What You Should Know about Dads and PPD
Your husband walks into the kitchen, two hours late for dinner. He grabs himself a drink—something he’s been doing more and more frequently after work. He tells you, “I have to go in early and stay late again tomorrow. I just can’t get caught up.”
Honestly, it’s bittersweet having him work so much. On the one hand, you miss him and want more help with your little one. But he’s been so irritable and critical lately. He just doesn’t seem like himself.
If you’re thinking, “It must be me,” take a deep breath. It’s not you. It’s not the baby. It could be postpartum depression.
Paternal Postpartum Depression
We don’t talk nearly enough about parenthood and mental health. And parents really feel it.
One in nine moms is diagnosed with postpartum depression (PPD) every year. But that’s only about 40% of all PPD cases. That means less than half of women are actually being diagnosed, and only 60% of those are getting help.
Research is showing more and more that our healthcare system is consistently failing new moms. But research is also indicating that new dads suffer, too. We don’t talk about it. And we’re barely studying it. Even though it’s incredibly common.
Paternal postpartum depression, also called paternal postnatal depression (PPND) affects anywhere from 2% to 25% of men in the first 12 months after their child is born. Ten percent of those will experience symptoms early on, from the first trimester through 6-months postpartum. The majority, about 26%, will experience symptoms between months 3 and 6 postpartum.
Obviously, 2%-25% is a huge range. That’s because we don’t actually know how many men experience PPND. Lack of research, screening, treatment, and good-ole-fashioned stigma are to blame. We often don’t ask dads how they’re doing, let alone let them know it’s okay and perfectly normal to be moody, overwhelmed, and irritable during this time.
If you’re looking to better support your partner in their transition to fatherhood, here’s what you should know about PPND.
Symptoms of Paternal Postnatal Depression
In moms, postpartum depression includes a variety of symptoms such as:
Sadness
Increased tearfulness or crying
Feeling overwhelmed
An awareness of "this doesn't feel like me"
Irritability and anger
Trouble sleeping
Loss of interest in formerly favorite activities
Poor concentration
Changes in appetite and sleep
Unexplained physical ailments, like headaches or stomach aches
Having a hard time caring for oneself (or baby)
Lack of feeling toward baby
Isolation
Guilt and shame
Hopelessness and helplessness
Co-occurring anxiety symptoms
Suicidal thoughts
If you’re having thoughts of harming yourself or someone else, call 911 or go to the emergency room right away.
For dads, PPND may also present with these classic signs. But it’s much more likely they’ll exhibit unique symptoms—which is why screening, diagnosis, and treatment are more difficult. Most clinicians’ tools are designed to detect women’s PPD, not men’s variations of the symptoms.
Men are more likely to show:
Frustration, anger, and irritability
Impulsivity
Sadness, hopelessness, and overwhelm
Frustration and discouragement
Cynical attitude
Risky behaviors, like substance use or gambling
Appetite changes
Violence toward their partner
Discouragement of breastfeeding or pumping
Increased attention and time spent at work
Physical symptoms, like headaches, stomach aches, racing heart, or unexplained pain
There’s some overlap here. But generally, men display their PPND with more irritability, risk-taking, attention to work, and physical symptoms.
Causes of PPND
It’s generally agreed that PPD is caused by hormonal fluctuations—which makes sense considering the nearly other-worldly things happening to women’s bodies during pregnancy, delivery, and postpartum.
But dads experience hormone fluctuations, too! When their baby is born, testosterone decreases and estrogen increases. This change is most likely evolutionary, designed to make fathers stick around and bond with their offspring. Add in a not-so-healthy dose of sleep deprivation, and you have a winning combination for a paternal postpartum mood or anxiety disorder (PMAD).
Social, economic, and interpersonal factors also contribute to PPND. Similar to motherhood, fatherhood is a time of great transition. New demands, responsibilities, fears, aspirations, and identities are formed when a baby enters the picture. Relationships also change significantly, which tends to affect men much differently.
Men have less social support than women. They have fewer friends, especially those with whom they feel comfortable sharing their deep-down feelings. They rely heavily on their partners—you!—for this. But when a baby enters, you’re suddenly tied up in all the new responsibilities of motherhood. This leaves Dad without their main source of social support. This shift can also make dads feel left out, since bonding tends to happen more easily and quickly between mom and baby.
Men also experience a different balance between work and home. When women have babies, we’re expected to give up our careers and become the child-rearer of the household. Because of this expectation, even if we return to work outside the home, most of us still put our families first. Dads, on the other hand, may feel like they have to do both work and family equally. They feel a significant pressure to be the breadwinner and an attentive father. This impossible balance can fuel feelings of worthlessness, stress, and disconnect from the new baby, leading to other symptoms of PPND.
