Jul 6, 2021 – Postpartum depression isn’t just something new mothers can get. It turns out that it can affect young fathers as well, according to a new study.
Michael W., a 38-year-old New Jersey lawyer, and his wife had excitedly planned the birth of their baby and were overjoyed when she was born.
But after that, “I found that raising a newborn was terrifying. I felt unprepared for the task, overwhelmed by the burden of the 24-hour schedule and lack of sleep, and I struggled with feelings of inadequacy “he tells WebMD.
Michael never thought he had postpartum depression (PPD), perhaps because the condition is more commonly associated with women. But a new study published in the American Journal of Men’s Health suggests that PPD affects men too.
A team of Danish investigators, led by researcher Sarah Pedersen from the Department of Public Health at Aarhus University, interviewed eight fathers with PPD in detail and found that their primary experiences were linked to feelings of overwhelm and powerlessness or inadequacy, sometimes turning into anger and frustration turned over.
Ultimately, all of the men surveyed for the study sought formal help from a health care provider, but six went through several months of depressive symptoms before seeking or receiving help.
“I think one of the most important takeaway messages is that practicing clinicians working with new parents should invite fathers to their consultations and involve the fathers as much as possible,” Pedersen told WebMD.
The results also contained a message for parents, she says.
“I hope you support each other and share your feelings and how you are making the transition to parenting – you know it takes time to get used to your new role,” she says.
Not enough attention
According to Pedersen, there was too little focus on fathers in PPD.
“Over the past decade, several studies have examined the prevalence of PPD in men, and there is growing evidence that paternal PPD is associated with an increased risk of long-term negative behavioral and emotional outcomes in children,” she says.
However, only three studies are based on interviews with fathers who have had personal experience with PPD.
“The purpose of our study was, first, to explore the life experiences of fathers with PPD and, second, to gain a deeper understanding of their help-seeking behavior – barriers to seeking help and facilitators of seeking help,” says Pedersen.
The study was based on “semi-structured” interviews with eight Danish fathers (aged 29 to 38 years) with PPD, none of whom had a history of depression.
All participants had received a formal diagnosis of PPD from a family doctor or psychologist, and all had been receiving or receiving psychiatric treatment at the time of the interview and considered recovering from depression at the time of the interview.
The researchers used a technique called interpretative phenomenological analysis to analyze the interviews.
This method “aims to produce in-depth studies of certain phenomena by examining how individuals make their own life experiences meaningful,” the authors write.
A “radical change”
Five of the fathers described pregnancy as “a time of happiness full of positive expectations of fatherhood”.
But “the great expectations of fathers were later replaced by a very different reality of fatherhood,” the authors write, noting that, in the words of one participant, the transition to fatherhood was a “radical change that is simply impossible to imagine. “
Most of the fathers reported feeling overwhelmed and three felt not ready for the task, which made their depression worse.
“Participants wanted to be emotionally and physically present in their child’s life, but during the time they were depressed, those good-hearted intentions turned into guilt and inadequacy as participants felt they did not have enough energy and mental strength to do the of the fathers they wanted to be, “write the authors.
Participants mentioned stressors they thought contributed to their PPD, including complications during their partner’s pregnancy, unplanned cesarean section (three fathers), difficulty breastfeeding their partner (five fathers), and work-related concerns. Five reported that their partners had postpartum emotional distress.
“Male Norms”
A second focus of the research was to examine the behavior of fathers seeking help, says Pedersen.
Ultimately, all participants sought formal help from either their family doctor or a health visitor, with two seeking help immediately after birth.
Although participants could see changes in mood and behavior with hindsight, many did not consider these to be signs of depression prior to diagnosis.
Most of the participants had heard of PPD, but primarily because it affects women. Three searched online for information about paternal PPD but couldn’t find any.
Four participants described experiencing PPD as “taboo” based on a “combination of false beliefs, stigma and male norms,” the authors said, since men “should be tall, strong and take care of everything, and suddenly you can ” Not.”
The authors reported that seven participants were examined by a doctor for PPD or depression.
“Screening was an important part of the help-seeking process as this was the first time two of the fathers were introduced to PPD,” the authors said.
Although the screening “had the potential to spark a conversation about PPD” it was targeted at women and some participants found it irrelevant to them.
“Future research should focus on identifying the educational needs of paternal PPD among parents, health workers, and other professionals caring for new families,” says Pedersen.
Michael W. says it would have been helpful if someone had prepared him and his wife for what to expect, or if there had been some sort of screening. He also advises parents-to-be “to get some real life experience by spending time with a newborn to see what goes with it.”
Different symptoms
“We often speak of mothers who have PPD, so it is more normal for mothers to bring it up or loved ones to ask mothers how they are physically and psychologically after giving birth,” said Craig Garfield, MD, a treating physician and Founder / Director of Family and Child Health Innovations at Ann and Robert H. Lurie Children’s Hospital, Chicago, told WebMD.
For fathers, “it’s not discussed that often, so friends and families don’t often ask fathers and fathers don’t know where to turn,” says Garfield, who is also a professor of pediatrics and medical social sciences at Northwestern University’s Feinberg School of Medicine , Chicago, and was not involved in the study.
He notes that symptoms in fathers can be different from those in mothers.
“I’ve seen fathers feel more anxious or moody than before or angry, and I’ve seen fathers throw themselves into work or drink more – all related to postnatal mood swings and depressive symptoms,” he says.
Symptoms can last longer in men than in women. Garfield’s group published a study interviewing 400 mothers and fathers of premature babies in the neonatal intensive care unit (NICU) about symptoms of depression around the time of admission to the NICU, at home discharge, and then at home after 30 days.
About a third of the mothers were tested positive for depressive symptoms when they were admitted to the neonatal intensive care unit, as was 17% of the fathers. But the mothers’ depression scores improved after discharge and 30 days after they were home, while those of the fathers “remained essentially unchanged,” he says.
“We also found that if doctors examined mothers and fathers while they were in the neonatal intensive care unit – on admission or even on discharge – it would greatly improve their ability to predict who would have depressive symptoms 1 month after returning home would have.”
Pedersen agrees that clinicians should incorporate screening for PPD into their practice and proactively encourage fathers to seek help.
“Keep up the pressure,” she advises, because “compared to women, men rarely seek help with mental health issues.”
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American Journal of Men’s Health: “I Wanted to Be There as a Dad, But I Couldn’t: A Qualitative Study of Fathers’ Experience with Postpartum Depression and Their Behavior in Finding Help.
Sarah Pedersen, Department of Public Health, Aarhus University, Aarhus, Denmark.
Craig Garfield, MD, attending physician and founder / director of Family and Child Health Innovations at Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois.
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