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When Dad’s Depressed: Pre- and Postnatal Depression in Men

Whether you’re a first timer or on your second (third, or fourth!) go around, the world of fatherhood can be a wild ride of emotions. For some men, a partner’s pregnancy, and later, the arrival of a newborn—with all the expectations, changes, and added responsibilities—can trigger more than just the usual new-dad jitters. Instead, these new dads develop symptoms quite similar to those of women diagnosed with prenatal and postpartum depression.

For many years, society viewed depression as a women’s illness influenced mostly by hormonal conditions, such as pre- and postmenstrual syndrome and menopause.

This view contributes to many men denying their depression and masking their true feelings. As a result, men are less likely to seek help for their depression and consequently experience their symptoms with growing intensity. According to the Centers for Disease Control and Prevention (CDC), an estimated 75 to 80 percent of people who commit suicide in the United States each year are men.

Many experts now believe that treatment and proper support can help allay some new fathers’ feelings of depression and confusion over their new roles. With proper education and treatment—whether through medical intervention or familial support—many men are able to successfully manage their depression.

Symptoms

The National Institute of Mental Health (NIMH), based in Bethesda, Maryland, estimates that in any given one-year period, about 18.8 million Americans will suffer from some form of depressive illness, and of that figure, three to four million men in the United States will be diagnosed with depression. The signs and symptoms of pre- and postnatal depression in men are often identical to those of typical depressive illness, and include irritability, anger, abuse of alcohol and illegal substances, low self-esteem, loss of interest in things and activities that were once pleasurable, fatigue, changes in appetite, and sleep disturbances—in addition to a lack of paternal bonding or involvement.

During the last two months of Rita’s* pregnancy with our first child, a lot of negative thoughts began consuming my mind,” recalls Thomas Howard*, a South Carolina real estate broker and now father of two. “I began to convince myself that I wasn’t going to be a good father, that I wasn’t making enough money in my job—even though I was—and that I wasn’t going to be able to handle all of the added responsibilities that first-time fatherhood brings.”

Howard further explains that as soon as these feelings became to occupy his thoughts, he began to lose weight and suffered from insomnia—something that he had never before experienced. His lack of sleep began to affect his performance at work. “My co-workers knew that something was wrong. I am a very punctual personality, but I began to come in late and started to miss showings, since I just couldn’t get myself together.”

Like many men who experience pre- and postnatal depression, not once did Howard admit that there was something wrong. “I thought that since these feelings came over me quickly, that they would disappear just the same. It was when I began to lose all interest in Emma, even after she was born, that I realized I needed to open up and get help.”

Lack of paternal bonding or involvement with the newborn are very common signs of postnatal depression in men,” explains Deborah Rich, PhD, licensed psychologist and coordinator of Pregnancy and Newborn Loss Services at Fairview Health Services, Minneapolis, Minnesota.

A study published in the June 25, 2005, edition of the British medical journal The Lancet revealed that children whose fathers experienced postnatal depression face increased risks of behavioral and emotional problems in early life. Researchers from Bristol and Oxford University analyzed medical records on 8,430 fathers and found that eight weeks after the birth of their children, 3.6 percent (303) appeared to be suffering from depression, with reported symptoms including anxiety, mood swings, irritability, and feelings of hopelessness.

Although many in the medical community have differing opinions about the revelations of this study, one thing is perfectly clear—healthcare specialists around the world should be on the lookout for signs of depression in fathers, as well as mothers, and should offer treatment when necessary.

Treatment

So, what can friends and family do for men who appear to be struggling with pre- or postnatal depression? Through love, support, and patience, families should be sure to let their struggling dad know that he may need help managing his feelings. If symptoms are apparent, families should encourage treatment. There is “no biological trigger that signals postnatal depression in men unlike postpartum depression in women,” explains Dr. Rich, who also warns that “as soon as depression becomes evident, it is highly important that the person seek professional attention quickly.”

For men who experience depression, one of the first steps in seeking treatment should be a preliminary physical examination by a primary care physician. The doctor will usually inquire about family history, when symptoms of depression began, and any new or increasing dependence on drugs or alcohol.

Specific laboratory testing will also be ordered, as certain symptoms of depression can be caused by an underactive thyroid gland or anemia. If there is no diagnosed physical cause for the depression, the depressed dad may be referred to a psychologist for further treatment.

Upon professional evaluation and diagnosis, depression can be successfully treated with a combination of antidepressant medications and psychotherapy. Common antidepressants prescribed for those with a diagnosed depressive illness include selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, Zoloft; and monoamine oxidase inhibitors (MAOIs) such as Nardil, Marplan, or Parnate. Just as with any prescription medication, these drugs may have side effects (dry mouth, constipation, and sexual effects), however temporary or not, which should be reported to a physician/therapist as soon as possible.

Support

“The role of a spouse/partner is highly important,” says Dr. Rich. “Constant social support and encouragement of a father’s family can be very instrumental in his treatment.” Often new dads are lost in the shuffle, overlooked in favor of a radiant mom-to-be or cute new baby. Wives and families should be sure to encourage and support new dads as they tend to pregnant wives, help decorate nurseries, and plan for the arrival of a new life. Help keep your new dad active and grounded in his role as an individual and as a new father. Encourage your partner to continue with his previous hobbies or to find new ways to enjoy time alone. And be sure that your new dad is getting regular exercise, too.

More and more, support groups are popping up for fathers who experience depression. Local churches, universities, hospitals, and rec centers around the country are hosting groups where dads can go and spend time talking with other fathers about the rewards and challenges of parenting. Encourage your new dad to seek out these groups or even start one of his own. A Saturday morning playgroup with other new fathers in your community can work wonders for struggling dads. Just knowing that he is not alone can help allay a new father’s negative feelings.

*Names changed to maintain privacy.

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