time of my life. I was having doubts of, 'Should I have had a kid?'"
Garrett and his fiancee Kam Williams, also a contestant on "The Challenge: All Stars," share son Kingston Lee, 23 months, and 9-week-old daughter Aria.
Garrett said once he opened up to Williams about his symptoms, they looked them up online and saw that they matched the symptoms of postpartum depression, feelings of which can be intense and longer-lasting compared to the "baby blues", which occurs after having a baby, according to the U.S. Centers for Disease Control and Prevention.
"That rocked me to my core too because I was more worried about her getting postpartum depression, and she was fine," he said. "So to know that it was me, it just made me feel even worse."
Postpartum depression is a common condition among women, with around 1 in 8 women experiencing postpartum depression after giving birth, according to the CDC.
While postpartum depression in fathers is less known publicly, it is still common, with around 1 in 10 fathers experiencing it, research shows.
Garrett said that after opening up to Williams, he began going to mental health counseling, which he said gave him the tools to cope following his son's birth, as well as after the birth of his daughter two months ago.
"I could feel some of the same feelings from before, but this time, I felt like I had the tools and I kind of knew what to do," Garrett said. "It's like, 'Hey, this is not going to last forever. This is just part of the process.'"
After Garrett opened up to friends and family about his experience with postpartum depression, he learned he was not alone.
He said he received the same feedback after opening up about his experience on this season of "The Challenge," calling it an "amazing response."
"I had my first kid when I was 39 and a lot of my peers had their children in their 20s. At that time ... I didn't even think to ask what they were going through," Garrett said. "I think a lot of times for men, we just never discussed it. You just went through it."
He added of the reaction to him speaking out, "It feels good, because it's not like misery loves company, but there's so many other men who have been through it or are going through it or are about to go through it ... and I can help them. It feels good to be able to lead by example."
Dr. Sheehan Fisher, a perinatal clinical psychologist whose focus is on fathers' mental health, said that a high-profile figure like Garrett speaking out about his experience with postpartum depression can help normalize it for men, in the same way postpartum depression was normalized when women spoke out publicly.
"It is just as important now for us to understand that men are vulnerable to depression and anxiety and other types of mental illness during the perinatal period at a heightening rate," Fisher, also an associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine, told "Good Morning America."
Men are at the highest risk for postpartum depression three to six months after their child is born, but it can begin as soon as after conception, according to Fisher.
The term perinatal mood and anxiety disorder, or PMAD, which covers pregnancy and post-childbirth and a range of conditions including anxiety and depression, is also used to classify the mental health struggles that new moms and dads alike may endure.
Why some dads are affected by postpartum depression comes down to a mix of biological, environmental and genetic factors, according to Fisher.
"Men, just like moms, are going through a life transition that is brand-new to them, but it's unique for fathers right now because they don't really have a blueprint on how to be a father," he said. "Modern-day fathers are actually much more involved than their predecessors in family and child-rearing while also doing similar levels of work outside the home, so they're trying to balance this adjustment along with the stressors that come with it."
Biologically, Fisher said research has shown that men's testosterone levels do change during the perinatal period, which can be associated with changes in mood.
And genetically, if a man has a predisposed genetic risk for depression or anxiety, that can be activated by the stressors of new parenthood, according to Fisher.
MORE: Husband speaks out about postpartum depression after wife dies by suicideNew dads, he noted, are often not screened for perinatal mood and anxiety disorder in the same way that new moms may be. In addition, Fisher said men may have different symptoms of depression and anxiety that are not picked up on, which means the rates of PMAD among men may be underreported.
"One of the problems is that traditional measures of depression have a gender bias that doesn't really include how men experience and respond behaviorally to depression," Fisher said. "You may have a father who won't say, 'I've been crying,' or, 'I've been sad,' but they might say, 'I've been getting more irritable lately,' or, 'I'm hypersexual.'"
MORE: Hayden Panettiere shares what she wished she knew about postpartum depressionOther symptoms of postpartum depression in men, according to Fisher, may include behavioral changes like isolation, seeming down or withdrawn, not finding pleasure in normal activities, aggressiveness and having difficulty functioning at work and at home.
Research has shown that a dad's mental health can affect not only him and his partner, but also their child's physical health and mental health.
Fisher said the biggest takeaway for men should be that they are not alone.
"There's a whole community of fathers that are dealing with a similar experience," he said.
If you are experiencing suicidal, substance use or other mental health crises please call or text 988. Trained crisis counselors are available for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org or dial the current toll free number 800-273-8255 [TALK].
