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Postpartum Depression in Men

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Clinically Reviewed by:
Lindsey Rae Ackerman, LMFT

Written by:
Alex Salman, MPH on June 10, 2024

In discussions surrounding parenthood and mental health, the focus has traditionally been centered on the mothers well-being, which can leave the mental health of fathers overlooked. However, emerging research sheds light on the impact of postpartum depression in men, also know as paternal postnatal depression (PPND) and paternal postpartum depression (PPPD), highlighting the importance of recognizing and addressing men’s mental health needs during the transition to fatherhood.[1]

Despite societal expectations and stereotypes, men can also experience a range of emotions and challenges during the postpartum (or post-birth) period, from joy and fulfillment to stress and anxiety.

The lack of acknowledgment and support for paternal mental health not only affects fathers but also has implications for family dynamics and the overall well-being of children as well. Opening up conversations about prenatal and postpartum depression in men provides them with the resources and support they need to navigate the emotional complexities of parenthood.

What is Postpartum Depression?

Postpartum depression (PPD), classified in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) as major depressive disorder (MDD) with peripartum onset, is a mood disorder that can affect people after the birth of a child.[2]

It’s characterized by feelings of extreme sadness, anxiety, and exhaustion, which can make it challenging for new parents to care for themselves and their child. It typically develops within the first few weeks after childbirth but can also occur later on as well.

Symptoms of postpartum depression can vary, but they may include:[3]

  • Persistent feelings of sadness, hopelessness, or emptiness
  • Loss of interest or pleasure in once enjoyable activities
  • Changes in appetite or weight
  • Difficulty sleeping or sleeping too much
  • Fatigue or loss of energy
  • Feelings of worthlessness or guilt
  • Difficulty concentrating or making decisions
  • Thoughts of self-harm or harming the baby

What is Postpartum Depression in Men?

Paternal postpartum depression (PPPD) is a perinatal mental health condition in which new fathers experience symptoms of depression after the birth of their child. Similar to postpartum depression in mothers, postnatal depression in men can manifest as feelings of sadness, anxiety, irritability, and exhaustion.[4]

The exact causes of paternal postpartum depression are not fully understood, but factors such as sleep deprivation, stress, and significant life changes associated with becoming a parent can contribute to its development.[5] Additionally, personal or family history of depression, relationship problems, and lack of social support can also increase the risk of PPPD.

Do Men Get Postpartum Hormones?

While men do not experience the same hormonal changes as women during pregnancy and childbirth, research suggests that they can experience fluctuations in certain hormones, such as testosterone and cortisol, during the postpartum period.[6] These hormonal changes in men are believed to be influenced by psychological and social factors related to becoming a parent.

For example, studies have shown that testosterone levels in men typically decrease during the transition to fatherhood, particularly during the early postpartum period.[7] This decrease may be related to the increased caregiving responsibilities and changes in social roles that come with fatherhood. Additionally, men who are more involved in childcare may experience greater reductions in testosterone levels.

Changes in cortisol levels, which are associated with stress and anxiety, have also been observed in men during the postpartum period. The stress of becoming a parent, coupled with sleep deprivation and the demands of caring for a newborn, can contribute to fluctuations in cortisol levels in new fathers.

While these hormonal changes in men may not be as well-studied as those in women during the postpartum period, they suggest that men undergo physiological changes in response to becoming a parent. These hormonal fluctuations, combined with psychological and social factors, can influence men’s emotional well-being and adjustment to fatherhood.

How is Postpartum Depression for Men Similar to Postpartum Depression for Women?

Paternal postpartum depression and postpartum depression in women share many similarities in terms of symptoms, risk factors, and impacts on individuals and families:

Postpartum Depression Symptoms

Both PPD in men and PPD can manifest as feelings of sadness, hopelessness, irritability, and anxiety. Other common symptoms include changes in appetite or weight, difficulty sleeping, fatigue, feelings of worthlessness or guilt, emotional and behavioral problems, and difficulty concentrating.

Onset of Symptoms

While PPD typically occurs in women within the first few weeks after childbirth, PPPD can also begin during this early postpartum period or develop later on. Both conditions may also have a gradual onset, with symptoms becoming more pronounced over time.

Risk Factors

Certain risk factors predispose individuals to both postpartum depression and paternal postpartum depression. These may include a personal or family history of depression or other mental health disorders, stressful life events, lack of social support, relationship difficulties, financial stress, and hormonal fluctuations.

Impact on Parenting

Both conditions can affect the ability of parents to bond with their child and engage in caregiving activities. Individuals with postpartum depression may have difficulty experiencing pleasure in interactions with their baby, have trouble coping with the demands of parenthood, and may feel inadequate or guilty about their parenting abilities.

Impact on Relationships

Postpartum depression in women and men can strain relationships with partners, family members, and friends. Feelings of sadness, irritability, and withdrawal may lead to conflict and communication difficulties within the family unit.

How Are They Different?

While paternal postpartum depression (PPPD) and postpartum depression (PPD) in women share many similarities, there are also some differences between the two conditions:

Hormonal Changes

Postpartum depression in women is often associated with significant hormonal fluctuations following childbirth, including changes in estrogen and progesterone levels. These hormonal shifts play a role in the onset of PPD symptoms.

In contrast, hormonal changes in men during the postpartum period are less noticable and do not directly mirror those experienced by women. However, hormonal changes in men, such as decreases in testosterone levels, have been observed and may contribute to postpartum depression in men.

Social and Cultural Factors

The experience of parenthood and the societal expectations placed on mothers and fathers differ significantly. Women face unique pressures related to pregnancy, childbirth, and maternal roles, which can influence the development and expression of PPD.

