How to Recognise the Signs of Paternal Postpartum Depression

“I’m just sick of feeling worthless,” I said, my head in my hands and holding back tears. I had spent the entire day in bed, the result of a panic attack at work the day before. In addition to feeling paralysed by the sadness that permeated my life, my body was too sore to move.

I couldn’t understand why this was happening. Months ago, our second son came into the world happy and healthy. But I was feeling overwhelmed. The job I’d held for over a decade was no longer secure, and I was trying to get my freelance career off the ground.

Society taught me that fatherhood would be a joyous time, and I should be proud of bringing a new life into the world. But since I became a dad, I was feeling anxious and depressed, dealing with overwhelming attacks of anxiety. I had run my fifth marathon a few months before taking on the job title of father. Now I had gained back all the weight I’d lost while training for it — and then some. I was carrying a lot of guilt for feeling this way, and my thoughts occasionally drifted into dangerous territory.

I realise I’m not the only parent who has experienced this mix of emotions. Thanks to increased research and celebrities like Reese Witherspoon and Chrissy Teigen opening up about their experiences, postpartum depression in women has become more widely understood. But as men have stepped up more into the role of caregivers, paternal postpartum depression (or paternal PPD) has only recently become more widely known.

What is paternal postpartum depression?

According to some studies, nearly 10 per cent of new fathers experience depressive behaviour after the birth of a child. And often, these men are scared to speak up because they don’t want to look weak or add anything to the plate of their already exhausted and emotional partner.

“For males, it’s hard to recognise the symptoms of depression,” says Dr. Scott Bea, a psychologist at the Cleveland Clinic. “They can start as soon as the first trimester of pregnancy, because things are already starting to change.”

It’s not only the shifts in sleep patterns and relationship dynamics that can cause symptoms of paternal PPD. Bea says other underlying issues — marital problems, financial pressures, a history of depression, or having a partner who’s experiencing postpartum depression or had a troubled pregnancy — can exacerbate symptoms.

I was experiencing some of the challenges Bea mentioned. But he also believes that for some men, these sudden mood changes could also be biological. I was frustrated I wasn’t feeling a connection with my son, and I’m not alone: Men often feel a connection with their newborn intellectually but not emotionally, at least initially, and the bond may form more slowly over time. And there are hormonal shifts happening inside the father’s body, too.

“There is a decrease in testosterone, which can play a role in depression in males,” he says. “Other hormones such as estrogen and prolactin, which are more prevalent in females but exist in males, go up. Cortisol, which is a stress hormone, is escalating.”

When stressors increase, it’s common for males to mask how they’re feeling instead of seeking help. This behaviour can lead to reckless behaviours like alcohol and substance abuse, gambling, or becoming involved in relationships outside of the partnership. And there is research that shows depressed fathers are more likely to withdraw from their children or become more critical of them.

“If individuals are not managing their emotions, that can interfere with what’s going on with the child,” Bea says. “If we are not responsive and active and energised as a parent, it’s getting programmed into the child, and they cannot fend that off.”

Despite feeling sad, irritable, agitated, worthless, or guilty, men often don’t want to burden a friend or partner despite how damaging their behaviour can be to their family. And when men do speak up about what they are experiencing, they’re often told to “stop whining” and “man up,” implying they are selfish for how they are feeling. That may be because many are unaware that paternal PPD exists and has recently garnered attention in medical and psychological circles. Bea himself remembers how overwhelmed he felt when becoming a father.

“I remember being stressed and not knowing what to do,” he says. “When I had children, there was no mention of postpartum depression in males.”

How to recognise and treat paternal postpartum depression

In addition to speaking with a professional, there are ways fathers can recognise and help treat the symptoms of paternal PPD. Despite the fatigue and sleep deprivation that most new parents experience after childbirth, Bea recommends making a schedule and setting aside time to be active. He also suggests learning to identify the signs and symptoms of paternal PPD and speaking with other dads to foster connection and camaraderie.

And if you’re someone who recognises symptoms of paternal PPD in your partner, Bea recommends gently approaching them about it to avoid them feeling confronted or attacked.

“People generally don’t like unsolicited advice, and I think if you can ask permission so they don’t feel ambushed and can monitor their reaction to it and see if that’s a viewpoint that’s shared,” he says. “It can injure the partnership if it isn’t addressed properly.”

Men whose partners show symptoms of postpartum depression are at increased risk themselves. Bea says it can be beneficial for both parents to visit an expert for an assessment.

And if a father believes he is suffering from paternal PPD, it’s normal to feel anxious about seeking help — but fathers shouldn’t feel ashamed to speak to a professional.

“Going to see a professional is frightening for us, but when you’re actually there, it can feel like the safest place you’ve ever been,” Bea says. “Therapists are trying to create an environment of absolute safety.”

Several weeks after I sought treatment and became reacquainted with my running shoes, my family noticed I was starting to get back to my old self. The panic attacks I’d been having were almost non-existent, and I was a little more confident in myself as a father. Now, I have a stronger connection with my boys, and I feel joy being with my family.