Paternal Postpartum Depression in Men: What You Need to Know

“Can dads have postpartum depression?”

“What is paternal prenatal and postpartum depression?”

We hear a lot about postpartum depression in new mothers. Those are important discussions. More recently, there is growing awareness that pregnancy and birth can trigger depression in new fathers too.

This type of depression can have a significant impact on both the father's mental health and the family dynamics. It is important to raise awareness about this issue and provide support and resources for men who may be experiencing these challenges.

What's in This Post

What is Paternal Prenatal, Perinatal, and Postpartum Depression?

Like maternal depression in moms, paternal depression can occur in dads during their partner’s pregnancy and within the first year after their child's birth.

Here's a guide to help you sort out the terms associated with depression in new parents:

Prenatal depression: Depression in a parent during a pregnancy is known as prenatal (pre-birth) depression.

Postpartum depression (PPD): Depression in a parent during the first year after the birth of a child is called postpartum (after birth) depression. Postpartum depression also goes by the shortform PPD. (Some people use postpartum depression loosely to include all pregnancy and birth related depression.)

Perinatal depression: Another term that shows up in discussions around this topic is perinatal depression which overlaps the two other terms a bit. Perinatal is the period of time from late pregnancy through delivery and into the first week after birth of a baby. (Some who use the term seem to expand the included time period well into the first year postpartum.)

The baby blues: The baby blues is notably different from postpartum or perinatal depression. The baby blues is a very common emotional period that happens between a few days before birth and couple of weeks after birth. It is short-term. Crying, irritability, confusion, and exhaustion are understandably common in new moms as they go through the extreme hormonal and life changes involved in birth.

How Common is Perinatal and Postpartum Depression in Dads?

A 2010 review of 43 paternal depression studies that included over 28,000 dads showed that around 10% of fathers get depression symptoms during their partner’s pregnancy or shortly after their child’s birth.

A similar 2020 review of depression in new dads broke the statistics down further.

Paternal prenatal depression in dads:

• 9.76% throughout the pregnancy
• 13.59% in the first trimester (three months)
• 11.31% in the second trimester
• 10.12% in the third trimester

Paternal postnatal depression in dads:

• 8.75% within the child’s first year
• 8.98% within one-month postpartum
• 7.82% one to three months postpartum
• 9.23% three to six months postpartum
• 8.40% six to twelve months

From these results we see that the highest rates of dad-related depression occur during pregnancy and the most vulnerable time is in the first three months of the pregnancy.

How Does Paternal Postpartum Depression Compare to Maternal Postpartum Depression?

Another way of stating the 10% incidence of paternal postpartum depression rate is around 1 in 10.

A National Institute of Health (NIH) postpartum depression article updated in 2022 says that around 1 in 7 new mothers experience postpartum depression.
It appears that the numbers for female and male postpartum depression aren’t as different as might be expected, especially from the lack of recognition given to paternal postpartum depression.

In their 2022 article, Fathers' experience of depression during the perinatal period: a qualitative systematic review, UK scholars who reviewed the paternal depression research of others noted that:

"Men were not eager to seek help for their feelings, in part due to prioritizing the needs of the mother (and child) as more important. There is a need for greater attention on paternal perinatal depression through research and practice."

Signs and Symptoms of Paternal Prenatal and Postpartum Depression 

Symptoms of PPD are similar to depressive symptoms that occur at other times but are associated with the prenatal or postnatal period surrounding the birth of a child.

I particularly appreciate the 2023 article on paternal depression by researchers from China and the US who recognize that symptoms of depression in men can look different than depression in women.

They describe potential male prenatal and postpartum depression symptoms as any of the following that lasts at least two weeks.

Emotional Symptoms

Men experiencing depression may encounter various emotional symptoms, such as low mood, feelings of powerlessness, overwhelm, self-criticism, loss of interest in activities, and, in some cases, even suicidal thoughts.

Physical Symptoms

Depression can manifest in physical ways as well, leading to sleep disturbances, changes in appetite, poor concentration, and reduced physical activity.

Parenting Challenges

In the context of paternal depression, some fathers may exhibit negative parenting behaviors. This can include feeling inadequate as a partner or father, resentment toward their children, or reduced interaction with them.

