Can men get postpartum depression?

During the COVID-19 pandemic, Tracey McInnes offered new parents an online couples’ postpartum support group. As coordinator of the IU Health Perinatal Mood Disorder Program Coordinator, Tracey already had a Monday moms-only group, but in the interest of offering more support during the COVID shutdowns, she thought a couples meeting would help bridge the gap between men and women talking about post-partum mood disorders, like post-partum depression and anxiety. She figured women might share more with their partners present.

She found that dads also had a lot to say.

“By having a group where they could be honest and share their thoughts, men really opened up. It was shocking how candid they were,” Tracey said. “I thought I’d have this group, and the women would talk, and the men would listen, but it was almost the opposite. There’s a lot of shame around postpartum depression, especially in men. They need someone to talk to about how they are feeling, too.”

Postpartum mood disorders, or PMADs, are the most common childbirth complication, affecting about 20% of women. But fewer people realize that about one in ten men also experience postpartum depression before or after the birth or adoption of a baby. This is usually called paternal postpartum depression.

Paternal postpartum depression (PPND)

Much like a new mother, new fathers are also adjusting to realities of suddenly having a baby. Sleep deprivation, exhaustion, financial stresses and new responsibilities can cause anxiety and depression in men in the same ways they do in women.

While most people know that women experience physical changes related to the hormonal shifts of childbirth, research shows that fathers also experience hormonal changes after the baby is born.

“Low testosterone is associated with increased depression. If a man is spending a lot of time taking care of the newborn, testosterone can drop from the increased stress and the loss of sleep and exercise,” Tracey said. “Men with high testosterone levels can still experience postpartum depression, but dads tend to experience lower testosterone levels.”

Symptoms of Paternal Postpartum Depression

Though they share some characteristics, male postnatal depression and maternal postpartum depression often show up differently. Both men and women often experience symptoms of feeling overwhelmed, sad, angry or disconnected. It’s common for men to have symptoms that show up later or appear slowly. These symptoms can also show up in unexpected ways that aren’t often noticed by healthcare providers.

Symptoms of paternal postpartum depression can include:

• Sudden outbursts of anger
• Participating in risky behaviors
• Avoiding the home
• Lack of concentration
• Irritability

Not only can these symptoms appear differently in men and women, but postpartum mood disorders in men are often brushed off or assumed to be something else.

“A lot of times we see men who are depressed who don’t want to come home after work– they work extra hours or go to the bar or a friend’s house to play videogames after work. It’s an escape,” Tracey said. “We’re quick to assume that these men are immature or avoiding their responsibilities. People say they just need to ‘man up.’ But what if he’s that one in 10? Would we support him differently or ask some questions before we make that assumption?”

Men are more at risk for paternal postpartum depression if they have:

• A personal or family history of depression or anxiety
• A partner with anxiety or depression
• Financial burdens
• A lack of sleep
• Relationship problems with their spouse or partner
• A lack of social support or close friends

Oftentimes, men can feel invisible in the postpartum period, with so much time and attention–including their own– focused on mom and baby. And without help or support, these men struggle to be healthy and available for their families, just like women with perinatal mood disorders.

Addressing the invisibility of paternal postpartum depression

With so little awareness about paternal postpartum depression, it can be difficult to identify and support these new fathers. Addressing male mood disorders is very similar to helping women with postpartum mood disorders: encouragement and support are key.

Shame prevents many men from asking for help when they feel overwhelmed. It can be helpful to create safe spaces for new dads to talk with other men or couples who are going through the same thing. Postpartum support groups may provide this kind of place for men to share experiences and find new ways to cope. Postpartum Support International provides this space for men who are struggling.

The most effective treatment for postpartum mood disorders for any parent is a combination of talk therapy, antidepressants and support groups. While there are fewer resources specifically designed for dads, it’s important for men to ask for referrals. This is how they can get connected to a psychiatrist, psychiatric nurse practitioner or other mental health professional who can advise on treatment options.

“Men need to know how treatable this is. Postpartum mood disorders can get out of control quickly if the father believes these feelings are permanent,” Tracey said. “They just don’t want to feel invisible. Being aware that this can also affect men is the best way we can support them.”