Male Postpartum Depression: Signs, Causes, & Treatments

Can Men Have Postpartum Depression?

Yes: One in four men experience postpartum depression three to six months after bringing the baby home.¹ While women are very openly dealing with hormonal changes, the new addition in the family also impacts the male hormone system as well. In heterosexual relationships, women tend to bond immediately with the baby while men take more time to connect, which can leave men feeling left out inadvertently, impacting their mood as they are not the only focus in the relationship. Men may have an instinct to double down at work and make sure they are able to provide for the family, which is a biological drive many men state.

How Common Is Postpartum Depression in Men?

• Postpartum depression affects between 8-10% of men but other surveys suggest that this number may be as high as 25%.^1,2,3
• Rates of male postpartum depression tend to increase over the first year.³ One study found that 4.8% of fathers met criteria for depression during pregnancy and three months postpartum, but this number increased to 23.8% in one year.
• The prevalence of male postpartum depression is around 24-50% among men whose partners also have depression.³
• Fathers who experience anxiety disorders are 30% more likely to experience depression.³

PPD Is Not Just Baby Blues

Paternal postpartum depression is more than the baby blues. It is a serious condition that can impact men in different ways. They may be more at risk for postpartum depression if they have a previous history of depression. Adjusting to being a parent is a difficult task for a person of any gender. They may experience loss of interest in things that once brought joy, anger issues, hopelessness, and withdrawal tendencies.

What Are the Main Differences Between Female & Male PPD?

While many of the symptoms of postpartum depression are similar for men and women, there are some notable differences. Depressed men may experience certain emotions and behaviors that are less common in women. For example, fathers with postpartum depression are more likely to experience irritable mood, difficulty making decisions, impulsivity, and a narrower range of demonstrated emotions.^1,4

Men also have a greater tendency toward violence, avoidance, and substance abuse. When it comes to how they feel, men report experiencing frustration, anger or postpartum rage, confusion, worry, and anxiety. Even among men, there can be significant differences in symptoms of postpartum depression. Each person is unique and so is their experience and reaction to fatherhood.

Male Postpartum Depression Symptoms

The idea that men can experience depression after childbirth is a relatively new phenomenon. In fact, there is no specific diagnosis or set of symptoms for male postpartum depression.¹ However, medical and mental health professionals agree that like women, men can experience this condition after the birth of a child. Fathers dealing with postpartum depression may show signs of major depressive disorder, a type of depression that lasts for at least two weeks and can affect many different aspects of a person’s life.

Common symptoms of male postpartum depression include:²

• Depressed mood, including feeling sad, hopeless, and empty
• A loss of interest in activities or pursuits that were once enjoyable
• An increase or decrease in appetite and/or weight
• Changes in sleeping patterns (either sleeping too much or too little)
• Low energy
• An increase or decrease in movement that is noticeable to others
• Feelings of guilt or worthlessness
• Difficulty concentrating on things
• Thoughts of death or suicide

To receive a diagnosis of depression, a person must exhibit at least five or more of the symptoms listed above.² The symptoms of depression must also cause the person distress and affect their functioning in several different areas of their life. Men are most likely to experience postpartum depression between three and six months after the birth of a child, but symptoms can develop at any point within the first year.¹

Causes & Risk Factors of PPD in Men

Male postpartum depression is believed to be caused by a combination of biological changes and environmental stressors.³ Like mothers, fathers also experience hormonal changes during their partner’s pregnancy and during the postpartum period. Testosterone, a hormone that increases a father’s sensitivity to their infant’s crying and aids in attachment, tends to decrease over the course of pregnancy. Studies have found that low testosterone is linked to depression in men, so this may explain why men are more vulnerable to depression during this time.

Some men may experience hormonal imbalances which can put them at higher risk of postpartum depression.³ Estrogen, cortisol, vasopressin, and prolactin are hormones that typically increase following birth to aid in parenting, but fathers with lower levels may be more vulnerable to depression.

