Fathers are at risk for postpartum depression, too

The rate of fathers identified as experiencing postpartum depression during routine well-child visits in the 15 months after their infants' birth was almost the same as that of mothers, found a recent study in JAMA Pediatrics.

by Katherine K. Dahlsgaard

Published Jul. 31, 2018, 9:50 a.m. ET

This surprising finding, the result of parent screenings carried out during visits to pediatric primary-care clinics in Indianapolis, joins a rapidly growing body of research documenting the reality of paternal "baby blues."

For instance, an analysis that combined results from multiple studies of paternal prenatal and postpartum depression in 2010 and then repeated in 2016 showed prevalence rates of depression of 8 percent to 10 percent for fathers, with highest rates generally found three to six months after a baby was born (26 percent). Paternal depression compromises parenting skills as well as the ability of men to support their co-parent and partner. It also makes new fathers – who often receive less emotional support – feel ineffective as caregivers and ashamed to admit they are struggling.

The burgeoning research interest in male postpartum depression follows a similar trajectory to that of maternal postpartum depression. For decades, new moms suffered in silence due to the lack of recognition, outright denial, and stigmatization of women struck low by depression during pregnancy and after giving birth. Fortunately, there are several very effective treatments for depression, including psychotherapy and antidepressant medication.

You might question why fathers experience postpartum depression at all, given that hormonal changes during and after pregnancy are thought to be the key culprits in mothers' depression. But other factors associated with having a child are potent risk factors for the onset of depression, including sleep deprivation, and the other new stresses that babies bring, such as increased financial strain and the need to juggle dramatic changes in schedules, roles, and expectations.

The body of research on fathers' postpartum depression recommends:

Pediatric primary -care providers should encourage both parents to attend well-child checks.
Both caregivers should receive routine screening for depression during well-child visits.
Pediatricians should be made aware that the screening tools commonly used to detect maternal depression are valid for use with fathers, too.
However, fathers' cut-off scores for detecting depression might actually be lower than those for mothers.
This is because fathers are less likely to endorse "crying" as a symptom and more likely to report symptoms of depression that some screening tools don't assess for at all, such as increased irritability and anxiety.
Pediatric and other primary care providers, as well as family members, should address the problem openly and directly with fathers. Fathers will benefit from referrals for effective treatments for depression, just as mothers do.
An excellent and free online resource is the American Academy of Pediatrics 2016 report on the role pediatricians can play in supporting fathers.

If you suspect that a father is experiencing postpartum depression, don't be afraid to speak up. You can simply mention you heard fathers can also suffer from postpartum and offer some resources. Hopefully, that will set up him on the right path. Support for newborns and mothers is crucial, but let's not forget fathers.