New dads can experience depression during their partner’s pregnancy or after the birth of their child, just as mothers can. It’s called paternal postpartum depression (PPD)—and we don’t talk about it nearly enough.
Estimates vary, but studies suggest that about 10 percent of fathers develop paternal PPD, and under-reporting means this number is probably even higher. When a man’s partner also has PPD, paternal rates may climb as high as 50 percent.
Despite its prevalence, silence surrounding paternal PPD can cause dads to wonder if their condition is real or legitimate and to grapple with their symptoms in isolation. Male gender norms like stoicism and self-reliance—along with a sense of duty to provide for their growing family—can also contribute to men feeling alone and overwhelmed.
But talking about the very real stress of fatherhood may be exactly what your family needs. Left untreated, paternal PPD can interfere with children’s mental and emotional development, worsen maternal depression, and lead dads to hurt themselves, their kids, or their partner.
Mark Boles, MD, an OBGYN affiliated with Fairview Park Hospital in Dublin, Georgia, explains some of the key differences between paternal and maternal PPD and offers practical advice on how to cope with the challenges of being a dad.
What does PPD look like in men?
All new parents—biological moms and dads, stepparents, adoptive parents, and others—may experience traditional symptoms of PPD. These include:
- Feeling sad, hopeless, or empty
- Losing interest in things they normally enjoy
- Withdrawing from or avoiding friends and family
- Having trouble bonding or forming an emotional attachment with their baby
- Resenting their baby and feeling guilty over this resentment
- Fearing their behavior around their baby
- Having a desire to hurt themselves or others
- Experiencing physical aches and pains
- Feeling anxious or irritable
- Having appetite changes
Moms who have given birth undergo dramatic physical and hormonal changes that make them especially susceptible to PPD. Women also are more likely to show sadness, talk openly about their symptoms, and seek help, says Dr. Boles. On the other hand, a lot of men try to be “the strong one” and suppress their feelings.
“For them,” Boles explains, “depression tends to come out in other ways, very few of which are constructive.” Men with PPD may be more prone to:
- Emotional withdrawal or physical absence
- High risk activities like reckless driving
- Drug or alcohol abuse
- Agitation or aggression
- Violence, including intimate partner violence
- Self-harm or suicide
Many men with PPD demonstrate irritability and a lack of desire to be home or to help with childcare, and it’s common for them to view the baby as the source of their issues, according to Boles. “That’s when a lot of women will say, ‘He doesn’t come home until late; I’m taking care of the baby all the time.’”
“It could be that this dad is experiencing PPD,” Boles adds, “but no one has made that connection.”
Sleep deserves a special mention: A new baby can interrupt your sleep like it’s their job. Poor rest, in turn, can trigger or worsen PPD symptoms, including anger at your baby’s cries. At the same time, depression can aggravate sleep problems like insomnia. This cycle is often a major source of stress for new parents.
What causes paternal PPD?
Many factors contribute to PPD in men, says Boles, and many factors make it difficult for them to get help. “Levels of testosterone and other hormones can change in men following their child’s birth,” he explains. “Sleep deprivation, changes to their relationship, and lack of intimacy may play a role as well.”
In one 2019 study published in the Journal of Family Issues, researchers analyzed online comments from dads with PPD to learn more about its causes and risk factors. A common theme among these posts was a sense of having been forgotten—including by healthcare providers—and a need for better education. Many dads voiced frustration over a lack of dad-directed parenting materials and the fact that paternal PPD is rarely brought up in discussions about postpartum depression.
“Dads often don’t have a provider that they’ve bonded with over the course of pregnancy the way moms tend to have,” says Boles. “So when these symptoms appear, they can feel like they’re on an island. They might not know a provider well enough to be able to be vulnerable and say, ‘I’m having a lot of difficulty adjusting to life with a child in the house.’”
Several studies suggest that feeling distanced from their partner affects dads, too. Since some men rarely—if ever—act vulnerable outside of their intimate relationship, this distance can mean losing their emotional lifeline right when they need it most. Couples may grow apart due to the lifestyle, scheduling, and responsibility changes that can arrive with a baby. In many cases, men’s emotional withdrawal fuels this dynamic as well: Dads may question their right to discuss their thoughts or to “burden” their baby’s mom with their experience. These unspoken worries may increase tension even further.
New territory for dads today
It’s increasingly common for people to define family and parenthood for themselves, rather than according to tradition. That means new dads may be occupying very important but possibly unfamiliar roles with few models to guide them. This can leave dads feeling in over their heads.
On top of that, paid paternal leave remains a rare employee benefit. Returning to work too soon after their child’s birth can add to a dad’s:
- Stress from balancing the financial demands of child care
- Physical absence from home due to long working hours
- Exclusion from parenting milestones
- Poor bonding and difficulty developing an attachment with his baby
Excessive absence also may lead to mounting resentment between a father and mother and can exacerbate maternal PPD.
Be real with yourself, your partner—and other dads
It takes courage to have difficult conversations. It’s not always comfortable, but being upfront about what’s on your mind can lead to solutions.
“The first thing I recommend is talking to your partner,” says Boles. This is crucial because it might help to clear up long-running misunderstandings. “For example, she might be thinking she’s no longer attractive to you after these body changes and assume you must be ‘stepping out.’”
Next, talk to someone who can give you the tools to improve your symptoms, such as your general practitioner or a mental health provider. As Boles advises, “Find someone who can help you understand this diagnosis, who can explain that it’s a real condition, and who can address it with medications, if appropriate, and with talk therapy.”
It also helps to reach out to a broader support system. Friends, co-workers, family members, and on-line or in-person support groups can help you consider issues from fresh perspectives. Finally, since stigma surrounding mental health often keeps men from getting treatment, being transparent with other dads you know might prompt them to seek lifesaving help, too.
The best version of you
Life is better for your family when you’re present and involved, and depression can get in the way of that. Dads with depression are nearly four times more likely to spank their one-year-old child and less than half as likely to read to them, according to one study. On the other hand, seeking help may have a ripple effect, easing depression for your baby’s mom and boosting her interest in parenting.
Here are some places to start:
- Access an online forum for new dads, get book recommendations, and more at Postpartummen.com.
- Explore Postpartum Support International (PSI), a platform for families affected by PPD. Call their 24-hour helpline at 800-944-4773 or text to 503-894-9453. Be sure to visit their Resources for Fathers page and dial in to Chats for Dads on the first Monday of every month.
- Follow the #Howareyoudad campaign on social media to connect with other fathers.
- Get tips for maximizing your sleep time.
- Call the National Suicide Prevention Lifeline at 800-273-8255 (TTY 800-799-4889) if you or someone you know is considering suicide.
- Reach the National Domestic Violence Hotline at 800-799-7233 (TTY 800-787-3224).
“Accessing mental health care can somehow be seen as weak or ‘less manly,’” says Boles. “But if there are changes taking place to your brain chemistry, it doesn’t matter how strong you are. Until you do something to address those changes, you’re not going to feel whole and you’re not going to have energy to be there for your kids.”
Sourcing: National Institute of Mental Health, National Institutes of Health