Author: Claudia M. Elsig, MD
The arrival of a baby is a life-changing event for all parents, and adjusting to parenthood, whether for a first or subsequent child, is an exciting and joyous time. But there are many challenges in the early days of parenting that can put additional strains on relationships, and sometimes unexpected feelings can arise.
Depression after childbirth is more common than you might think. When we speak about post-natal depression we tend to focus on the woman. But research shows that approximately 1 in 10 men also struggle with their mental health during the early years of parenting.1
Many cases of post-natal depression in men go unreported, so the figure is likely much higher. Men all too often suffer in silence; some estimates put the prevalence of post-natal depression in men at closer to 1 in 4!3
There is plenty of research on the causes and effects of post-natal depression in women4, but in men it is much less understood. This blog explains the impact of childbirth on the mental health of men.
What is baby blues?
Many mothers experience baby blues for a short time in the weeks after childbirth. There is a considerable decrease in hormones estradiol, progesterone, and prolactin in the time following delivery.4 Low mood and mild depressive symptoms are caused by these sudden hormonal and chemical changes in the body.
Such mild depressive symptoms are commonly known as the ‘baby blues.’ Symptoms typically develop two to three days after childbirth, peak in the following few days, and then subside and resolve by themselves within two weeks of onset.4
Symptoms include sadness, crying, exhaustion, irritability, anxiety, insomnia, inability to concentrate, sensitivity and changeable mood.
What is post-natal depression, and can men suffer from it?
Baby blues is self-limiting, has a direct physical cause and symptoms are quite mild. When mothers experience a more prolonged and severe depressed state it is known as post-natal depression. It generally presents with a persistent depressed mood and is more than feeling a bit low. Fathers and partners can also suffer from this condition (also sometimes known as post-partum depression (PPD) or paternal depression).
Depression after the arrival of a new baby can arise from a combination of factors and symptoms range from mild and relatively short-lived to long and severe. In extreme cases, a person may feel too overwhelmed to look after themselves or their baby and may even experience psychotic episodes. While post-partum psychosis is extremely rare in men, it is possible.5
Post-natal depression can start anytime in the first year after the baby is born, but prevalence is highest when the baby is between 3 and 6 months. Interestingly, and maybe a reason why this condition is under-reported in males, PPD develops more slowly and gradually over the course of a year postpartum among men.2
What are the causes of post-natal depression in men?
There are numerous studies that examine post-partum depression (PPD) in women, but much less is known about the condition in men. Doctor’s questionnaires and post-birth support tends to focus on the well-being of the mother.
Sleep deprivation, new responsibilities, and a lack of ‘me time’ can all have a negative impact on emotional and mental health, both in new moms and dads.
The reasons fathers or partners can feel depressed after the birth of a child are often the same as that of the mother. These include:
- Negative childbirth experience
- Lack of sleep (a disrupted circadian rhythm)
- Overwhelming sense of responsibility
- Difficulty bonding with the baby
- Significant changes to routines and lifestyle
- Relationship stress
- Financial pressures
- Resurfacing of childhood trauma
In addition, there are other reasons, peculiar to men. A man is more likely to experience depressed feelings if their partner is suffering from post-natal depression. Studies show that around 50% of men who have partners diagnosed with postpartum depression go on to develop depression themselves.6
Research also highlights a history of depression, marital discord, and unintended pregnancy as other possible causative factors of post-natal depression in men.7
Surprisingly, it’s not only women who experience hormonal changes after childbirth. Kim and Swain assert that a father can experience hormonal changes during pregnancy and for several months following the birth of the child.2
Research shows that new fathers experience an increase in hormones estrogen, oxytocin, prolactin and glucocorticoids.8
What are the risk factors for post-natal depression in men?
There are numerous risk factors that can make paternal post-natal depression more likely. The lack of a social support network, difficulty adapting to the change in lifestyle, changes in the marital/partner relationship, and feeling excluded from the mother-baby bonding, can all act as triggers for depressive episodes.
Men who enjoy powerful positions in business can experience feelings of inadequacy as a new father.
A traumatic birth experience can also trigger anxiety and mental health problems in men. In some cases, this leads to post-traumatic stress disorder (PTSD). A man can feel hopeless when childbirth doesn’t go according to plan. Even in straightforward cases of childbirth, seeing a partner in pain can make a partner feel helpless, especially when it is something they can’t ‘fix’.