Risk Factors

Factors that can contribute to depression in new or soon-to-be fathers include:³

• Having a partner who is experiencing postpartum depression
• A lack of support after the baby is born
• Having stress in their relationship
• Jealousy of the bond and time spent between mother and child
• Difficulty around intimacy in their relationship
• Increase in stress as they renegotiate their roles in the family

Addressing the Stigma of Postpartum Depression in Men

Postpartum depression is rarely screened for in men and is believed to be underdiagnosed.⁵ This means that the rate of postpartum depression in men is likely higher than we think. There are several reasons for this. First, because postpartum depression is related to giving birth, many people falsely assume that men cannot be emotionally impacted by the transition to parenthood in the same way that mothers can.

Fathers are also less likely to be screened for postpartum depression by their healthcare providers. Women are typically screened in the hospital shortly after giving birth and again six weeks later. Even if a father does have an appointment scheduled with his healthcare provider, he is unlikely to be screened for postpartum depression unless he specifically brings up his symptoms.

Men may also experience stigma, which they can internalize. One study found that new fathers tended to endorse traditional gender expectations, like the image of a father as a “tough guy.”⁵ Depressed fathers may feel that they cannot share their feelings because they will be viewed as “weak.” As a result, they may avoid talking about these feelings with their partners, loved ones, and healthcare providers. Unfortunately, internalizing these beliefs and feelings may worsen depression and prevent a new father from getting help.

We can help change the narrative and erase stigma by acknowledging postpartum depression in men. Healthcare providers can help by routinely screening new fathers for depression and providing education. Family and friends can check in with fathers on how they are feeling, normalize the difficulty of adjusting to parenthood, and encourage them to open up about their experiences. The more open and honest we can be about how the postpartum period affects both men and women, the better we can help families cope with this challenging stage in life.

9 Ways to Cope With Male Postpartum Depression

If you are a new father dealing with postpartum depression, there are steps you can take to help yourself cope. Maintaining a connection with your support system, finding outlets to express yourself, and prioritizing your physical and mental health as a man can help you adjust to parenthood.

Here are nine tips for coping with male PPD:

1. Give Yourself a Break

Parenthood is difficult and can bring about a range of feelings, both positive and negative. It is common to feel overwhelmed, stressed, anxious, and burnt out at times. Many new parents who experience negative feelings think that there is something wrong with them. This can cause shame, which can further increase depression. Rest assured that these feelings about being a parent are normal. Stop beating yourself up and instead praise yourself for acknowledging the difficulty and trying to help yourself be a more present parent.

2. Connect With Other Dads

Social support and connection with other people can help you cope with the adjustment to parenthood.³ Even if you do not talk openly about your experiences, spending time with others decreases isolation and loneliness. Try to plan an outing with a friend or see if there is a dad’s group in your area.

3. Express Yourself Creatively

Finding creative outlets to express your emotions can also be helpful. If you are someone who struggles to express yourself verbally, getting creative may feel less daunting. Some ways to do this include creating music, art, or through writing. Even simply journaling your thoughts and feelings for a few minutes a day can be a release. If you are having a hard time opening up to others or feel unsupported, try finding a creative outlet to express yourself, whether it is one that you have tried before or something new.

4. Exercise

Exercise has been widely known to help improve mood and as a tool to cope with stress, depression, and anxiety.⁶ Finding time to exercise a few days a week for about an hour can help you feel better. Whether you go to the gym, on a run, or play sports, moving your body in any form is good for your physical and emotional health.

5. Talk to Your Partner

Because male postpartum depression is more likely when a mother is depressed, maintaining a supportive relationship with your partner is important for both of your emotional states. Prioritizing time with your partner is challenging when you have a newborn. If possible, try to schedule time each week to spend with one another. Date nights may be different now that you have a baby, but even having a date night at home can help you to remain connected. Use this time to check in on how each of you are feeling, talk about parenthood, and do things together that you enjoy.

6. Start a Hobby

Having an activity that you enjoy and can look forward to can help lift your mood. Whether it is a hobby you have tried before or something new, brainstorm a list of possible activities. Many hobbies also offer the opportunity to connect with other people, which can help with loneliness and isolation. There are countless hobbies that you can try, but some ideas include joining a team sport or book club, learning how to play an instrument, building something, writing, or taking a class.

