When we hear the word “postpartum depression,” we probably imagine a mother who experiences feelings of sadness, anxiety, and worthlessness soon after giving birth to a baby. According to the Office on Women’s Health, one out of 9 new mothers will develop postpartum depression. Given that it takes two to create a baby, some people may be left wondering about how fathers fare after the birth of a baby. So, can dads develop postpartum depression? It turns out that they can.

Postpartum Depression in Men 

When a father develops depression after the birth of a baby, it is formally referred to as paternal postnatal depression. While fathers can legitimately develop depression after a baby is born, postpartum depression in fathers is not well-researched, and it often goes undetected. 

Based upon what is known about paternal postnatal depression, it is estimated that 8 to 10 percent of men experience symptoms after the birth of a baby. Symptoms most often develop within three to six months after a baby is born, but they can develop slowly over the course of a year following the birth. 

Symptoms of Paternal Postnatal Depression 

Paternal postnatal depression is diagnosed using the criteria for a depressive episode. Common symptoms of depression, based upon diagnostic criteria, are as follows:

• Depressed mood, which is characterized by feelings of sadness or hopelessness 
• Loss of interest in usual activities
• Weight loss despite not dieting, or significant weight gain
• Sleep disturbances, which can manifest as either insomnia, or on the contrary, over-sleeping
• Change in motor activity, which can involve either psychomotor agitation (restlessness, pacing) or psychomotor retardation (slowed movement)
• Low energy levels
• Feeling worthless or excessively guilty
• Trouble thinking or making decisions
• Thoughts of death or suicidal behavior (thinking about suicide, making a plan for suicide, or attempting suicide)

While fathers with postnatal depression may show the above symptoms of depression, sometimes, symptoms manifest differently in men. For instance, research suggests that fathers showing depressive symptoms may experience the following:

• Withdrawing socially
• Cynical attitude
• Irritability 
• Avoidance behavior, such as working late to stay away from home
• Fear and anger
• Drug or alcohol misuse
• Extramarital affairs
• Violence toward spouse

Risk Factors for Depression in Fathers

Symptoms of paternal postnatal depression can happen in anyone, but some men are more at risk than others. Common risk factors for depression in new fathers include:

• History of depression
• Marital conflict
• Poverty
• Depression in the mother
• Unplanned pregnancy
• Sleep disturbances
• Hormonal changes 
• High anxiety levels

Hormonal changes from pregnancy are often attributed only to mothers, but there is evidence that fathers also experience changes in hormone levels in response to the birth of a baby. For instance, testosterone levels seem to decrease in men in the months leading up to birth, which is believed to strengthen their ability to bond with a new baby. Decreases in testosterone can also increase the risk of depression. 

When It’s Time to Seek Treatment

Postnatal depression may go unrecognized in men, but that doesn’t change the fact that it’s a significant public health issue. Men who show signs of depression following the birth of a baby benefit from seeking treatment. If depression symptoms are beginning to interfere with daily functioning or make it difficult to maintain family relationships, including relationships with the mother and baby, it’s likely time to seek depression treatment. 

Left untreated, paternal postnatal depression is associated with the following problems: 

• Hostility toward children in the family
• Increased risk of emotional or behavioral problems in children
• Higher likelihood of aggression in children
• Delays in social and behavioral development in children 
• Higher distress levels in the infant

Fathers who experience ongoing symptoms of depression benefit from seeking treatment to improve their own mental health, as well as the well-being of their family. If depression symptoms do not present as extreme sadness, loss of interest in usual activities, or thoughts of suicide, they may manifest as extreme irritability, and withdrawal from home life. When these symptoms persist and make it difficult to participate in daily life, it’s critical to seek treatment.

Depression is often treated with medication, counseling, or a combination of the two. A class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs), are often the first line of medical treatment for depression, including paternal postnatal depression. Specific counseling strategies called cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are also beneficial. CBT can help men to correct unhelpful or distorted thinking patterns that make depression worse, and IPT is beneficial for improving relationship functioning.

Other treatments that may be beneficial for fathers experiencing postnatal depression include:

• Light therapy
• Couples counseling
• Educational programs
• Support groups 

What To Do When Depression Doesn’t Improve 

The good news is that there is help available for men who experience symptoms of postnatal depression. In many cases, some combination of support, counseling, and medication can help new fathers to overcome symptoms of depression. While treatment is beneficial for many people, some fathers may find that their depression is treatment-resistant, meaning it does not improve significantly with these usual treatment methods.

If postnatal depression does not improve with typical treatment methods, it may be time to explore alternative or add-on options. One such option is transcranial magnetic stimulation (TMS). This non-invasive treatment modality uses an electromagnetic coil placed against the head to stimulate areas of the brain associated with mood regulation. It’s an ideal treatment option for fathers, as it can be completed in 20-minute sessions, after which patients are free to drive and carry on with their usual activities, such as working or caring for a family. 

Pulse TMS offers services in the Los Angeles community. Contact us today to learn more or to determine if you are a candidate for TMS treatment.