16 April 2022

New Dads Get Postpartum Depression Too

Written by Chloe Garnham

Content warning

Please note this article references potential trauma triggers, including suicide, depression, substance abuse, and domestic violence. If you are in distress and need immediate help, trained counselors are available to take your call. Please find a crisis hotline in your country here. Welcoming a new child is a big milestone, and for many, it is one of life’s happiest times. However, becoming a new parent or growing your family is also a major adjustment period. For many parents, it can be a stressful, anxious time, and it may be exceptionally challenging to look after your newborn’s needs as well as your own wellbeing. While postpartum depression is a well-documented phenomenon in women — most mothers will experience some depressive symptoms after birth — there is generally less public awareness of postpartum depression in men. 

One 2019 study examining a lack of recognition of postpartum depression in men found that participants were almost twice as likely to correctly identify signs of postpartum depression in women than in men. Often, the participants thought that the man in the case study was suffering from stress or tiredness. Even when the male and female had identical symptoms, participants would attribute them to “stress” 21% of the time in the man, and 0.5% of the time for the woman.¹

Paternal postpartum depression (PPPD) does in fact affect many fathers. Fortunately, there are ways to get help.

1 in 10 men experience paternal postpartum depression (PPPD)

According to PostpartumDepression.org, 10–20% of women in the US will experience clinical postpartum depression (PPD), a serious form of depression that requires medical attention.² Maternal PPD typically occurs within a few weeks of giving birth, but research indicates it can happen anytime in the first year.³

An estimated 70% of women experience “postpartum blues,” a temporary condition that might show up as bursts of crying, mood swings, and sadness. “Baby blues,” as the condition is sometimes called, usually get better in a matter of weeks without treatment.⁴

Men experience postpartum depression in relatively high numbers as well. A 2010 meta-analysis that reviewed 43 studies found that 10% of men are affected by depression following the birth of a newborn.⁵ The same analysis showed that, in fathers, postpartum depression can develop during pregnancy, or during the first year after birth, but the risk is highest in the first three to six months.⁵ ⁶

Risk factors for PPPD

Some of the factors that elevate the risk of postpartum depression in dads include 

Partner depression

A review of 20 studies found that the male partner may be twice as likely to develop paternal postpartum depression if his female partner is depressed.⁷

This finding highlights the need for the whole family to seek support, even if only one partner exhibits symptoms of depression.

Emotional triggers

Introducing a child into the household can cause stress, sleep deprivation, and add tension to the relationship. Rather than keeping the emotions that this new dynamic may bring up, talking about these changes with a trusted friend, family member, or counselor can provide crucial emotional support.

Lack of sleep

Not surprisingly, one study found that mothers’ and fathers’ sleep satisfaction declined immediately after birth and hit its lowest three months after a newborn’s arrival.⁸ Clinical research shows that treating sleep deprivation also helps treat symptoms of depression and anxiety.⁹

Hormonal shifts

Similar to how a new mother's hormone levels will fluctuate after giving birth, hormonal shifts may also contribute to developing paternal postpartum depression. One study found an average 26-34% decrease in new fathers’ testosterone levels after their baby is born.¹⁰ A different study also noted a similar decrease in testosterone and an increase in depressive symptoms.¹¹ However, psychiatrists, Kim and Swain describe¹² that the decrease in testosterone also increases new fathers’ responses to their crying infant, and decreases aggression, strengthening the family unit.

History of depression and anxiety

A history of depression or other forms of mental illness can heighten a father’s risk of developing paternal postpartum depression.¹³

Lack of social support

The partner, friends, family, or employer may all contribute to a new father’s support network. However, a lack of public awareness about PPPD may mean that those who could offer their support don’t or are less sympathetic because they are uninformed.

Symptoms of PPPD

Some of the red flags for postpartum depression in fathers overlap with symptoms experienced by new mothers. However, there are some distinct differences. 

Common symptoms noted in males include:¹² ¹⁴

  • Increased feelings of anger 

  • Extreme worry about unintentionally harming the infant

  • Feeling scared, nervous, or restless

  • Increased use of alcohol and drugs 

  • Feeling frustrated, irritable, or impulsive

  • Feeling easily stressed or discouraged

  • Getting into conflicts with others 

  • Violent behavior 

  • Significant weight gain or loss

  • Overworking 

  • Feeling sad for no apparent reason 

  • Lack of pleasure with most (or all) activities such as work, hobbies, relationships, and sex 

  • Indigestion, diarrhea, constipation, fluctuations in appetite

  • Headaches and insomnia

  • Disengaged parenting or mistreatment of infant

  • Increased hostility

  • Violence towards partner

  • Self-harm

  • Thoughts of suicide or death 

Eliminating stigma and barriers to help

Improving screening

In the US, it’s common for mothers to be screened for postpartum depression, but evaluation for postpartum depression in fathers is much less routine. Unfortunately, this disparity can result in men being underdiagnosed and not receiving the necessary treatment.¹⁵ The National Perinatal Association encourages screening fathers for depression at least twice during the first postpartum year. Even so, a preferred screening tool has yet to be agreed upon.¹⁶

Challenging gender stereotypes

Another barrier to help with postpartum depression can be fixed beliefs about gender roles. For example, a man might feel the need to be a strong protector who doesn’t need assistance from others. 

Though views about masculinity are evolving, psychotherapist and men’s health expert Dr. Will Courtenay describes that men are often still unwilling to ask for help. In a comment for a psychiatric article¹⁷, he elaborated, “So when men start to feel anxious, empty, or out of control, they don’t understand it—and they certainly don’t ask for help. Men need to recognize that depression is a medical condition; it's not a weakness of character. For a man to admit he's depressed isn't unmanly or admitting defeat. It's taking charge of his life.” 