Conversely, men experience distinct stressors related to fatherhood, such as financial concerns, changes in work-life balance, and societal expectations regarding their role as providers and caregivers. These social and cultural factors can impact the manifestation and perception of postpartum depression in both women and men.

Recognition and Diagnosis

Postpartum depression in men is often under-diagnosed and less widely recognized compared to PPD in women. Healthcare providers may be less likely to screen for depression in fathers, leading to missed diagnosis for early intervention and support. Additionally, men may be less likely to seek help for mental health issues due to stigma or societal norms around masculinity. As a result, PPPD may go unrecognized and untreated more frequently than PPD.

Parenting Dynamics

While both mothers and fathers may experience challenges in bonding with their baby and adjusting to parenthood, the dynamics of caregiving and parental roles can vary between genders. Mothers may have more primary caregiving responsibilities early on, which can impact their experience of PPD. Fathers, on the other hand, may feel pressure to provide for their family while also navigating their role as caregivers, which can contribute to Paternal Postpartum Depression (PPPD) symptoms.

How Common is Paternal Postpartum Depression?

Seen in about 8 to 10 percent of fathers, paternal postpartum depression typically peaks within 3 to 6 months after childbirth, although it can gradually emerge over a year depending on the individual.[8]

Related: The Relationship Between Men and Mental Health

How Can Men Get Support for Paternal Postpartum Depression?

Men experiencing paternal postpartum depression can seek support through health care providers and various channels to address their mental health needs. Here are some ways they can get support and seek out postpartum depression treatment:

Therapy

Men with PPPD can benefit from therapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy. These approaches can help men explore and understand their feelings, develop coping strategies, and improve communication skills. Therapists experienced in working with men and parental mental health issues can provide a supportive and non-judgmental environment for addressing PPPD.

Medication

In some cases, medication may be recommended to manage the symptoms of PPPD, particularly if therapy alone is not sufficient. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed by a healthcare provider to help alleviate symptoms of depression. It’s important for men to discuss the potential benefits and risks of medication with their healthcare provider and to closely follow their guidance regarding dosage and usage.

Self-Care Strategies

There are several self-care strategies men can try at home to manage their symptoms and promote overall well-being:

  • Prioritize sleep: Getting adequate rest can help improve mood and reduce feelings of fatigue. Establishing a consistent sleep schedule and creating a relaxing bedtime routine can support better sleep quality.
  • Exercise regularly: Engaging in regular physical activity can have positive effects on mood and energy levels. Men can incorporate exercise activities they enjoy, such as walking, jogging, or playing sports, into their daily routine.
  • Connect with others: Building a support network of friends, family members, or fellow fathers can provide valuable emotional support and understanding. Men can seek out support groups specifically for fathers experiencing postpartum depression, either in-person or online, to connect with others who may be facing similar challenges.
  • Practice stress management techniques: Techniques such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce stress and promote relaxation. Men can experiment with different techniques to find what works best for them.
  • Engage in enjoyable activities: Participating in hobbies or activities that bring pleasure and fulfillment can help lift mood and distract from negative thoughts. Whether it’s pursuing a creative hobby, spending time outdoors, or trying something new, carving out time for enjoyable activities is important for mental health.

 Seeking Help for Depression in Fathers

By seeking support through therapy, considering medication if necessary, and implementing self-care strategies at home, men can effectively address paternal postpartum depression and work towards improved mental health and well-being.

If you or a loved one is struggling with postpartum mental health or other mental disorders, don’t hesitate to reach out to a mental health professional for help. At Clear Behavioral Health, we understand the impact parenthood can have on your mental health. Our programs are designed to help people navigate the complexities of mental illness and work toward improving mental health and well-being.

We provide a full continuum of care for both mental health symptoms and substance abuse disorders. Contact us today to learn more about our mental health programs including residential mental health treatment for severe conditions, outpatient mental health programs, and virtual IOP. If you’re struggling with substance abuse, we offer medical detox and residential treatment as well as dual diagnosis outpatient programs. Your healing journey is only a call or click away.

References:

  1. Scarff, J. R. (2019). Postpartum Depression in Men. Innovations in Clinical Neuroscience, 16(5-6), 11–14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659987/ on June 2, 2024
  2. Mayo Clinic. (2022, November 24). Postpartum depression – symptoms and causes. Mayo Clinic; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617 on June 2, 2024
  3. Cleveland Clinic. (2022, April 12). Postpartum Depression: Types, Symptoms, Treatment & Prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression on June 2, 2024
  4. Horsager-Boehrer, R. (2021, August 17). 1 in 10 dads experience postpartum depression, anxiety: How to spot the signs. UT Southwestern Medical Center. https://utswmed.org/medblog/paternal-postpartum-depression/ on June 2, 2024
  5. Male postpartum depression: Causes, symptoms, and more. (2022, June 29). Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/male-postpartum-depression on June 2, 2024
  6. Edelstein, R. S., Chopik, W. J., Saxbe, D. E., Wardecker, B. M., Moors, A. C., & LaBelle, O. P. (2016). Prospective and dyadic associations between expectant parents’ prenatal hormone changes and postpartum parenting outcomes. Developmental Psychobiology, 59(1), 77–90. https://doi.org/10.1002/dev.21469 on June 2, 2024
  7. Cárdenas, S. I., Tse, W., León, G., Kim, A., Tureson, K., Lai, M., & Saxbe, D. E. (2023). Prenatal testosterone synchrony in first-time parents predicts fathers’ postpartum relationship quality. Hormones and Behavior, 156, 105440–105440. https://doi.org/10.1016/j.yhbeh.2023.105440 on June 2, 2024
  8. Better Health Channel. (2012). Postnatal depression (PND). Vic.gov.au. https://www.betterhealth.vic.gov.au/health/healthyliving/postnatal-depression-pnd on June 2, 2024
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