Yes, There Is Such a Thing as Postpartum Depression in Men
Sleepless nights, feelings of isolation and the overall radical life change after the birth of a child can be difficult for all new parents. It's true whether the baby is a couple's first or their fourth. This difficulty is compounded when the mom or dad also experiences postpartum depression (PPD).
Though it's typically discussed as it pertains to mothers, PPD can impact fathers as well.
Postpartum depression affects about 6.5 percent to 20 percent of women and is most common in the first six weeks after birth. For men, however, PPD can hit months later.
"PPD in men can happen in about 8 percent to 10 percent of fathers and has the highest prevalence within three to six months after childbirth," said Julian Lagoy, M.D., a psychiatrist with Mindpath Health in San Jose, California.
Delayed PPD can occur when parents have to go back to work or readjust to "normal" life. The help mothers and fathers receive from friends and family just after a baby is born can sometimes ward off mental health conditions, which is why it's crucial to establish a strong social support system that can be utilized past the first few weeks of the postpartum period.
Postpartum depression symptoms
Common symptoms of postpartum depression in men and women vary by individual case. PPD symptoms in women include:
- Feelings of sadness, apathy or detachment
- Lack of energy
- Trouble sleeping through the night
- Loss of appetite or overeating
- Issues bonding with the baby
- Feelings of guilt
- Problems concentrating
Male postpartum depression can present in other ways.
"Postpartum depression symptoms in fathers can look different than in mothers, which contributes to it being underdiagnosed and treated. A sad mood is less often seen," explained Rachel Diamond, Ph.D., L.M.F.T., the clinical training director for couple and family therapy at Adler University in Chicago.
According to Diamond, paternal postpartum depression (PPPD) may present as:
- Hostility and anger
- Isolation and withdrawal
- Risky behaviors such as increased substance use
The impact of PPD on men can be wide-reaching in the family unit. Paternal PPD is associated with an increased risk of a poor marital relationship and, in some cases, violent behavior toward the female partner, according to a 2021 article published in the Journal of Psychosomatic Research.
Parental depression in general can also cause social, emotional and developmental delays in children.
Why PPD happens
"Maternal depression is the most influential risk factor for the onset of paternal depression," Diamond said. "This is different than maternal postpartum depression, in which her own mental health history is her strongest risk factor."
Postpartum depression is often attributed to postpartum hormonal changes in women. While less is known about PPD in men, there is some evidence that new fathers also experience a connection between hormones and the condition.
Fathers with lower aggregate testosterone levels reported more depressive symptoms at two months and nine months after childbirth, according to a 2017 study published in the journal Hormones and Behavior. Fathers with higher aggregate testosterone levels showed more fathering stress and more intimate partner aggression at 15 months after childbirth. However, more research is needed on the connection between testosterone and PPD.
The good news, though, is PPD prevention is possible in some cases.
"There are numerous prevention methods for PPD in men," Lagoy said. "A few tips are to educate yourself about it, sleep and eat well, regularly engage in exercise, set yourself up with family and friend support during childbirth, and have a strong support network, if at all possible, during the postpartum period with the new baby."
Help for postpartum depression
Sometimes you can try everything to prevent or avoid postpartum depression and it still happens. It might be more difficult for men to seek help.
"New fathers may hesitate to reach out for help for many reasons, including minimizing their experience in comparison to the birth parent postpartum, gendered or internalized expectations to be strong, or simply a lack of knowledge," said Peggy Loo, Ph.D., a licensed therapist and the director at Manhattan Therapy Collective in New York City.
Beyond the stigma, the sheer exhaustion of parenthood can make understanding yourself and recognizing issues more difficult than usual.
"Significant life adjustment and sleep deprivation in the early months of postpartum can make it difficult to self-reflect on how you're really doing," Loo explained.
In general, men have more difficulty than women reaching out for help when they're depressed, Diamond added.
"One study found that only 3.2 percent of new fathers sought out mental health services," she said. "This can likely be attributed to societal messages men receive about what it means to be both a man and a father."
Another reason new dads might have trouble reaching out? Men have fewer interactions with the healthcare system during pregnancy and the postpartum period.
"A woman might have 10 to 15 prenatal appointments during a typical pregnancy, as well as one to two postpartum appointments," Diamond explained. "Mothers are also more likely to take the baby to their wellness checks with the pediatrician during their first year of life, which is another seven appointments.
"During all these visits, a provider might screen the mother for mental health concerns. There are no screening guidelines, however, in place for paternal mental health disorders," Diamond said.
Treating postpartum depression in men
Treating PPPD starts with seeking help, which is not always as easy as it sounds. Societal stigmas may tell you it's "unmanly" or unnecessary to address mental health struggles, but the best thing you can do is take care of yourself. You support your partner and your new baby best when you're in a healthy headspace.
There are ways to treat postpartum depression in men, and it starts with screening. While there are no specific mandates or guidelines for fathers, screening for PPPD can be done through measures such as the Edinburgh Postnatal Depression Scale (EPDS) or the Patient Health Questionnaire (PHQ-9 or 2), Diamond said.
"Both have been validated for postpartum depression in fathers," she said.
Not all doctors offer paternal PPD screenings, so if you're experiencing symptoms, you may have to ask.
"This is an important topic that has not been discussed very much in mental health," Lagoy said. "I think we all need to be aware that postpartum depression can happen in men and screen men more regularly in order to care best for our patients."
"Universal screening should be done not just on mothers, but both parents attending medical visits during pregnancy and pediatrician appointments during the postpartum period," Diamond added.
'Postpartum depression symptoms in fathers can look different than in mothers, which contributes to it being underdiagnosed and treated. A sad mood is less often seen.'
Treatment for paternal PPD is largely similar to treatment for maternal PPD. Depending on the severity of your situation, your doctor or therapist may recommend counseling, antidepressants or lifestyle changes.
Those directives may change, however, if more research is done on paternal PPD.
"Because PPD is understudied, there is a need for more research to support the effectiveness of various medication and non-medication approaches for fathers," Diamond said.
The symptoms of postpartum depression can adversely impact more than just you. If you think you may be experiencing PPD, it's crucial to make an appointment with a licensed therapist or other mental health professional.
If you don't have a therapist you see regularly, taking that first step can be difficult. Video visits have become a viable option for most people, and more physicians and therapists have added them as a service. Giddy telehealth makes it easy to get connected to a qualified healthcare professional who can help with a variety of conditions, including postpartum depression.