Male postpartum depression describes when a new father experiences postpartum depression (PPD). Although PPD is more commonly diagnosed in women who give birth, men can also experience it. Some research suggests that 8-10% of fathers experience PPD. Other estimates are even higher.
PPD causes major depressive disorder (MDD) in new parents after the birth of their child. Male PPD, also called paternal postpartum depression, shares symptoms with female PPD, including persistent depressed mood and insomnia. You may also feel irritable or indecisive.
Understanding the symptoms and causes of male postpartum depression, and what you can do if you’re experiencing it, can help you feel better.
Postpartum depression is a condition that includes symptoms of major depressive disorder that you experience in the first year of your child’s life. Male PPD symptoms usually peak 3-6 months after the baby is born.
Specific symptoms may vary from person to person. Your healthcare provider can diagnose you with male PPD if you experience at least five of the following symptoms for at least two weeks:
- Depressed mood, sadness or hopelessness most of the time on most days
- Apathy, or loss of interest in activities
- Unintentional weight loss or changes in your usual appetite
- Trouble falling or sleeping or sleeping too much almost every day
- Fatigue, lethargy, restlessness, agitation
- Inappropriate guilt or worthlessness
- Indecisiveness or reduced ability to concentrate or think
- Recurrent thoughts about death or suicide
Symptoms of PPD in women and men
PPD men are more likely to experience irritability, agitation, and difficulty making decisions than PPD women. You may notice hostility and feelings of hopelessness, frustration or cynicism.
People with male PPD may also be more likely to withdraw from relationships and engage in activities such as drinking alcohol, drug use, gambling, or overworking to escape or cope with their feelings.
Postpartum depression is caused by a combination of genetic, biological and environmental factors. Rather than having a single cause, male PPD can be caused by a number of factors.
Hormonal changes
Hormonal changes may play a role in PPD in men. During and after your partner’s pregnancy, estrogen levels increase while testosterone levels decrease in men’s bodies.
Research suggests that this hormonal change can help promote bonding with your baby by reducing aggression and increasing helpful responses to your baby’s cries. The researchers also found that these changes may increase the risk of PPD in men.
Partner with PPD
Research suggests that maternal postpartum depression may be a strong predictor of PPD in men. In other words, having a partner with PPD greatly increases your chances of developing it, possibly because one partner’s emotions can affect the other.
Personal or family history of depression or anxiety
If you have or have had anxiety or depression in the past, this may increase the risk of PPD after your child is born.
There may also be a genetic component. Research suggests that having a parent with a history of anxiety or depression may also increase your chances of developing male PPD.
Sleep Deprivation
For many new parents, having a baby means not getting enough sleep. Lack of sleep can affect your mood and executive function (ability to concentrate and plan), and significantly increases your risk of depression.
Expectations for provision
Your own expectations about your role in parenting can add stress. For example, if you believe that your job is to provide for the finances or provide for the family, that can be a lot of pressure. This stress can increase the risk of depression over time.
Relationship Troubles
The stress of parenting can lead to more disagreement and conflict between parents, which can contribute to depression, especially if there is abuse and violence at home. New parents may have less or no sex, which can also be a factor in PPD.
Relatedly, a history of physical, sexual, or emotional abuse also increases risk.
Other risk factors
A number of social factors can also increase the risk of PPD. The chances of developing depression are higher for those who have:
- Poverty or low income
- Lack of social or family support
- Unstable housing
- Unintended or unplanned pregnancy
- Older age
- Unemployment
- Lower level of education
Your healthcare provider can diagnose male PPD by evaluating your medical history and asking about your symptoms.
When asking about symptoms, they can use standard scales, such as the Edinburgh Postnatal Depression Scale (EPDS), which are specifically designed to detect PPD. In these tests, the provider asks questions and scores the answers based on your report.
If you think you have PPD or are at risk for it, the most important step is to admit you have a problem and get help, even if you are hesitant to seek support. Treatment can help you feel better. Specific treatment approaches may vary depending on your individual case.
Medicines
Health professionals may recommend antidepressants for male PPD. Common options include:
- Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (sertraline) or Lexapro (escitalopram)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Effekor XR (venlafaxine) or Cymbalta (duloxetine)
- Tricyclic antidepressants, such as Elavil (amitriptyline) or Pamelor (nortriptyline)
Counseling and therapy
Your doctor may recommend counseling and therapy, which can play a central role in the management of male postpartum depression. Used for other types of depression, researchers have found several approaches to be particularly effective for PPD:
- Parenting classes: Parenting classes can help you deal with any stress, feelings of inadequacy, lack of control, low self-esteem or aggravation you may be experiencing. Classes are also a source of social support.
- Cognitive behavioral therapy (CBT): CBT involves developing relaxation methods and working to retrain your thinking about your emotions and stress. This can happen in individual, couples or group sessions with a therapist.
- Interpersonal therapy (IPT): This therapy focuses on the relationships in your life and the impact your thoughts and feelings can have on the people in your life. IPT sessions help you understand how your relationships may be affecting your depression. You also develop strategies to improve the way you interact with others.
Transcranial magnetic stimulation
In severe cases of postpartum depression that do not respond well to other treatments, doctors may recommend a procedure called transcranial magnetic stimulation (TMS). TMS relies on magnetic fields directed at parts of the brain associated with depression, changing the electrical activity there.
TMS involves 4-6 weeks of daily treatments and is relatively well tolerated and safe. However, more research is needed to evaluate its effectiveness specifically for PPD.
The effects of male PPD can cascade through the entire family, potentially affecting child development and family dynamics. Complications of PPD that go away without proper support include:
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- Family stress: Research has noted that paternal PPD can lead to increased levels of stress throughout the family, affecting relationships with partners and children.
- Lack of binding: In the postpartum period, hormones and behaviors (such as skin-to-skin contact) allow babies and parents to develop a special bond. Male PPD can get in the way of this process, which can affect the relationship that forms between you and your child.
- Increased risk of physical abuse: Researchers noted higher rates of child spanking or other physical discipline or abuse among men with a history of male PPD. This can lead to problems with the child’s mental health.
- Emotional regulation issues: Children of parents with PPD are more likely to have trouble regulating their emotions, leading to increased tantrums, tantrums, and other episodes.
- Behavioral disorders: Children of people with male PPD are 33-70% more likely to have mental health or conduct disorders characterized by outwardly aggressive behavior and consistent disobedience.
- Attention Deficit/Hyperactivity Disorder (ADHD): A father’s depression may increase the child’s risk of ADHD. ADHD can cause difficulty concentrating, poor impulse control, and increased and erratic activity.
Postpartum depression is usually seen as a problem for mothers, which means fathers may be less willing to admit they have a problem and more hesitant to seek support.
To deal with PPD—and even prevent it from happening—fathers need to be proactive. Strategies that can help include:
- Get enough exercise, aiming for at least 30 minutes a day of light to moderate activity
- Get enough sleep by going to bed and waking up at a specific time each day
- Eat nutritious, well-balanced meals
- Avoid using alcohol, drugs, gambling, or other high-risk behaviors
- Talk to a trusted person or loved one about your feelings and tell your partner how you feel
Male postpartum depression (PPD) is a condition involving persistent depressed mood and behavioral changes that new fathers may develop after the birth of a child.
Male PPD, although often under-recognized, is quite common. Symptoms include aggression, depressed mood and withdrawal from family life.
If left untreated, male postpartum depression can affect family dynamics, partners, and children. Treatments for PPD in men vary and are similar to those for major depression. Lifestyle changes and social support can also help you prevent and manage PPD in men.