Breaking the Silence on Paternal PPD

Parenthood is a time of adjustment and ongoing change in identities, responsibilities, routines, and relationships. While this is often paired with feelings of excitement and happiness, it may also come with increased stress, fear, and anxiety. The experience of this transition itself, along with the well documented hormonal changes that occur in both men and women following the birth of a child and throughout the first year of life, puts new parents at risk for mood disorders, amongst them depression and anxiety, in the months to years following childbirth.


Many have heard of maternal postpartum depression (PPD). Maternal PPD is a health condition that is commonly discussed in the media, childbirth education, and throughout the entirety of maternity care. But, did you know that new fathers can experience depression in the postpartum time period as well? Shockingly, evidence suggests it occurs in rates not that dissimilar to new mothers. It is estimated that in the United States up to 1 in 4 new dads suffer from postnatal depression. Despite this, paternal postnatal depression is still not widely recognized, researched, nor understood resulting in many new fathers suffering in silence. Similar to maternal PPD, there is a significant amount of evidence suggesting that depression in men during the postnatal period is associated with numerous adverse childhood outcomes, linked to later cognitive, emotional, and developmental delays. Because of this, the sheer lack of awareness of paternal postnatal depression, and my experiences first hand with new families at Minnesota Birth Center as a student nurse intern, paternal postnatal depression became a significant interest of mine and the key topic of my scholarly work.

What are the known risk factors for paternal postnatal depression?

In addition to known risk factors for traditional depression, there are numerous risk factors directly associated with the development of paternal postnatal depression. The most widely supported of these include:

  • Lack of social and emotional support from partner
  • Partner is suffering from a postpartum mood disorder
  • Poor quality and perception of marital relationship
  • A previous history of a mental health disorder
  • Poor physical health
  • Pregnancy or birth-related distress
  • Low income and/or current unemployment status
  • Difficult infant/child temperament or behavior  

What are the signs and symptoms of paternal postnatal depression?

While many of the symptoms of paternal postnatal depression may be similar to those seen in mother’s, men also manifest unique symptoms that often go unrecognized, including:

  • Irritability
  • Anger/outbursts
  • Inability to make decisions
  • Isolating or withdrawing from relationships
  • Self-criticising
  • Impulsivity
  • Avoidance behavior
  • Risk taking behaviors, which may include turning to substance abuse or violent behavior
  • Suicidal thoughts

What resources and support are available to new fathers and their families in our community?

For new dads, there are many different types of support may help to ease the transition process to fatherhood.

  • Evidence suggests that one of the most effective supports for both new moms and dads comes from their partner. Finding opportunities to engage in active discussion about mental health with your partner prior to the birth of a new baby can help to promote the couples involvement in parenting together. Sharing parenting roles with your partner may help to decrease feelings of paternal isolation from the mother-infant relationship.
  • Prenatal education programs in the community help fathers better understand their expected roles. These programs are found to be most effective when the content of the program revolves around both parents and when both parents attend together.
  • Postpartum Support International (PSI) is an organization whose mission is to promote awareness, prevention, and treatment of mental health issues related to pregnancy and postpartum. Their website, http://www.postpartum.net offers numerous resources for new or expecting parents.
    • PSI offers a “DADS Chat with an Expert” on the first Monday of every month at 7pm. This is a free call-in forum for dads facilitated by a perinatal mood disorder expert, Daniel B. Singley. To participate, simply call 1-800-944-8766, code 73163#.
    • Created by the coordinator of PSI, www.postpartumdads.org is an online forum to help dads and families by providing firsthand information and guidance. Postpartum Dads offers a private online dads support group via Facebook. If you would like to be part of the Postpartumdads Facebook group please send a request with your Facebook name to info@postpartumdads.org.
  • Pregnancy and Postpartum Support Minnesota, is a group of mental health and perinatal practitioners, service organizations, and volunteers who provide support, advocacy, awareness, and training about perinatal mental health in Minnesota. This website also offers a “find a provider” tool in which you can enter your zip code, and all mental health and perinatal providers in your area will appear. Their website can be located at http://www.ppsupportmn.org/
  • National Alliance on Mental Illness Minnesota (NAMI) is an organization that is dedicated to improving the lives of child and adults with mental illness. NAMI MN, offers more than 500 free classes and over 70 support groups. Their website can be located at http://www.namihelps.org/

The most important thing to remember is if you’re a new dad with paternal postpartum depression, you’re not alone! Everyone at Minnesota Birth Center sees you and supports you!

Savanha Winkel, RN, is a Clinic Nurse and Birth Assistant at MBC. She devoted her nursing school research to the topic of paternal postpartum mental health. She’s proud to be part of the MBC team in supporting all parents in the postpartum period.

References
Anding, J. E., Röhrle, B., Grieshop, M., Schücking, B., & Christiansen, H. (2016). Couple comorbidity and correlates of postpartum depressive symptoms in mothers and fathers in the first two weeks following delivery. Journal of Affective Disorders, 190, 300-309. doi:10.1016/j.jad.2015.10.033
Bergström, M. (2013). Depressive symptoms in new first-time fathers: Associations with age, sociodemographic characteristics, and antenatal psychological well-being. Birth: Issues in Perinatal Care, 40(1), 32-38. doi:10.1111/birt.12026\
Biebel, K., & Alikahn, S. (2016). Paternal postpartum depression. Journal of Parent and Family Health, 1(1), 1-4. Retrieved from http://escholarship.umassmed.edu
Don, B. P., & Mickelson, K. D. (2012). Paternal postpartum depression: The role of maternal postpartum depression, spousal support, and relationship satisfaction. Psychology: Research and Practice, 1(4), 323-334. doi:10.1037/a0029148
Goodman, J. H. (2004). Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of Advanced Nursing, 45(1), 26-35. doi:10.1046/j.1365-2648.2003.02857
Melrose, S. (2010). Paternal postpartum depression: How can nurses begin to help? Contemporary Nurse: A Journal for the Australian Nursing Profession, 34(2), 199-210. doi:10.5172/conu.2010.34.2.199
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA: Journal of the American Medical Association, 303(19), 1961-1969. doi:10.1001/jama.2010.605
Philpott, L. F. (2016). Paternal postnatal depression: How midwives can support families. British Journal of Midwifery, 24(7), 470-476. doi:10.12968/bjom.2016.24.7.470
Pinheiro, R. T., Magalhães, ,P.V.S., Horta, B. L., Pinheiro, K. A. T., da Silva, ,R.A., & Pinto, R. H. (2006). Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil. Acta Psychiatrica Scandinavica, 113(3), 230-232.
Rosenthal, D., Learned, N., Liu, Y., & Weitzman, M. (2013). Characteristics of fathers with depressive symptoms. Maternal & Child Health Journal, 17(1), 119-128. doi:10.1007/s10995-012-0955-5
Roubinov, D. S., Luecken, L. J., Crnic, K. A., & Gonzales, N. A. (2014). Postpartum depression in Mexican American fathers: Demographic, cultural, and familial predictors. Journal of Affective Disorders, 152-154, 360-368. doi:10.1016/j.jad.2013.09.038

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