DADS GET POSTPARTUM DEPRESSION TOO!

Jake greeted the news that he would soon be a first-time father with tremendous pride and excitement. As the months passed, however, Jake began to feel anxious and unsettled about his upcoming role as father and primary provider. He wondered if he was up to the challenge.

His fears did not dissipate after the birth of the baby. Instead, they worsened. One night when the baby began to cry, and his wife failed to get up immediately to soothe him, Jake yelled out, “Shut the F… up!” Horrified by his actions, his wife turned on him. “What is wrong with you?!” she asked.

Jake eventually discovered what was wrong, but not before his job and his marriage suffered the effects of his changed behavior. Jake had developed what one in ten new fathers (13 percent according to some estimates) suffer from. Until recently, it was believed that only women suffered from Postpartum Depression (PPD.) While there is still no diagnostic category for PPD in the DSM, it is subsumed under the general category of Major Depressive Disorder.

SYMPTOMS OF MALE POSTPARTUM DEPRESSION

Symptoms of male PPD share many similarities to those in women. A partial list, includes:

• Irritability, anger, or aggressive behavior.
• Easily stressed.
• Withdrawal from family and relationships.
• Poor concentration and difficulty focusing.
• Changes in appetite or sleep patterns (insomnia or oversleeping).
• Feeling overwhelmed, anxious, or hopeless.
• Suicidal thoughts.
• Risk-taking behaviors including substance and alcohol use.
• Physical symptoms including headaches and stomach aches.
• Indecisiveness.
• Restricted range of emotion

CAUSES OF MALE PPD

Several factors put men at risk for PPD, including sleep deprivation, a prior personal or family history of depression, or a feeling of being shut out from mother and child. Up to half of all men with a depressed partner also show signs of depression according to one study, but surprisingly, fathers also experience hormonal shifts that alter mood, especially a decline in testosterone.

A 2024 article on Understanding Paternal Postpartum Depression notes that while more women than men suffer PPD (one in 7 versus one in 10), men also experience hormonal changes.

Jonathan R. Scarff, in his article Innovations in Clinical Neuroscience; Postpartum Depression in Men, explains that low testosterone in general is linked to symptoms of depression in men, while low levels of estrogen, prolactin, vasopressin, and/or cortisol in new fathers negatively affect father-infant bonding/attachment.

PUSHED OUT BUT RESPONSIBLE

Jenna Berendzen, ARNP at UnityPoint Health, suffered severe postpartum depression and anxiety after the birth of her son. While Berendzen was admitted to the county perinatal psych unit, her husband was left to worry about her and to figure out how to single handedly care for their new baby. Two years later they discovered that he, too, had suffered PPD, yet he couldn’t say anything at the time because, in his mind, he hadn’t given birth, especially a C-section. Instead he felt pushed aside while trying to carry the load of the entire family,”

An Allied Health article notes, “Many dads want to be active participants in the care of their new baby, but sometimes end up feeling like they’re on the outside. As the bond between mother and child begins to strengthen, fathers may feel sidelined. “Many men have a breadwinner mentality that compels them to bottle up the pressure and downplay symptoms of PPD both as they are preparing for fatherhood and afterward.”

In an article I wrote for L.A. Baby when my own son was a baby, I noted how women tended to believe they knew what was best for their baby, and as a result, often pushed their husbands out of the nursery, which only added to the father’s feelings of ineptitude, rejection and even abandonment. The result was that dads didn’t really bond with their babies until the child was older.

BECOMING A FATHER

Despite the dearth of research on new fathers, some experts claim that the journey to fatherhood represents a unique and transformative time in a man’s life. According to one study, “A man does not become a father only at the moment when the child is born…it is a long-lasting dynamic process where the father’s identity is formed and sustained through various experiences.”

Once the baby is born, everything suddenly becomes real. Even the diminutive size and fragility of a newborn can feel overwhelming. Dads need support, reassurance and education about how to hold and care for an infant. This is where some men back off, preferring to abdicate the “tender tasks” to mom, rather than learn from her.

In my own book Midlife Parenting, A Guide to Having and Raising Kids in Your 30s, 40s and Beyond, I found that men who start parenting later in life are more mature and settled. However, many of them are also accustomed to more freedom and independence, which presents its own challenges.

CHANGING ROLES AND EXPECTATIONS FOR FATHERS

Researchers point out that the psychological process of becoming a father has changed in the last couple decades. As one study notes: “We can observe a shift in the perception of the father’s role in Western societies, and in younger generations there is a growing incidence of the so-called “new fatherhood” associated with emotional intimacy and availability of the father as well as increased involvement of the father in childcare and household care.” The authors point out that today men are not only welcomed, but are expected to attend parenting preparation courses and to be present during childbirth as well as postnatal care.

SO WHAT’S A DAD TO DO?

The good news is that there is treatment for male PPD. It begins the moment the couple learns they are having a baby. That’s when the conversations should start, says one researcher who offers the following advice:

• Invite Active Participation: Active participation in the pregnancy, supporting one’s partner, and learning what to expect during and after delivery will help fathers feel involved and prepared.
• Talk to a Financial Planner: Money is a top challenge. With proactive conversation and some professional guidance, new fathers will know what to expect and how to best navigate the expenses of having a child.
• Lean into Support: As the baby’s arrival date approaches, soon-to-be fathers should lean into their support system. Reinforcing relationships and being open to advice will help fight the fear of the unknown.
• Seek out Help: As men are preparing for fatherhood, it’s normal to occasionally feel overwhelmed. It’s important to seek out help sooner rather than later and work to solidify a healthy mindset before the baby arrives.

If symptoms do emerge, dads should seek out professional help. Jonathan Scarf suggests that in serious cases, psychotherapy, especially cognitive behavior therapy (CBT) and interpersonal therapy (IPT) have been shown to be effective, as well as daily morning light to correct circadian rhythms, which are related to PPD.

For some men, individual or couples therapy may be preferred over anti-depressants. Other times a combination may be most effective. Treatment can be short-term or long-term, based on whether there are deeper or more serious underlying issues, which are exacerbated by the birth of a child.

Other recommendations include meditation, yoga and other “mindfulness” approaches to stress. And finally, it would be helpful if employers or government programs supported paid paternity leave for men, recognizing the value of fathers in the earliest stages of parenthood.

Christi Taylor-Jones is a Licensed Marriage and Family Therapist, Jungian Analyst and writer. She is author of Midlife Parenting and Touched by Suicide. She is also a mother and soon-to-be grandmother.