Risk Factors for PPND
Some fathers are at greater risk than others for developing PPND. Maternal PPD and becoming a dad at a young age often come out on top. In fact, if you have symptoms of PPD, your partner is 50% more likely to experience symptoms himself. It’s even worse for young dads; one study found that first time fathers had the same prevalence of depressive symptoms as new moms.
Other PPND risk factors include:
History of depression
Sick or premature baby
Significant losses prior to fatherhood
Difficulties developing attachment to the baby
Lack of good male role models
Lack of social support
Poor sleep
Changes in marital relationships, including intimacy and sex
Feeling excluded or jealous about mother-child bonding
Lack of rewards in parenting
Financial and work stress
Low testosterone
The Bottom Line: Dads Matter, Too
When you and your partner decide to parent, you become a whole new kind of team. When a team member is sick or hurting—you, your partner, or both—the team can’t function. In order to maintain a healthy household, and healthy you, it’s important to look out for one another.
If you notice some PPND symptoms in your partner, sometimes the most effective approach is to ask how they’re doing without judgment. There remains a huge stigma surrounding men’s mental health. Since they’re supposed to be stoic and tough, men rarely ask for help when feeling negative emotions. Remind your partner that mental health challenges aren’t a weakness, and that you’re in this together.
Here are some other ways you can help:
Encourage them to talk to other new dads.
Prioritize a few minutes a day to connect with your partner!
Suggest they take time off work, if possible.
Remind them of the importance of eating well, exercising, and getting good sleep (as much as possible as a new parent).
Establish sessions with a couple’s therapist if your relationship is already going through a rough patch.
Offer to go with them to an appointment with a medical doctor, psychiatrist, or therapist to discuss their mood with a professional.
Connect them with Postpartum Support International’s Monthly Dad Support Group.
Avoid the “who’s got it worse” game.
Take care of you, too!
You don’t have to do this alone.
Part of being an effective parenting team is taking the best care of you. Keeping Mommy in Mind, my online course, supports you through this transition to motherhood with honest conversation and actionable skills. Take the best care of you—for you and the ones you love. Start today!
Sources
The American Academy of Pediatrics. (2018, December 17). Dads Can Get Depression During and After Pregnancy, Too. HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Dads-Can-Get-Postpartum-Depression-Too.aspx.
Bass, P. F., & Bauer, N. S. (2018). Parental postpartum depression: More than “baby blues.” Contemporary PEDS Journal, 35(9). https://www.contemporarypediatrics.com/view/parental-postpartum-depression-more-baby-blues
Cleveland Clinic. (2019, September 16). Yes, Postpartum Depression in Men Is Very Real. Health Essentials from Cleveland Clinic. https://health.clevelandclinic.org/yes-postpartum-depression-in-men-is-very-real/.
De Bellefonds, C. (2021, April 27). What It's Like to Be a Dad With Postpartum Depression. What to Expect. https://www.whattoexpect.com/first-year/postpartum/what-its-like-be-dad-with-postpartum-depression/.
Garfield, C. F., Duncan, G., Rutsohn, J., McDade, T. W., Adam, E. K., Coley, R. L., & Chase-Lansdale, P. L. (2014). A Longitudinal Study of Paternal Mental Health During Transition to Fatherhood as Young Adults. Pediatrics, 133(5), 836–843. https://doi.org/10.1542/peds.2013-3262
Nonacs, R. (2013, March 19). Postpartum Depression in New Fathers: Risk Factors. MGH Center for Women's Mental Health. https://womensmentalhealth.org/posts/postpartum-depression-in-new-fathers-being-younger-is-a-risk-factor/.
Postpartum Support International. (n.d.). Help for Dads. Postpartum Support International. https://www.postpartum.net/get-help/help-for-dads/.
Ream, A. (2019, November 25). Is it baby blues or postpartum depression? How to tell the difference. Motherly. https://www.mother.ly/life/is-it-baby-blues-or-postpartum-depression-how-to-tell-the-difference.
Rosen, M. D., & Kelly, D. (2020, February 14). Why We Need to Talk More About Male Postpartum Depression. Parents. https://www.parents.com/parenting/dads/sad-dads/.
Saxbe, D. E., Schetter, C. D., Simon, C. D., Adam, E. K., & Shalowitz, M. U. (2017). High paternal testosterone may protect against postpartum depressive symptoms in fathers, but confer risk to mothers and children. Hormones and behavior, 95, 103–112. https://doi.org/10.1016/j.yhbeh.2017.07.014
Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women's health (London, England), 15, 1745506519844044. https://doi.org/10.1177/1745506519844044
