Unhappy Father's Day: Struggling Dads

 

Dads are more involved in family-life than ever before.  In just 50 years the percentage of dads attending the birth of their babies has jumped from approximately zero to 91%.  Beyond childbirth, many dads are active – physically and emotionally – in caring for their kids.   

We know that warm fathering has a direct positive impact on the short and long-term development of children (cognitively, physically, and emotionally).  Warm, active fathering also positively impacts mom’s postpartum adjustment.  Partner support has been shown to reduce the risk and severity of postpartum depression in moms.We care a lot about warm fathering, and rightfully so.  But what happens when dad is struggling himself?  When he is sad, angry, anxious, or withdrawn?  Becoming a dad can be a rewarding experience, but also a stressful and challenging time.  New dads are more vulnerable to developing mood challenges compared to men in general, yet paternal postpartum depression is underscreened, underdiagnosed, and undertreated.

Here are 4 things you should know about paternal postpartum depression:

  1. Symptoms of depression may start later in new dads than moms. 

The first 12-weeks postpartum is a high-risk time for new moms to develop mood or anxiety symptoms.  The picture may look a bit different for new dads.  The rates of paternal postpartum depression are estimated to be between 4-25%, peaking between 3-6 months postpartum.  This highlights the need for screening beyond the initial postpartum.2.  Paternal postpartum depression may look different than you think. Many men (and their partners) have difficulty recognizing the signs of paternal postpartum depression.  Although new dads may feel sad, tearful, and worthless (typically considered the hallmark symptoms of depression), they may also or alternatively be anxious, angry, moody or irritable, and frustrated.  They may appear hostile or cynical, develop drug or alcohol use problems, and have somatic complaints such as nausea, headaches, or changes in appetite.  Men may also withdraw, avoiding spending time with their baby and partner.  Some men report becoming preoccupied with work.  Men are also vulnerable to experiencing distressing intrusive thoughts that they feel unable to control.  For more information on intrusive thoughts click HERE (link to previous blog post I wrote on my website).3.  The number one risk factor for depression in dads?  You guessed it.  The number one risk factor for depression in dads is maternal postpartum depression.  The rates of paternal postpartum depression increase to 24-50% among men whose partners are depressed.  The reason for this intuitively makes sense.  When one partner experiences stress it is common and healthy to turn to the other for support.  However, when both partners experience a joint stressor (like having a baby), the couple is drained of the resources they need to support one another.   A new mom has less energy and resources available for her partner.  This is especially true if she is depressed or anxious.Other risk factors for paternal depression include a history of depression, younger age (less than 25 years), and lower socioeconomic status.  Research also suggests that there is a subgroup of men that are sensitive to low testosterone levels and therefore at higher risk for depression.4.  Treatment options varyThe treatment for paternal postpartum depression varies depending on cause and severity.  As with depression in new moms, reaching out for support can be beneficial.  This can include connecting with other dads.  Attending baby classes or hiring a postpartum doula may also help increase dad’s confidence and skills in caring for his baby, decreasing feelings of helplessness and powerlessness. 

"Research has shown that fathers may cope by learning to “take control” of a situation.  Empowering fathers to acquire baby-care skills promotes self-confidence and decreases frustration."Musser et al., 2012

We need to raise awareness – among parents-to-be, health-care providers, childbirth educators, and the general public – of the risk factors, symptoms, and treatment for paternal postpartum depression. 

A new dad may benefit from talking to his family doctor for information and support.  In some cases therapy and/or medication may be helpful in supporting dad’s mood and coping.  Looking for support?  Contact Oma to discuss psychotherapy options or reach out to Lindsay at lindsaywitton@gmail.com.

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