Have you noticed your husband feeling down and isolating himself after the birth of your child? And if you are a new father yourself, do you find yourself feeling distant your newborn? These changes may be signs of paternal postpartum depression. Upon reading this, some of you may be wondering, "You mean men get postpartum depression too?". The transition to parenthood is also an extremely stressful period for parents, and fathers are not immune to postpartum depression. Studies have found that about 13% of fathers display depressive symptoms at around 2 to 6 months postpartum (Costa et al., 2019). This is somewhat consistent the experience in our practice, where about one in five males who are seeking help for depression had experienced the birth of a child in the recent year.

In Singapore, there is currently no official protocol in hospitals to screen new fathers for postpartum depression or programmes to support fathers going through this condition. This highlights the lack of awareness and support available to fathers undergoing postpartum depression in Singapore.

What is paternal postpartum depression?

Paternal postpartum depression is a form of depression where a father become overly distressed and moody after the birth of his child. This stress is usually caused by the array of new responsibilities as a parent. Increased irritability and aggressive behaviours, such as lashing out at others and even thoughts of harming themselves or their child may occur. Many fathers who have postpartum depression also stated that they would intentionally avoid their child and wife in order to suppress the negative emotions. These negative thoughts and behaviours are often followed by immense guilt of being a bad father.

Additionally, the stress of wanting to be a good parent and the financial cost of having a new family member to feed can be incredibly taxing. Thus, a father is most definitely not immune from feeling depressed upon the birth of his child.

Paternal postpartum depression usually rear its ugly head around the first few months of fatherhood. According to Cameron, Hunter, Sedov & Tomfohr-Madsen (2017), new fathers are twice as likely to suffer from depressive symptoms as compared to men who are not fathers. You may find out more about the experiences of fathers undergoing postpartum depression here.

How is paternal postpartum depression unique?

Compared to typical depression

As its name suggests, postpartum depression is specific to parents suffering from symptoms of depression after the birth of their child. The main sources of distress in postpartum depression are difficulties in coping with the demands of being a caregiver to an infant as well as doubts about well they are performing their role as parents. The diverse views on how to care for a baby, such as how to manage a crying infant, exacerbates the doubts and frustration in parents.

Compared to postpartum depression in mothers

While mothers with postpartum depression usually experience more sadness and lower moods, fathers tend to avoid interacting with their family and are more likely express anger, irritability and aggression towards people around them (Ramchandani et al., 2011; Eddy et al, 2019). Additionally, due to gender stereotypes, many men feel that they have to stay strong and support their wives during and after their pregnancy. As a result, fathers are usually less compelled to express their emotions or admit when they feel down which makes postpartum depression in men harder to be detected.

Although fathers do not go through the same hormonal changes that mothers experience following childbirth, the stress and responsibilities of being a new parent can still be overwhelming. Having a new child can exert a large toil on one’s physical and emotional wellness. In order to take care of the infant, parents get very little sleep and their sleep-cycle are usually disrupted. In Singapore, fathers often return to work within weeks of the birth of their child. They may struggle with being productive at work after a poor night’s rest. Fathers may also feel that they do not have the right to feel depressed when their spouse are the one who spends significantly more time caring for their infant.

Why should anyone care about paternal postpartum depression?

Paternal postpartum depression can have devastating consequences on the individual, the relationship and the child. Experiencing paternal postpartum depression without proper support can be overwhelming to a point where suicidal thoughts may arise (Eddy, Poll, Whiting & Clevesy, 2019). Additionally, couple fights and disputes become increasingly common when a father suffers from postpartum depression (Ramchandani et al., 2011). Marital disharmony and the lack of warmth caused by paternal postpartum depression may also negatively impact the emotional and cognitive development of the child. Research has shown that children, especially boys, of fathers with postpartum depression are at a higher risk of developing an anxiety disorder, conduct disorder, hyperactivity and delayed language skills (Nazareth, 2011; Eddy et al., 2019).

How to help depressed fathers?

Psychotherapy has proven to be an effective way to help mitigate the symptoms of paternal PPD (Cameron, Hunter, Sedov & Tomfohr-Madsen, 2017). If you suspect your spouse or yourself have paternal postpartum depression, seek help. You can find out more on how to obtain support here.

Protective measures against postpartum depression in fathers:

• Talk about postpartum depression with your partner

• Communicate with your partner and support each other during the antenatal and postnatal period

• Pay attention to their moods and do not downplay their experience if they report feeling down

• If you are a new father, take more time off work if you have to

• Engage in self-care as you care for your infant. This may include exercising and eating healthily.

• Seek support from people who care, or from a psychologist or a counsellor

It is common to see parents posting their blissful and happy family moments on social media. However, few do actually show the realities of having to deal with a constantly crying baby or the exhausting middle of the night diaper changes that new parents constantly deal with. Although parenthood is wonderful, many forget that taking care of a new child is no easy task and is most definitely a very stressful period in any parent’s life. Thus, to the fathers (and even mothers) out there who can’t seem to cope with the stress of a new child, you are definitely not alone and there is no shame at all in admitting that raising a child is not always fun and games.

References.

Cameron, E. E., Hunter, D., Sedov, I. D., & Tomfohr-Madsen, L. M. (2017). What do dads want? Treatment preferences for paternal postpartum depression. Journal of Affective Disorders, 215, 62–70. doi: 10.1016/j.jad.2017.03.031

Eddy, B., Poll, V., Whiting, J., & Clevesy, M. (2019). Forgotten Fathers: Postpartum Depression in Men. Journal of Family Issues, 40(8), 1001–1017. doi: 10.1177/0192513x19833111

Nazareth, I. (2011). Should men be screened and treated for postnatal depression? Expert Review of Neurotherapeutics, 11(1), 1–3. doi: 10.1586/ern.10.183

Ramchandani, P. G., Psychogiou, L., Vlachos, H., Iles, J., Sethna, V., Netsi, E., & Lodder, A. (2011). Paternal depression: an examination of its links with father, child and family functioning in the postnatal period. Depression and Anxiety, 28(6), 471–477. doi: 10.1002/da.20814

Ramchandani, P. G., Psychogiou, L., Vlachos, H., Iles, J., Sethna, V., Netsi, E., & Lodder, A. (2011). Paternal depression: an examination of its links with father, child and family functioning in the postnatal period. Depression and Anxiety, 28(6), 471–477. doi: 10.1002/da.20814

Article written with Charmaine Leong. Charmaine is a psychology undergraduate from the National University of Singapore (NUS). Charmaine is an aspiring clinical psychologist who is passionate about raising awareness of mental health issues in Singapore. She is currently on internship with ImPossible Psychological Services under the supervision of senior clinical psychologist, Haikal.