Postpartum Depression in Dads

Postpartum

Jun 27

Fathers are fifty percent of a couple, supplying half of the genetic material to create a baby, but when we talk about the postpartum period, they receive less than 10% of the attention. This means that as much as postpartum depression is missed or underdiagnosed in women, it is that much more so in men.

What does postpartum depression in fathers look like?

Depression in men presents differently than in women. It is often characterized by more irritability and anger, rather than tearfulness and sad mood. Fathers may also become more withdrawn, isolated, and less involved with their partners and children.

How common is postpartum depression in fathers?

Postpartum depression in men occurs at about a rate of 3-10%, depending on the strictness of the definition of clinical depression. This is about 3x less common compared to postpartum depression in women, a difference that is similar to the general lifetime prevalence rates of depression in men and women overall.

Data suggests that the rate of depression in men, from prenatally through postpartum, is 2-3 times as high as the rates of depression in men outside this time. That confirms the need to be mindful of depression in men during this vulnerable time.

The most common time for onset of postpartum in men is thought to be about 3-6 months postpartum.

How do I know if I (as a father reader) or my partner (as a mother reader) has postpartum depression?

The Edinburgh Post-Natal Depression Scale is a routine questionnaire of 10 items that many women are familiar with – often administered by OB offices and pediatrician offices. It has now also been validated in men. You can find it here.

Which fathers are at risk for postpartum depression?

Risk factors for fathers include:

Depression in a partner, either prenatally or postpartum
Poor social support
Conflict in the relationship
High work/economic pressures
Prior experience with mental health problems, including depression or substance use
Significant anxiety during pregnancy
Lack of experience and education about the postpartum period and infant care can also raise stress levels and increase the risk of depression.

How can I decrease these risks?

As depression in mother can predict postpartum depression in father, it is essential to be aware of the signs and symptoms of prenatal and postpartum depression in women and treat accordingly.
A strong relationship prior to the addition of an infant will decrease the risk. This could mean couples counseling either before or during pregnancy.
Ensuring social supports are in place. Prior to delivery, reaching out for help and ensuring there will be friends or family available to provide both practical support as well as emotional support. Just like for new mothers, there are also some support groups for new fathers. It may also mean that the new father reaches out to others in his social circle who have gone through fatherhood for advice and coping strategies. This last action may be the hardest to take as men asking for help and advice is often not culturally as accepted as it is for women.
Education about the postpartum period and knowing what to expect. This could mean taking a parenting class offered at your local hospital or health center, or more informally learning from others who have gone through the process.

What are the consequences of postpartum depression in men?

There are consequences for the father, his relationship, and also significant consequences for his child.

It makes sense that postpartum depression in fathers would affect their children. A depressed man has difficulty with the day-to-day interactions necessary for parenting a child, and this has long-term consequences. He is less interactive, less engaged, less attentive to his child.

One investigation looked at scores of depression and compared it to child functioning up to age 7. This study found, even after controlling for maternal depression, that paternal depression was associated with a 66% increase in the odds of psychiatric diagnosis in the child, particularly conditions of poor conduct and behavior. The strength of this study was that it controlled for later depression in fathers, thereby isolating that postpartum period as the source of this heightened risk for children.

Postpartum depression in a father affects the relationship as well, leading to less harmony and more conflict. In married couples, this increases the risk of divorce.

How do I treat postpartum depression as a father?

There are a number of treatment options, both pharmacologic and not. If you suspect you are struggling with postpartum depression (perhaps you have taken the screening test above and scored high), please contact your physician. Many primary care physicians are quite adept at treating mental health concerns such as depression and would be able to recommend a psychotherapist or a medication. Alternatively, your child’s pediatrician can also make this referral. While awaiting an appointment, I would also recommend you explore some of the treatment options described in this website and the resources provided.

Selected References:
Ramchandani, P.G. et. al. Depression in men in the postnatal period and later child psychopathology: A population cohort study. (2008) Journal of the American Academy of Child & Adolescent Psychiatry, 47(4): 390-398.
Paulson, J.F., Bazemore, S.D. Prenatal and postpartum depression in father and its association with maternal depression: A meta-analysis. (2010) JAMA 303(19): 1961-69.
Wee, K.Y. et. al. Correlates of ante- and postnatal depression in fathers: A systematic review. (2011) Journal of Affective Disorders 130: 358-377.

Anna Glezer, M.D.

Dr. Glezer began her training at Harvard and then transitioned to the University of California, San Francisco, where she has been a practicing physician, teacher, mentor, and is an associate professor. She is board certified in adult and forensic psychiatry, a member of the American Psychiatric Association, and the immediate past President of the Northern California Psychiatric Society.

She has worked with hundreds of women going through the emotional challenges of conception, pregnancy, loss, and postpartum. She has been interviewed for, and her written work has appeared on multiple leading sites, including Huffington Post, Fit Pregnancy, Health Line, Help Guide, and more. She has presented at local and national conferences and published in academic journals. Several years ago, she established the annual Bay Area Maternal Mental Health Conference and launched the educational website Mind Body Pregnancy, aimed to inform women, their partners, and their providers about mental health and emotional issues common in the reproductive years.

She began her private practice to help women throughout the Bay Area access reproductive mental health services and is really passionate about helping as many women as possible.