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The rain comes down on new dads, too.
Fathers of newborns are twice as likely to be depressed as men in general, according to a new study. And postpartum depression may be contagious: When one spouse is depressed before or after the baby arrives, the other is more likely to be depressed. “There hasn’t been enough attention to male partner depression around the perinatal period,” says Heather Flynn, Ph.D., director of women's mental health at the University of Michigan Medical School. “This is an important study.”
Ten percent of men experience depression either during their wife’s pregnancy or within the year following the baby’s birth, finds the meta-analysis of 43 studies including 28,000 parents, published today in the Journal of the American Medical Association. That’s still less than the 15 to 20 percent of new moms who suffer depression, and the study didn't examine the severity of this depression in men. But it does suggest that pregnancy and the arrival of a new baby may be triggering depression in many men. And that’s not good for the baby: Depression in dads, as in moms, has been linked to a host of poor outcomes in children, including behavioral and emotional issues.
Perhaps the most intriguing finding was that mothers’ and fathers’ depression seem to parallel each other. “We found that there was a clear and significant positive association between moms’ and dads’ depression,” says the study’s lead researcher, James Paulson, Ph.D., associate professor of pediatrics at Eastern Virginia Medical School in Norfolk. Postpartum depression should no longer be thought of as solely a woman’s issue, but as a family affair, he says. “If we see depression increase in one partner, we can expect that it will increase in the other,” says Paulson.
It’s not known whether one partner’s depression causes the other’s, or whether the state of the couple’s life (such as their relationship, financial issues, support system, fatigue and shared childcare issues) causes depression in both. “There’s been an assumption that it goes from the mom to the dad, but we don’t have the evidence that this is true,” says Paulson. These psychosocial factors, which are strongly correlated with postpartum depression in women, can affect men as well, though postpartum dads don’t experience the wild swings in hormones that women do. Research on the general population shows that depression may simply be infectious: If your partner is depressed, you’re more prone to depression yourself.
For men, the peak period of depression seems to occur between three and six months after the baby's birth. The study found that depression rates jumped to 25 percent during these three months, but this finding was based on only a few studies that measured depression during this time frame and needs to be studied further. “We can speculate that this is a time when family leave runs out, when crying in babies tends to peak and the demands of the baby become greater,” says Paulson. Curiously, American men had higher rates of depression than their international counterparts, which may reflect our less-than-liberal work-leave programs in this country or other societal pressures.
Experts say depression in men is underdiagnosed and undertreated. Women are more likely to seek care than men, and while more pregnant women are being screened for depression, expectant dads are not. “If we see depression in one partner, we should start screening for depression in the other partner,” says Paulson.
He recommends that men get screened when they come in with their partner for a prenatal visit or that first ultrasound, or even during the birth at the hospital. If you recognize depression in your partner during your pregnancy or after the baby is born, try to speak to him in a nonthreatening, nonjudgmental way, and show concern or caring. Symptoms in men may be more difficult to recognize because men may not appear sad or down, but they may lose interest in regular activities, become more withdrawn or irritable, or use substances like alcohol. “Encourage him to talk to his primary care doctor about his symptoms as a first step,” says Flynn. Adds Paulson, “Rather than looking at depression as an individual phenomenon, we really should begin to see this as a family phenomenon.”
Do you think men are aware when they are depressed? Chime in below!