The high comorbidity of postpartum paternal depression with other psychiatric disorders, in particular anxiety and obsessive-compulsive disorder (OCD), has also been recognized.2 One study of 356 fathers, found the chance of developing post-natal depression was increased by 30 to 100 percent when they had existing anxiety problems.9
What are the symptoms of post-natal depression in men?
Many of the symptoms of post-natal depression in men are alike those in other forms of depression. Commonly, these include:
- fear, confusion, and feelings of helplessness and uncertainty about the future
- withdrawing from family life, work, and social situations
- feeling sad, alone and hopeless
- feeling guilty for not feeling happiness
- indecisiveness
- apathy
- frustration, irritability and anger
- marital conflict
- partner violence
- negative parenting behaviors
- alcohol and drug use
- insomnia
- physical symptoms, such as indigestion, changes in appetite and weight, diarrhea, constipation, headaches, and nausea.
The impact of dad’s depression on the child
Just as with mothers, depression in fathers can have a significant impact on the child (or children). A growing body of evidence shows paternal depression as a major risk factor for difficulties in a child’s life. A depressed parent is less responsive to their child and can exhibit inappropriate parenting behaviors, either in the form of neglect or hyper-vigilance.
Parenting can swing between two spectrums – from neglect, and then following guilty feelings, a parent can be over-engaged. There is a lack of sensitivity to a child’s cues.
A study of 22,000 children from two-parent homes found that dad’s depression increases a child’s risk of emotional problems.10
What treatment is available for post-natal depression in Dads?
When it comes to post-natal depression in males, there is a greater difficulty for men to acknowledge a problem exists and this can make it harder for them to access treatment. For a man to admit they have post-natal depression can feel like a failure and is in many circles taboo.
The good news is that post-natal depression is treatable. But it is a unique process for everyone. Psychotherapy is very effective, but every case must have its own treatment protocol.
At CALDA we can treat Dads who are suffering from postnatal depression. Our highly individualized programs are based on a comprehensive and detailed diagnosis. We perform a detailed clinical-chemical analysis to determine status. We treat the causes, not the symptoms.
Personalized treatment plans are delivered by our team of experts, including specialist therapists, world-leading psychiatrists, and expert nutritionists.
We dedicate our entire expertise and time to one client at a time. Clients are self-payers which ensures absolute secrecy is possible. Clients stay in our luxurious highly private residences overlooking Lake Zurich in a serene and elegant home-from-home environment. We provide a premium full service, including a butler, chef, chauffeur and limousine.
We take care of everything so you can heal quickly, get back to your position within the family and enjoy fatherhood. If you have any questions, we are happy to help you anytime. Simply, get in touch.
Sources/References
- National Childbirth Trust. Feb2018. Viewed 14 July 2022. Postnatal depression in dads: 10 things you should know.
- Kim P, Swain JE. Feb 2007. Sad dads: paternal postpartum depression. Psychiatry (Edgmont).;4(2):35-47.
- O’Hara, Michael & Swain, Annette. 2009. Rates and Risk of Postpartum Depression-a Meta-Analysis. International Review of Psychiatry. 8. 37-54.
- Balaram K, Marwaha R. Jan 2022. Postpartum Blues. [Updated 9 Mar 2022]
- Shahani L. 8 May 2012. A father with postpartum psychosis. BMJ Case Rep: bcr1120115176.
- Carberg, J (Medically fact checked by Langdon, K). Postpartum Depression Statistics. Postpartumdepression.org
- Scarff JR. 1 May 2019. Postpartum Depression in Men. Innovations in Clinical Neuroscience; 16(5-6):11-14.
- Gholipour, B. 14 Jun 2014. 5 Ways Fatherhood Changes a Man’s Brain. Website: livescience.com [accessed 16 July 2022]
- Matthey S, Barnett B, Howie P, Kavanagh DJ. Apr 2003. Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disord. 74(2):139-47.
- Weitzman, M. Rosenthal, D.G. Ying-Hua, L. Dec 2011. Paternal Depressive Symptoms and Child Behavioral or Emotional Problems in the United States. Pediatrics 128 (6): 1126–1134.