More than the daddy blues: Paternal Postpartum Depression
How familiar does this sound? “I was so excited during the whole pregnancy. I went to almost all of the doctors’ appointments and ultrasounds with my wife, and read as much as I could. When our baby was delivered, I was psyched. I was worried, but felt I could get things under control. A couple of weeks after we came home, I lost it. I just snapped. I couldn’t take it anymore and lost control of myself. The time I was hoping would be the most magical of my life became a disaster.”
This very likely describes you or any other new father. Awareness of Postpartum Depression and the lesser version, the baby blues is way up recently, but most new parents, friends, family, and even many health care providers aren’t aware that new fathers are almost as likely to experience anxiety or depression as well. Paternal Postnatal Depression, or PPND is a serious condition and can be just as frustrating and potentially harmful to the father, mother, and children. Monday October 10 is World Mental Health Day. This year, let’s spread awareness of this poorly understood condition that can ruin what should be the best time of a new dad’s life.
According to studies, as many as 25% of fathers experience PPND, typically in the first six months of their children’s lives, with occurrences peaking between three and six months. During this period, depression scores increase up to 68%. At one in four fathers, this means about 3000 men experience symptoms every single day. Perhaps even worse is that for the spouses of women experiencing some level of Postpartum depression, as many as 50% exhibit signs of PPND. This is particularly problematic as it means both parents are not themselves and potentially causing long term harm to familial bonds and development.
It isn’t just the fathers who are affected. The effects of PPND reach the entire family. Children with parents who exhibit symptoms of depression or anxiety are more likely to have delayed developmental milestones, more social issues, and increase propensity for risky behavior such as alcohol and drug use. For the mother, wives of fathers with PPND are more likely to develop anxiety or depression themselves. They are also more likely to separate before the children reach adulthood and to exhibit relationship issues. Children who are raised through such relationship issues are more likely to experience such issues in their adult lives as well.
PPND is only recently beginning to be better understood, but the causes appear to be related closely to those of Postpartum Depression, namely hormones and stress. Everyone understands the effects and expects the hormone drop that mothers experience pre and post birth. Most people don’t know that men often experience a similar, though less extreme buildup of hormones and drop after birth. This drop results in higher levels of anxiety and depression and a general feeling of being low. Combined with the almost certain sleep deprivation and increased stress levels, the brain chemistry is highly disrupted with new children in the father’s life.
Stress levels are also increased through many factors in the first six months for a father. At home, the first six months are a constant experience of new anxieties and stress factors. Feeding, schedules, amount of sleep, amount of naps, development milestones, and weird diaper stuff all seem to crop up as new concerns the second a parent thinks they finally have a handle on things. Around this time, babies also tend to get their first cold, start teething, and possibly experience reflux or colic, adding to an already stressful situation that has disrupted life as it was known. Stress may also increase at work as fathers have to figure out how to find balance in new and unexpected ways while still worrying about providing for their family. In this period, many mothers also go back to work, adding to stress about the daytime care for the child. The father also often experiences a feeling of being less connected to their child than the mother and a loss of connection to their spouse as the child takes more attention. Balancing all of these stress factors can take an immense toll on fathers.
The way men react to and process this stress can vary dramatically. Some may be totally fine and show no signs. Many will exhibit some signs of anxiety, perhaps with increased irritability or becoming more withdrawn. This is commonly called the daddy blues. This is more common and less intense than PPND, but if not addressed, can lead to PPND. With PPND, men may reach points of increased irritability to the extent where they become angry or incensed easily. They may also show signs of sadness and quietness, extending even to a feeling of worthlessness. With these feelings, many may turn to riskier behavior as an outlet, increasing alcohol and possibly drug use. Others may compensate by immersing themselves further in work, extending hours and spending even less time with their family.
For symptoms of the daddy blues, the easiest remedies are getting more sleep, exercise, and social interactions, particularly with friends. The importance of sleep is coming back into focus recently with Arianna Huffington leading the charge with her book and initiative. More sleep can lead to better general moods and an increased resistance to stress. Exercise and especially the endorphins that come with it can also help destress, extending even beyond the exercise session and throughout the day. The time dedicated to oneself can also be an effective outlet to process and prepare for the day as well as to take time just for oneself. Interacting socially with friends can have similar benefits, providing positive brain chemicals that help with stress and anxiety and providing time away from the stress and rigors of childcare.
Men typically have less options to simply talk about their fears and problems. A certain stigma prevents most men from expressing their worries and anxieties to other men, especially at work and with friends. Many men also just feel generally less comfortable discussing their non-work life at work. It’s fairly rare for men to discuss family and home life at work. Many men also forget the stress and anxiety of the first few months so even those who have been through similar experiences may not be very helpful to talk to. Due to the lack of knowledge around PPND, most men experiencing it will think it is just them and not a common mental health issue, so won’t seek help. Even worse, other men may even make the father feel worse for having such feelings. Because of these, the father may make things worse by feeling guilty for having such thoughts and feelings and not being a perfect father. This just adds to the anxiety and depression.
While depression is a nightmare for anyone, it can be particularly bad for men as many health care professionals don’t know much about PPND. Mothers at least are now beginning to be tested for depression symptoms at OB appointments and even in the hospital after delivery before being discharged. While much more can be done still, at least mothers are given questionnaires to help identify behavior that may indicate depression. Men are not given any such information and have to actively know to seek it on their own. They are also not educated about the commonality of PPND and thus feel like they may be alone in their feelings.
The best way to solve these issues is to talk to a professional. In some cases medication may be needed, but often just having some one professional to talk to can make a huge difference. If you or someone you know may be experiencing these thoughts or feelings, they can take a short assessment online to determine their risk of PPND. At that point, they should consult a health care professional. There are many resources online that can help find help. Start here. http://www.postpartummen.com/ppnd.htm
If you are a dad experiencing these symptoms, know you are not alone out there. A huge number of dads experience some or all of these symptoms early in their children’s lives. Don’t be afraid to ask for help.