"Masked" Symptoms

Due to male gender-role norms and expectations, men may suppress depression-related emotional pain. That suppression of emotions can show up as substance abuse, risk-taking behaviors like reckless driving and gambling, or increased irritability and aggressive.

Risk Factors and Causes of Paternal Postpartum Depression

The life-changing experience of pregnancy and childbirth can be welcomed and joyous. It can also be challenging.

Even when pregnancies are planned and without complication, the birth of your baby can be a difficult time as it involves many changes and new responsibilities (whether it is your first child or an addition to a growing family). And pregnancy and childbirth don’t always run smoothly.

The most significant risk factor for paternal postpartum depression is the mother experiencing postpartum depression. Researchers from Cornell and Yale summarized the risk this way in their 2007 Psychiatry MMC article, Sad Dads:

"The incidence rate of paternal depression among men whose partners are having postpartum depression ranges from 24 to 50 percent . . . fathers whose partners also has postpartum depression have a 2.5 times higher risk to be depressed themselves at six weeks postnatal compared to fathers whose partners don't have depression."

There are many other potential risk factors and causes of depression in dads, including:

• sleep deprivation
• increased stress
• feeling excluded from mother-infant bonding
• changes in relationship dynamics
• lack of support
• financial pressures
• personal history of depression, anxiety, or other mental health issues
• hormonal changes (more about this in a minute)

Hormone Changes in New Dads

The hormone changes that dad’s experience may help them engage with their children. They may also make them feel less energetic and contribute to depression.

Many studies have found that men’s testosterone tends to go down when they become fathers.

For example, one study on men’s fatherhood-related testosterone levels followed over 600 single childless men for five years to compare their testosterone levels to each other and within themselves during different stages of fatherhood. They found that:

1. Men with higher testosterone were more likely to become partnered fathers.
2. Men who became partnered fathers experienced large declines in testosterone.
3. Fathers reporting 3 hours or more of daily childcare had lower testosterone compared with fathers not involved in care.

Researchers from the University of Michigan in the US examined prenatal and postpartum hormone changes in men and women from 29 first-time expectant couples. They note that the decline in father’s testosterone was seen during the pregnancy. They also found that cortisol, the stress hormone, shows similar trends within couples.

Other research shows that expectant dads who are living with their pregnant partner experience changes to prolactin and oxytocin.

How is Paternal Prenatal and Postpartum Depression Treated?

For new dads who are experiencing emotional strain it can be helpful to know that you are not alone, and that such big life transitions create lots of thoughts and emotions that you might do well to address and process.

My Building Skills to Uplevel Life: Silver Lining Emotional Intelligence Workbook can guide you step-by-step to figure out what you are thinking and feeling, help you feel less weighed down, and provide tips for boosting your mood and energy.

What you can do to help depressed dads:

Moms: Talk to your partner about what he's thinking and feeling. Engage him in co-parenting. Educate your mom friends about paternal postpartum depression. Be aware that if you have PPD, there's a good chance that he has it too. 

Family: Be attentive to providing support to both mom and dad.

Bosses: Ensure adequate paternal leave policies

Health care providers: Educate yourself and your patients about paternal prenatal and postpartum depression.

Everyone: Get the word out about how common depression is for dads during their partner's pregnancy and in the child's first year. Advocate for support groups and parenting classes for dads. 

What depressed dads can do:

• Talk to supportive friends and family.
• Exercise: As little as 20 minutes of moderate exercise can boost mood for up to 12 hours. If you can’t get out on your own or do the types of exercise you were able to do in the past, brainstorm alternatives like going for a walk with your partner and baby.
• Watch your diet: Resist junk food. Get enough protein and water. (For more quick healthy eating tips, check out my post, 7 Diet Tips for Mental Health and Wellbeing).
• Reduce demands on yourself that made sense pre-child but are overwhelming with the extra duties of fatherhood.
• Take a parenting class to help you feel more confident as a dad.
• Seek a support group, or therapy as an individual or couple. 

For a free consultation to see if we are a counseling match, fill out the contact form found here. 

Disclaimer: The contents of this post and website are not intended to replace one-on-one advice and care from personal health professionals. It is always advisable to seek the help of health care providers who can focus on the specifics of your situation. 

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