Four wellness tips for new dads

The first line of treatment if you suspect that you or someone you care about have paternal postpartum depression is to speak with a qualified healthcare professional, such as a family doctor, psychologist, or registered counselor. If it’s challenging to find a specialist in your area, telehealth options may also be available.

Additional ways to support your wellness after becoming a new parent: 

Talk with someone

In addition to speaking with your doctor or a counselor, reaching out to your partner, trusted friends or a family member can all be helpful ways to alleviate feeling alone or isolated.  While many men feel uncomfortable sharing their feelings, keeping things suppressed can lead to increases in frustration and anxiety. Often, new fathers find they are not alone in what they’re going through, and many others have the same challenges after a newborn’s arrival.

Explore meditation and breathwork

Feelings of stress or anxiety can make you tense up and take shallow breaths, which can activate fight-or-flight mode.  Diaphragmatic breathing (sometimes known as abdominal or belly breathing) is a technique proven to calm the nervous system.¹⁸ Relaxing the diaphragm (which happens when you breathe into your belly as opposed to your chest) signals to the body that you aren’t in any current danger.  A systematic research review concluded that meditation can reduce depression levels or depressive symptoms, but also noted that further research is recommended to better understand the underlying mechanisms of its therapeutic effects.¹⁹

Get active

Getting more active is a powerful way to support your mental health. Research confirms that even a single session of exercise can improve mood and reduce symptoms of depression.²⁰ Physical activity stimulates endorphins (mood-boosting chemicals) and increases blood circulation to the brain, which can improve your reaction to stress.²⁰

Discuss therapeutic options with your doctor

Taking antidepressant medication can have side effects, so it’s important to have a detailed conversation with your doctor about the risks and benefits. Clinical research shows that both psychotherapy and antidepressant therapy are effective postpartum treatments.²¹

The risk of domestic violence

Treating postpartum depression in men is critical. When left untreated, depression affects not only the father’s well-being but also how he interacts with his children and partner. One study on the prevalence of physical and sexual violence postpartum found that 69% of the participants who experienced threats or abuse had not been subject to abuse previously—suggesting that postpartum depression acted as a trigger.²² Research also indicates that depressed fathers are less likely to positively engage with their children and are more likely to spank them.²³ One study showed that children of fathers with a mental illness (including depression), had a 33—70% increased risk of developing behavioral and emotional problems.²⁴

Research also indicates that a cyclical effect can happen, in which parenting becomes harsher due to the child’s behavioral issues, thus increasing the behavioral problems.²⁵

These risks highlight the critical need for both medical professionals, and families to be aware of the possibility of postpartum depression in men and to seek medical attention if symptoms occur. 

The lowdown

PPPD is a significant problem that deserves more public awareness, education, and resources. Left untreated, postpartum depression impacts not just the sufferer, but the whole family unit. Getting appropriate help is critical. Connecting with your doctor, psychologist, or counselor is the first step if you or someone you care about are experiencing postpartum depression symptoms. 

Two of the biggest predictors of paternal postpartum depression are when the father has a previous history of depression, or when the maternal partner also experiences postpartum depression. If you have limiting beliefs about reaching out for help, it can be helpful to reframe getting the right support as a way to take charge of your life.

The information provided in this article is designed to support, not replace, the relationship that exists between a patient/site visitor and their existing health care professional(s).

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Sources:
  1. People fail to recognize male postnatal depression (2019)

  2. Statistics on postpartum depression | Postpartum Depression

  3. Postpartum depression | The American College of Obstetricians and Gynecologists

  4. What is peripartum depression (formerly postpartum)? | American Psychiatric Association

  5. Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis (2010)

  6. Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys. - Abstract - Europe PMC (2019)

  7. Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health (2004)

  8. Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and father (2019)

  9. Treating depression and anxiety with digital cognitive behavioural therapy for insomnia: A real world NHS evaluation using standardized outcome measures (2016)

  10. Longitudinal evidence that fatherhood decreases testosterone in human males (2011)

  11. High paternal testosterone may protect against postpartum depressive symptoms in fathers, but confer risk to mothers and children (2017)

  12. Sad dads (2007)

  13. 1 in 10 dads experience postpartum depression, anxiety: How to spot the signs | Your Pregnancy Matters | UT Southwestern Medical Center

  14. A mini-review on paternal postpartum depression (2020)

  15. Postpartum depression in men (2019)

  16. Sensitivity and reliability of screening measures for paternal postpartum depression: an integrative review (2021)

  17. Why dads also need support for postpartum depression | Meridian Psychiatric Partners

  18. This is why deep breathing makes you feel so chill | Right as Rain by UW Medicine

  19. Effects of mindful and non-mindful exercises on people with depression: A systematic review (2008)

  20. [Effects of exercise on anxiety, depression and mood] (2004)

  21. Postpartum depression in men (2019)

  22. Postpartum, also a risk period for domestic violence (2000)

  23. Fathers' depression related to positive and negative parenting behaviors with 1-year-old children (2011)

  24. Paternal depressive symptoms and child behavioral or emotional problems in the United States (2011)

  25. The effects of parental depressive symptoms, appraisals, and physical punishment on later child externalizing behavior. - Abstract (2012)

General Sources:

Chloe Garnham is a writer exploring a broad range of topics, including healthcare, education, and technology

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