In a recent conversation about how postpartum depression (PPD) can lead women to have fewer children than they hoped, an acquaintance shared that the four-year gap between her second and third children was related to postpartum depression… in her husband. At first I thought that I’d never heard of such a thing, but then I realized I had. Thanks to the power of the reticular activating system—the part of your brain that sees every Honda Pilot on the road after you buy a new one—I remembered that I avait seen an article somewhere in the not-too-distant past on paternal postpartum depression.
And the more I thought about it, the more I realized that the same factors that put moms at risk for PPD (plus a few unique ones) can put dads at risk, too. And postpartum depression in both men et women is something we should take seriously. We know that maternal PPD negatively affects babies (even as they grow older), and paternal postpartum depression can lead to strained marital relationships, poor bonding with babies, and mental and behavioral problems in preschool-aged children. Here’s what you need to know about postpartum depression in men.
New dads experience a steep hormonal drop too
You may already know that new moms experience an abrupt drop-off in the hormones estrogen and progesterone after childbirth. But did you know that new dads also experience a hormonal downshift? It’s true. Men’s testosterone levels—which tick up when their favorite sports team wins, when they have sex, when they win or accomplish something, etc.—begin to decline during pregnancy, and then tank after the birth of a child, most especially during the first month postpartum. Recall from high school biology class that testosterone is responsible for male sexual development during adolescence, sperm production from puberty until death, sex drive, assertiveness, and competitiveness.
A fascinating 2011 study found that when compared to single men and fathers with children older than one month, brand new dads had four to five times lower testosterone levels than the single men and levels twice as low as dads with babies aged 1 month to 1 year [1]. Fathers with babies aged one month to one year in turn had levels twice as low as single men.
A fascinating 2011 study found that when compared to single men and fathers with children older than one month, brand new dads had four to five times lower testosterone levels than the single men and levels twice as low as dads with babies aged 1 month to 1 year [1]. Fathers with babies aged one month to one year in turn had levels twice as low as single men.
While higher testosterone levels are associated with going out and achieving in the world outside the home, including risk-taking and competitive behaviors, lower testosterone levels are associated with Dad staying home to guard the roost and to help Mom with caregiving. What’s more, caregiving behaviors appear to keep testosterone lower throughout the child’s first year of life. Of course, these tendencies have obvious biological advantages for a man’s offspring, but it’s unsurprising that a man experiencing this hormonal downshift might not “feel like himself” during his child’s first year of life.
Dads are often sleep-deprived too
And then, of course, there’s the issue of sleep, which is both precious and fleeting during those early months with a newborn. Anyone who’s experienced long nights (and days) with a newborn eventually comes to understand why sleep deprivation is considered a form of torture [2].
Of course, a breastfeeding mom will naturally experience more sleep deprivation than a new dad, but both parents will be affected to some degree. This may be especially true if both parents take shifts waking up to feed the baby during the night, as is often the case when parents decide to bottle feed.
But even if Dad isn’t waking up through the night to feed the baby, he may be the one to get up and at ‘em with any early-rising older kids, so that Mom can sleep for a few hours in the morning. Dads may also have inadequate or no paternity leave, meaning that they’re going back to working full-time jobs when their child is just a week or two weeks old.
Who checks in on Dads?
Arguably, we in America do a poor job caring for postpartum women’s basic needs for healthy diet, adequate sunshine, gentle exercise, community plus childcare support, and breastfeeding support. But we have at least some basic awareness that it would be a good idea to bring a meal over or text with Mom occasionally. Who even thinks to check in specifically on Dad?
A new mom may take advantage of a breastfeeding support group, a new moms group at a church, or a mood disorders support group. What outlets exist for dads?
Dads may struggle to connect with their wives and babies
A child’s birth ushers in new roles and responsibilities for both Mom and Dad. Sometimes, dads may feel left out of the caregiving, either by a mother who says or thinks “You don’t know how to do x or y for the baby. Let me do it,” or simply because Mom is able to breastfeed and gets substantial quality bonding time with the baby that way. Particularly if this is their first child together, both parents may have unvoiced expectations about who will do what in caring for the baby. This can all lead to feelings of helplessness in Dad, and disconnect between him and Mom, or between him and his baby.
The 6-week minimum moratorium on sex (which is actually longer for a C-section, or if Mom suffered a severe tear or other birth injury) may also exacerbate feelings of isolation in Dad, since sex makes men feel secure, needed, and connected.
Dads are expected to “man up” for their wives and families
And if he should happen to recognize that he feels “off,” how does a father even begin to speak up about it when he is expected (and likely expects himself) to be the strong one and “keep it together” for his wife and family? What is he to do if he’s worried about his own wife? According to UT Southwestern Medical Center, up to half of men whose wife or partner experiences PPD will also have symptoms themselves. But while a woman is encouraged to get help for PPD or postpartum anxiety symptoms, is there a double standard when it comes to dads, where society perhaps expects them to “man up” because they weren’t the ones who gave birth or struggled with breastfeeding, etc.?
Signs of postpartum depression in dads
Postpartum depression symptoms may manifest differently in men versus women. According to UT Southwestern Medical Center, 1 in 10 new dads may experience PPD. They also say that the signs to watch out for include:
- Anger, sudden outbursts, or violent behavior
- Increase in impulsive or risk-taking behavior, including turning to substances such as alcohol or prescription drugs
- Irritability
- Low motivation
- Physical symptoms such as headaches, muscle aches, stomach, or digestion issues
- Poor concentration
- Suicidal thoughts
- Withdrawing from relationships
- Working a lot more or a lot less
How is postpartum depression treated in men?
Much like with moms experiencing postpartum depression, treatment for postpartum depression in men may look like cognitive behavioral therapy (CBT) and/or medication such as antidepressants. While moms suffering from PPD may benefit from bioidentical progesterone support as prescribed by a restorative reproductive medicine-trained healthcare professional, there isn’t a similar hormonal protocol (such as testosterone supplementation) for PPD in dads. However, since moms may benefit from seeing a perinatal psychiatrist or psychotherapist trained in perinatal mood disorders, it stands to reason that dads experiencing postpartum depression would similarly benefit from working with someone with this specialized training.
How can men naturally increase their testosterone levels?
We know there’s a connection between postpartum depression and nutrient deficiencies like low Vitamin D in moms. While the role of nutrient deficiencies in paternal postpartum depression hasn’t been studied, research shows that men with Vitamin D deficiency tend to have lower testosterone levels–and remember, testostérone is a crucial hormone for men physically and mentally [3]. According to Healthline, eggs, avocado, berries, salmon, leafy greens, and dark chocolate may help raise testosterone levels naturally because they contain selenium, Vitamin D, zinc, and other nutrients important to maintaining healthy testosterone levels.
Exercise of any kind, but especially high intensity interval training (HIIT) and resistance training (like weight lifting), is also known to increase natural testosterone production in men. Avoiding tobacco products and endocrine-disrupting chemicals (more on that ici from Harvard Health), moderating alcohol consumption, and prioritizing sleep (easier said than done with a baby, of course!) can all contribute to aiding a man’s natural testosterone production.
The bottom line on postpartum depression in men
If you suspect that your husband or partner may be experiencing paternal postpartum depression, check out the extensive resources over at Postpartum International. Just as with moms, new dads needn’t suffer in silence. Things don’t have to remain this way. There is treatment and hope.
Lecture complémentaire :
Les bases de FAM : La testostérone
