Subjects surrounding mental health and well-being are being more widely discussed today than ever before. This includes postpartum depression – but not just for women.
Studies show that 1 in 10 dads struggle with postpartum depression and anxiety as well. Their symptoms are slowly becoming more recognized, diagnosed, and treated. A mom recently shared the story of her husband’s postpartum depression in The New York Times, and health care providers are encouraging pediatricians to incorporate postpartum depression screenings of fathers as well as mothers during well-child visits.
Parents’ mental health greatly affects the well-being of a child. Research has shown that depression in fathers is associated with:
- Less attention to baby’s health and well-check visits
- Higher risk of behavioral problems in preschool-age children
- Children with more physical and mental health problems
- Poor family and marital relationships
The stakes are high – fortunately, treatment and support are available when we recognize prenatal and postpartum depression and anxiety in any parent.
Paternal depression can set in before or after birth
As with women, men can experience depression at any time – including before a baby is born.
Women often show symptoms of postpartum depression within four to six weeks after delivery, but signs can appear as late as three months after birth.
A 2019 meta-analysis of studies found that the highest risk of depression during pregnancy for expecting fathers occurred during the first trimester. The study also showed that postpartum depression was highest among men when the baby was 3- to 6-months-old.
A variety of factors can play a role in dad developing prenatal or postpartum depression, including:
- Hormones: Research has shown that fathers experience hormonal changes during and after their partner’s pregnancy, particularly declines in testosterone.
- Partner’s depression: Up to half of men with depressed partners show signs of depression as well.
- Feeling disconnected from mom and baby: Dads want to be part of the newborn experience, but often they feel as if they’re on the “outside.” Moms may not always realize they’re excluding dad from caring for the baby. Or they may be so caught up in bonding with the baby, they fail to recognize dad wants time with the little one, too.
- Personal or family history of depression: Any history of depression or other mental illness raises the risk of prenatal or postpartum depression.
- Psychological adjustment to parenthood: Becoming a parent requires significant coping skills. This can be overwhelming for moms and dads.
- Sleep deprivation: Most new parents underestimate the role a lack of sleep can play in developing symptoms of anxiety and depression. They also often underestimate just how sleep deprived they are!
Other factors that may contribute to paternal postpartum depression include having a colicky or premature baby, financial stress, relationship problems, recent loss or trauma, and lack of social support for parenting, such as not having parental leave at work.
Watch for signs of paternal depression and anxiety
Prenatal and postpartum depression can look different in men than it does in women. Men may experience some “traditional” symptoms – fatigue and changes in sleep or appetite – but they often exhibit fewer outwardly emotional expressions, such as crying.
Common symptoms for paternal prenatal or postpartum depression include:
- Anger, sudden outbursts, or violent behavior
- Increase in impulsive or risk-taking behavior, including turning to substances such as alcohol or prescription drugs
- Low motivation
- Physical symptoms such as headaches, muscle aches, stomach, or digestion issues
- Poor concentration
- Suicidal thoughts
- Withdrawing from relationships
- Working a lot more or a lot less
Anxiety is also common in men during and after pregnancy. A 2021 study showed that 1 in 10 men experience prenatal and postpartum anxiety. In the general population, approximately 14.3 percent of men have anxiety – approximately 9 percent less than women.
Anxiety can cause:
- Persistent, excessive worry about life in general
- Nervousness or a sense of impending doom
- Trouble concentrating
- Panic attacks
- Symptoms of obsessive-compulsive disorder
Related reading: Pregnancy, anxiety, and the pandemic: 4 ways to manage symptoms
If you or a loved one experience prenatal or postpartum anxiety or depression symptoms that intensify or last longer than two weeks, talk with your doctor about possible treatment options.
Future screening for paternal postpartum depression
Most Ob/Gyns check new moms for depression and anxiety symptoms during a postpartum visit. But there is no such check-up for men.
In 2019, the American Academy of Pediatrics recommended that postpartum depression screenings not be solely the responsibility of obstetricians. They urged pediatricians to incorporate maternal postpartum depression screenings and referrals for treatment during well-child visits.
In 2020, an editorial in the Journal of the American Academy of Pediatrics called on pediatricians to assess the mental health of all new parents, regardless of gender, and to make appropriate referrals when necessary.
Don’t be surprised if your partner’s Ob/Gyn or baby’s pediatrician asks about your mental health during a visit. This evaluation could range from engaging in an informal discussion to filling out the Edinburgh Postnatal Depression Scale (EPDS), a simple screening tool consisting of 10 questions. Prioritizing the mental well-being of moms and dads is not only good for them, but for the baby.
How is paternal prenatal and postpartum depression treated?
Sometimes, self-help isn’t enough. Professional treatment may be necessary. Using one or a combination of therapies may help fathers cope during pregnancy and the stressful postpartum period:
- Psychotherapy, or talk therapy
- Couples therapy, especially if both parents are depressed or the relationship is suffering
- Medication that works on the mind, behavior, or mood
- Complementary or alternative therapies, such as exercise, massage, or acupuncture
How can family members support depressed dads?
The first step is to recognize what’s going on and take it seriously. If you notice a personality shift in a dad who is expecting or has a new baby, encourage him to talk with a mental health professional.
After your baby comes, tips to support dad include:
- Encouraging him to be involved with the baby, bathing, dressing, or feeding him or her whenever possible.
- Taking childcare shifts so you both get adequate sleep. Family members of single parents can step in to make sure mom or dad gets as much rest as possible.
- Spending time together. Understand that it’s common for your sex life to change after having a baby.
Finally, make sure dad knows prenatal and postpartum depression are common and treatable. And dads, please remember that asking for help when you are struggling is the best thing you can do for yourself and your family.