Postpartum Depression and Anxiety… in Fathers?

Children are a heritage from the Lord, offspring a reward from him. Like arrows in the hands of a warrior are children born in one’s youth. Blessed is the man whose quiver is full of them. — Psalm 127:3-5 NIV

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Becoming a father is one of the most wonderful experiences in a man’s life. Whether you have a son to carry on the family name or a daughter who you pray will be a daddy’s girl, your fatherhood future looks so promising. But even the most naïve of pending papas know that there will be a lot of diapers, sleepless nights, diapers, crying, diapers, exhaustion — oh, and more diapers. What many men do not anticipate is the potential for significant changes to their mental health.

Prenatal and postpartum depression and anxiety are among the most common mental health issues that arise during the transition to fatherhood. Often, we think of the “baby blues” as being an issue only moms struggle with. However, research has shown that upwards of 26% of new fathers experience depression, and 11% experience anxiety during the perinatal period.

Until we make substantial headway addressing the underlying causes of these issues and implement proper screening and intervention, fathers will continue to be depressed and anxious while simultaneously trying to care for their families.

Biological Changes

Mothers clearly exhibit physical changes before, during, and after pregnancy. This is not surprising given the act of growing a human. However, dad bods aside, men experience actual biological changes throughout the pregnancy and following the birth of their child. Namely, testosterone, dopamine, and oxytocin — the Big Three ingredients to bake a loving and doting father.

Testosterone comes with a reputation as the backbone of masculinity — aggression, Type A, domineering, sex-seeking personalities. There is much more to testosterone than the traits of the “bad boys.” Significant changes in testosterone occur when a man becomes a father. Specifically, testosterone decreases just before and right after birth. This decrease has been associated with increased caregiving and child-related household tasks.

Men can also expect to have increased bonding hormones, such as dopamine and oxytocin, as the levels of testosterone dip. This helps us fellas be more attuned to the baby’s cries and bond emotionally with our bundle of joy. This continues well after birth; this is particularly helpful as fathers tend to emotionally bond with their children later than mothers.

Our brains change too when we become a father. Areas of the brain associated with attachment, empathy, and nurturing show an increase in gray and white matter within four months after birth. These areas in the brain actually increase in size.

Psychological Changes

Depression and anxiety are very common mental health issues, particularly for mothers during the postpartum period. However, we are overlooking fathers on a societal level, in the delivery room, and in the nursery. Let’s take a look at what depression and anxiety in newfound fathers looks like.

Symptoms of postpartum depression in fathers include:

• Sadness, anger, emotional outbursts, or irritability
• Little interest in doing things, including caring for their family
• Reduced attention to the baby’s health and well-child visits
• Changes in motivation, energy, sleep, and/or appetite
• Feeling worthless as a father
• Suicidal thoughts
• Withdrawal from their relationship with their spouse or child
• Physical symptoms such as racing heart rate, panic, gastrointestinal distress, headaches, nausea
• Poor ways of coping with stress, such as an increase in drugs, alcohol, gambling, or working too much

Symptoms of anxiety in fathers include:

• Excessive and persistent worry about their child, relationship, and life in general
• Fears of doom or that something bad will happen to them or their new family
• Trouble focusing
• First onset or increase in panic attacks
• Troublesome and/or fearful intrusive thoughts

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Social Changes

Many of the reasons men struggle during the postpartum period include drastic changes to their social lives. Similar changes are often observed when a man gets married. Single men tend to have mostly single friends, and when a man gets married tension can arise about whether to bring his bride along. Even if a man’s friends are okay with it, her presence does have an impact.

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When a man becomes a father, typically they are so invested in caring for their child and their growing family, calls, and texts from friends go unanswered as friendships get overlooked. The window of free time a new father would have given to dudes' night out has all but closed.

Marital relationships often change after the baby comes as well. Although couples often feel closer initially, this honeymoon period wears off after about a month when the sleepless nights begin to feel permanent and childcare chores pile on top of already neglected household chores.

Let’s not forget that having a baby puts the wrong kind of kink in your sexual relationship. The OBGYN you both (hopefully) liked is now telling you to hold off on the sex. Although it might feel like it will never end, sex after baby most often returns.

Resources for Fathers

One of the best things you could do as a new father who is experiencing distress leading up to or following the birth of your child is to talk to someone about it. Talk to your spouse, friend, pastor, counselor, psychologist, pediatrician — someone you trust.

Postpartum Support International (PSI) is a good online resource that includes a call or text hotline and an online Dad Support Group.

If you are ready to commit to something more in-depth, Psychology Today's online directory is a quick way to find treatment facilities in your area.

Resources for Mothers

Mothers can be incredibly helpful for fathers who are struggling with any sort of postpartum mental illness. Mommas – please know that you are not responsible for fixing it or making it all go away for him. However, you know your husband enough to know when he needs to speak with a professional. Give him a push!

Resources for Physicians

OBGYNs should be the first line of defense for screening against depression for both parents. The American College of Obstetricians and Gynecologists recommends completing full assessments for mood and emotional wellbeing during each postpartum visit with the mother-to-be. However, given that both mothers and fathers experience depression during his wife’s pregnancy, these screenings should be happening earlier on in the transition to fatherhood.

Pediatricians are also next in line for screening for postpartum mental health issues. The America Academy of Pediatrics also recommends incorporating screenings postpartum during well-child visits.

In addition to incorporating mental health screening protocols for both parents before and after their child’s birth, OBGYNs and Pediatricians should develop strong working relationships with referral sources. Having trusted psychologists, counselors, social workers, and pastors to who they can refer struggling parents is essential in ensuring the mental health issues described above do not negatively impact their own or their child’s physical and emotional wellbeing.

To find a therapist, please visit the Psychology Today Therapy Directory.