Male postpartum depression describes when a new father experiences postpartum depression (PPD). Although PPD is more often diagnosed in the female birthing parent, men can also experience it. Some research suggests that 8-10% of fathers experience PPD. Other estimates are even higher.
PPD causes major depressive disorder (MDD) in new parents after the birth of their child. Male PPD, also called paternal postpartum depression, shares symptoms with female PPD, including persistent depressed mood and insomnia. You may also experience irritability or indecisiveness.
Understanding the symptoms and causes of male postpartum depression, as well as what you can do if you’re experiencing it, can help you feel better.
Postpartum depression is a condition involving symptoms of major depressive disorder that you experience within the first year of your child’s life. Symptoms of male PPD most often peak 3-6 months after the baby’s birth.
The specific symptoms can vary by person. Your healthcare provider may diagnose you with male PPD if you experience at least five of the following symptoms for at least two weeks:
- Depressed mood, sadness, or hopelessness most of the time on most days
- Apathy, or a loss of interest in activities
- Unintentional weight loss or changes in your usual appetite
- Trouble falling or staying asleep or sleeping too much nearly every day
- Fatigue, lethargy, restlessness, agitation
- Inappropriate guilt or worthlessness
- Indecisiveness or reduced ability to concentrate or think
- Recurring thoughts about death or suicide
Female vs. Male PPD Symptoms
Male PPD is more likely to cause irritability, agitation, and difficulty making decisions than female PPD. You may notice hostility and feelings of hopelessness, frustration, or cynicism.
People with male PPD may also be more likely to withdraw from relationships and take part in activities like alcohol consumption, drug use, gambling, or overworking to escape or cope with their feelings.
Postpartum depression arises due to a combination of genetic, biological, and environmental factors. Rather than having a singular cause, male PPD may be triggered by a range of factors.
Hormonal Changes
Hormonal changes may play a role in male PPD. During and after your partner’s pregnancy, estrogen levels increase while testosterone levels decrease in men’s bodies.
Research suggests this hormonal change may help promote bonding with your child by reducing aggression and increasing helpful responses to the baby’s crying. Researchers also found these changes may raise the risk of male PPD.
A Partner With PPD
Research suggests that maternal postpartum depression can be a strong predictor of male PPD. In other words, having a partner with PPD greatly increases your chances of developing it, likely because the emotions of one partner can affect the other.
Personal or Family History of Depression or Anxiety
If you have or have had anxiety or depression in the past, it may raise your risk of PPD after the birth of your child.
There may also be a genetic component. Research suggests that having parents with a history of anxiety or depression can also increase your chances of developing male PPD.
Sleep Deprivation
For many new parents, having a baby means you’re not getting enough sleep. Sleep deprivation can affect your mood and executive function (ability to concentrate and plan), and it significantly raises the risk of depression.
Expectations To Provide
Your own expectations about your role in parenthood can add stress. For example, if you believe it’s your job to secure finances or provide for the family, that may feel like a lot of pressure. This stress may raise your depression risk over time.
Relationship Troubles
The stress of parenting can lead to more disagreement and conflict between parents, which may contribute to depression, especially if there’s abuse and violence at home. New parents may have less or no sex, which can also be a factor in PPD.
On a related note, a history of physical, sexual, or emotional abuse also raises risk.
Other Risk Factors
A range of social factors can also increase PPD risk. The chances of developing depression are higher for those experiencing:
- Poverty or low income
- Lack of social or family support
- Unstable housing
- Unintended or unplanned pregnancy
- Older age
- Unemployment
- Lower level of education
Your healthcare provider may diagnose you with male PPD by evaluating your medical history and asking about your symptoms.
When asking about symptoms, they may use standard scales, such as the Edinburgh Postnatal Depression Scale (EPDS), that are specifically designed to detect PPD. In these tests, the provider asks questions and rates responses based on your report.
If you think you have PPD or are at risk for it, the most important step is to acknowledge the issue and get help, even if you’re hesitant to seek support. Treatment can help you feel better. Specific approaches to treatment may vary based on your individual case.
Medications
Healthcare providers may recommend antidepressant medications for male PPD. Common options include:
- Selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) or Lexapro (escitalopram)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Effexor XR (venlafaxine) or Cymbalta (duloxetine)
- Tricyclic antidepressants, such as Elavil (amitriptyline) or Pamelor (nortriptyline)
Counseling and Therapy
Your provider may recommend counseling and therapy, which can play a central role in managing male postpartum depression. Used for other types of depression, researchers have found several approaches particularly effective for PPD:
- Parenting classes: Parenting classes may help you address any stress, feelings of inadequacy, lack of control, poor self-confidence, or aggravation you may be experiencing. The classes are also a source of social support.
- Cognitive behavioral therapy (CBT): CBT involves developing relaxation methods and working to retrain your thinking about your emotions and stress. This can happen in individual, couple, or group sessions with a therapist.
- Interpersonal therapy (IPT): This therapy focuses on the relationships in your life and the impact your thoughts and feelings can have on people in your life. Sessions of IPT help you understand how your relationships may affect your depression. You also develop strategies to improve how you interact with others.
Transcranial Magnetic Stimulation
In severe cases of postpartum depression that don’t respond well to other treatments, providers may recommend a procedure called transcranial magnetic stimulation (TMS). TMS relies on magnetic fields directed to parts of the brain associated with depression, changing the electrical activity there.
TMS involves 4-6 weeks of daily treatments and is relatively well-tolerated and safe. However, more research is needed to assess its effectiveness for PPD in particular.
The effects of male PPD may cascade through the whole family, potentially influencing child development and family dynamics. Complications of PPD that goes without proper support include:
- Family stress: Research has noted that paternal PPD can lead to increased levels of stress within the whole family, affecting relationships with partners and children.
- Lack of bonding: In the postpartum period, hormones and behaviors (like skin-to-skin contact) allow infants and parents to develop a special bond. Male PPD can get in the way of this process, which may impact the relationship that forms between you and your child.
- Increased risk of physical abuse: Researchers have recorded a higher rate of child spanking or other physical discipline or abuse among people with a history of male PPD. This can lead to mental health issues for the child.
- Emotional regulation issues: Children of parents with PPD are more likely to have trouble regulating their emotions, leading to increased outbursts, tantrums, and other episodes.
- Conduct disorders: Children of people with male PPD have a 33-70% greater chance of mental health or behavioral disorders characterized by outwardly aggressive behaviors and consistent disobedience.
- Attention-deficit/hyperactivity disorder (ADHD): Paternal depression can raise the risk of ADHD in the child. ADHD can cause difficulty concentrating, poor impulse control, and increased and erratic activity.
Postpartum depression is typically considered an issue for mothers, meaning fathers may be less willing to admit they have an issue and more hesitant to seek support.
To cope with PPD—and even prevent it from happening—fathers need to be proactive. Strategies that may help include:
- Get enough exercise, aiming for at least 30 minutes a day of light to moderate activity
- Get enough sleep by going to bed and waking up at consistent times every day
- Eat nutritious, well-balanced meals
- Avoid alcohol, drug use, gambling, or other high-risk behaviors
- Talk to a trusted person or loved one about your feelings, and communicate how you feel to your partner
Male postpartum depression (PPD) is a condition involving persistent depressed mood and behavioral changes new fathers can develop after the birth of a child.
Male PPD, though often underrecognized, is quite common. Symptoms include aggressiveness, depressed mood, and withdrawal from family life.
Left untreated, male postpartum depression can impact family dynamics, partners, and children. Treatments for male PPD vary and are similar to those for major depression. Lifestyle changes and social support can also help you prevent and manage male PPD.
