Men who have a history of mental health conditions are at higher risk for postpartum depression.
Life was good for Kevin Shafer in 2008. The then-27-year-old was launching a career in academia, married and expecting his first child. He had a history of , but it was under control. “I was in a good place,” he says.
Then, his wife gave birth to their son.
“I saw him in the hospital room, and I freaked out,” recalls Shafer, an assistant professor of social work at Brigham Young University. “All of a sudden, I felt a lot of pressure to be good in my job, to be good as a dad, to be a good husband. All of those things just sort of overwhelmed me at the same time.”
In response, Shafer froze. “This is supposed to be one of the happiest moments of your life and … I was very withdrawn,” he remembers. “Scared to hold him, scared to do anything. Just paralyzed.”
Studies suggest that 5 to 10 percent of new dads experience depression, compared to about 15 percent of . Other suggests that new dads’ depressive symptoms increase an average of 68 percent during the first five years of their child’s life.
“It used to be thought that postpartum depression was largely a biological and hormonal process that affected only women,” says David Diamond, co-founder and director of the Center for Reproductive Psychology in San Diego. “But we know really that’s not true – it’s not true of women either. There are biological, psychological and social factors.”
‘Suffering Silently’
Men with histories of mental health conditions are at higher risk for after becoming a father, but for some new dads, “that lack of sleep and lack of control and lack of a routine is enough to just kind of tip them into a depression,” says Dr. Craig Garfield, an associate professor in pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine, who led the Pediatrics study on depressive symptoms.
Parents who have multiple roles – say, being both a biological father and a stepfather – have an increased risk for developing depression too, according to a 2013 of more than 6,000 families. Stepdads with a new child and biological child who doesn't live with them have the highest risk, the study found.
“They felt particularly pulled in different directions because there aren’t a lot of norms surrounding being a nonresidential biological father,” says Shafer, who led the study.
New dads can also be vulnerable to depression because they often lack the type of social support more common among women. “People will come up to [pregnant women] on the street and ask them how they’re doing and reminisce about their own pregnancies and things,” Shafer says. “Dads don’t often have that. Dads can be … suffering silently because there’s no outward manifestation of this pregnancy.”
For Diamond, that reality hit home when his for the first time about 20 years ago. Friends would occasionally tell him childbirth horror stories – and then follow them up with, “Don’t tell your wife – it may upset her,” Diamond remembers. They rarely considered that it might upset him, too.
“There’s kind of a lack of awareness on the part of potential support systems,” says Diamond, a clinical psychologist who specializes in parenting issues. “And the lack of support in general can make men more vulnerable to stresses and depression and other problems."
The Roadblocks to Seeking Help
You’ve heard that men never ask for directions. “Now apply that to their actual lives,” Shafer says. “That sort of gives you an idea of what we’re dealing with.”
In other words, getting men to recognize and is a tall order. “Men have a great sense of shame about seeking help, and in their efforts to seem tough and in control, they feel that they should be able to handle everything,” says Diamond, whose male patients predominantly come to him because their wives or another woman sent them.
A new father might also feel like wallowing in his own troubles is selfish, particularly at a time when he believes his role is to support his wife and child. “I think a lot of dads feel like, ‘Well gosh, I didn’t even go through the childbirth – how can I even complain?’” Garfield says.
To make matters worse, medical and mental health professionals often overlook postpartum depression in men since their symptoms don’t always look the same as women’s, Shafer says. “When we think about symptoms of depression – feelings of worthlessness, [feeling] blue or even somatic symptoms like restlessness or sleeping a lot or changes in appetite – those aren’t necessarily ways that men manifest depressive symptoms,” he says.
Instead, men are more likely to feel irritable or angry, , or avoid the family by spending more time at work or with friends. “Within the context of having kids, that becomes a very serious concern,” Shafer says.
Getting Past the Blues
Just a couple months ago, Shafer’s wife gave birth to their fourth child. This time, “it was a much better experience,” he says. Why? Therapy, for one, but also talking to friends who are also dads. “I’ve come to learn that’s a pretty unusual thing for guys to actually talk about their feelings around those sorts of moments, but it was really, really helpful for me,” Shafer says.
Shafer also took a week off work – about all he could manage in the middle of a semester – and committed to going to the office later and leaving earlier in order to spend more time with his family. “A lot of dads want to be available and want to have that sort of bonding time with the children as well, and … I think it actually would help with issues of depression and stress,” he says.
Shafer may be onto something. According to Diamond, men often keep their distance because they don't feel like there's much space for them to get involved at home, even though they want to. Moms can help by making a point to give dads one-on-one time with their kids, he says. "Men develop better relationships and get more involved when the mom is actually out of the home."
Garfield recommends dads go to their baby's doctors’ appointments – both so they can ask questions about their and interact with a health care provider who hopefully is tuned into mental health issues among parents. Even better? If they also , who can screen for depression and direct them to more specialized care when needed.
“Dads are really more involved with kids and families than they really have ever been before,” Garfield says. “I don’t think this is a blip – I think this is a new reality. And the more we can support dads in their world, the better off their families.”