Dads and Paternal Postpartum Depression

Postpartum Depression Doesn’t Discriminate: Dads Get It Too

In recent years, the recognition, diagnosis and treatment of postpartum depression in mothers has become much more prevalent, helping to create huge strides in maternal mental health. With it has come the interest in dads and deeper investigation into paternal mental health. Do fathers suffer similarly from postpartum depression (PPD)?

The answer has been a clear “yes” and the numbers coming out are surprising. A reported 13.3% of first-time dads showed signs of depression even before the babies are born [4]. After the baby is born, the rate of PPD in men has been seen to range from 8% [3] to as high as 17% [10] according to studies from 1980 to 2015.

Risk Factors of Postpartum Depression in Men

Some of the risk factors associated with paternal PPD include poor sleep, less satisfaction with social support and in their marriages, financial issues, any psychological issues in the family [4], smoking [8], and if the baby has very low birth weight [7]. Factors that predicted both maternal and paternal depression included: low income, symptoms of depression during the pregnancy, and limited social support [8].

One study found a connection between fathers with high testosterone and decreased risk of paternal PPD for the first 9 months of a baby’s life, however it coincided with greater maternal depressive symptoms [9]. By 15 months, the fathers were said to have more fathering stress and depressive symptoms as well, which may be a result of the continual maternal stress over the months before.

It has also been noted that fathers with increased testosterone were more aggressive by 15 months. One explanation for how fathers with high testosterone can have reduced PPD risk initially while the mothers had depressive symptoms might be due to the differing gender roles and stressors put on moms versus dads in society. Or maybe it is because many fathers might be less emotionally sensitivity towards their babies early on [5] and as a result are not as stressed by the day to day life events.

How Depression in Men Can Impact Their Babies

Studies have also considered the impact of paternal PPD on their babies’ wellbeing. A study that is still being evaluated demonstrates that depressed fathers have a harder time understanding their infants emotions, specifically in regards to sensitivity and responsiveness [6]. The dads suffering from paternal PPD also exhibited difficulty in recognizing specific adult facial emotions, like happiness, but were competent at picking out sad adult faces. One can only worry about what a father’s unresponsiveness to the child could do to their parent-infant attachment.

What Are The Next Steps?

The rates at which dads are exhibiting PPD makes it likely that we will see screenings and more interventions for dads as well. Some suggested interventions include psychological and pharmacotherapy, both of which are used for mothers with PPD. However, some studies indicate that fathers prefer psychological treatments over pharmacological [2]. Some countries have also been testing to see how feasible it is to include paternal mental health screenings similar to what moms have to fill out each pediatric visit. Results from Sweden found that if done correctly, such screening would be fairly cost-effective [1].

REFERENCES

[1] Asper MM, Hallén N, Lindberg L, Månsdotter A, Carlberg M, Wells MB. Screening faterhs for postpartum depression can be cost-effective: An example from Sweden. Journal of Affective Disorders. 2018 Dec; 241: 154-163.

[2] Cameron EE, Hunter D, Sedov ID, Tomfohr-Madsen LM. What do dads want? Treatment preferences for paternal postpartum depression. Journal of Affective Disorders. 2017 Jun; 215: 62-70.

[3] Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal of Affective Disorders. 2016 Dec; 206: 189-203.

[4] Da Costa D, Zelkowitz P, Dasgupta K, Sewitch M, Lowenstein I, Cruz R, Hennegan K, Khalifé S. Dads Get Sad Too: Depressive Symptoms and Associated Factors in Expectant First-Time Factors. American Journal of Men’s Health. 2015 Sep 18; 11(5): 1376-1384.

[5] Fuertes M, Faria A, Beeghly M, Lopes-dos-Santos P. The effects of parental sensitivity and involvement in caregiving on mother-infant and father-infant attachment in a Portuguese sample. Journal of Family Psychology. 2016 Feb; 30(1): 147-156.

[6] Koch S, De Pascalis L, Vivian F, Meurer Renner A, Murray L, Arteche A. Effects of postpartum depression on father-infant interaction: the mediating role of face recognition. Infant Mental Health Journal. 2019.

[7] Helle N, Barkmann C, Bartz-Seel J, Diehl T, Ehrhardt S, Hendel A, Nestorius Y, Schulte-Markwort M, von der Wende A, Bindt C. Very low birth-weight as a risk factor for postpartum depression four to six weeks post birth in mothers and fathers: Cross-sectional results from a controlled multicentre cohort study. Journal of Affective Disorders. 2015 Jul 15; 180: 154-161.

[8] Leung BMY, Letourneau NL, Giesbrecht GF, Ntanda H, Hart M. Predictors of Postpartum Depression in Partnered Mothers and Fathers from a Longitudinal Cohort. Community Mental Health Journal 2017 May; 53(4): 420-431.

[9] Saxbe DE, Schetter CD, Simon CD, Adam EK, Shalowitz MU. High paternal testosteron may protect against postpartum depressive symptoms in fathers, but confer risk to mothers and children. Hormones and Behavior. 2017 Sep; 95: 103-112.

[10] Suto M, Isogai E, Mizutani F, Kakee N, Misano C, Takehara K. Prevalence and Factors Associated With Postpartum Depression in Fathers: A Regional, Longitudinal Study in Japan. Research in Nursing & Health. 2016 May 22; 39(4): 253-262.