7. Come Up With a Sleeping Plan

The newborn stage is known for sleep deprivation, which is believed to play a role in female postpartum depression.⁷ It is likely that sleep loss also contributes to or worsens depression in men. To help address this problem, consider creating a sleep plan with your partner. Brainstorm ways that you might be able to schedule night-time feedings and diaper changes to maximize each person’s sleep. For example, some families will assign the first feeding to the father and the second feeding to the mother, so that each partner can aim for a six to eight hour stretch.

Your options may be different depending upon whether you are breast or bottle feeding, but it can help to create a list of possibilities and choose one that seems the most beneficial to both of you. If you find that you are struggling with sleeping problems that are unrelated to the baby, bring up these concerns with your healthcare provider.

8. Reflect on the Positive Aspects of Fatherhood

Though fatherhood is challenging, there are most likely positive parts of it that you find pleasurable. It can be hard to remember these parts when you are tired, overwhelmed, or sad. Keep a list in your head or write one down and reference it when you are feeling stressed. Add more as your baby grows and you experience new joys. Reminding yourself to feel gratitude for the pleasures of parenthood can help you cope with the challenges.

9. Watch What You Eat (and Drink)

Aim to eat a healthy diet that consists of a mixture of fruits, vegetables, protein, whole grain carbohydrates, and healthy fats and is free of processed foods.
Avoiding or limiting certain substances may also help improve your depression. Smoking cigarettes, drinking alcohol, and consuming large amounts of caffeine can contribute to or worsen depression and anxiety.¹⁰ While small amounts of caffeine may help improve mood, too much caffeine can interfere with your sleep. If you use caffeine, try to limit yourself to 400mg a day.¹¹ When it comes to alcohol, the Centers for Disease Control and Prevention (CDC) recommend that men consume no more than two drinks per day.¹² Smoking should be avoided altogether, since it is linked to depression and other physical health problems. If you are having trouble quitting, be sure to speak with your healthcare provider.

Treatment of Postpartum Depression in Men

Because males with postpartum depression have not been studied as extensively as females, we do not know as much about what types of treatments for PPD are most effective.¹ However, professionals believe that many of the types of treatment, including therapy and medication, that can help treat major depressive disorder can also work for male postpartum depression.

Therapy

Therapy is usually the first type of treatment that is recommended for mild to moderate male postpartum depression. Therapy for depression involves meeting with a therapist, either individually, in a group, or as a couple. Therapy is effective in treating postpartum depression in fathers by helping decrease symptoms of depression and improving overall well-being. Treatment length can vary depending upon the severity of your depression and other factors, like whether you have a good support system or are dealing with other mental health issues at the same time.

Common types of therapies used to treat male postpartum depression include:^1,8

• Cognitive behavioral therapy: CBT helps fathers identify and change negative thoughts that are causing their depression, as well as teaches coping skills to manage stress and other emotions.
• Interpersonal therapy: IPT focuses on helping fathers improve the relationships in their lives that are contributing to their depressive symptoms.
• Psychodynamic therapy: This type of therapy focuses on making unconscious thoughts and feelings conscious, which can help improve insight.
• Supportive therapy: Unlike other types of therapy, supportive therapy is less goal-oriented and structured. This approach involves a therapist providing empathy, support, and a safe space for the father to share his thoughts and feelings.

The type of therapy you pursue can impact how quickly your symptoms improve. For example, interpersonal therapy is typically limited to 12 to 16 sessions, while psychodynamic therapy is not limited to a specific number of sessions.

Medication

Since male postpartum depression has not been adequately studied, there are no specific medications that have shown to be effective for treating this condition.¹ However, medications used to treat major depression may help alleviate symptoms of postpartum depression in men. Selective serotonin reuptake inhibitors (SSRIs) like sertraline are often used for this purpose. If you feel that you may benefit from medication, you can speak with your physician or seek out a psychiatrist or psychiatric nurse practitioner that specializes in this area.

How to Get Help for Male Postpartum Depression

You can start the process of getting help for postpartum depression by bringing up your symptoms with your physician. They can assess you for depression and provide you with a referral for treatment. You can also contact your health insurance company for a list of in-network mental health providers or conduct your own search through an online therapist directory. There are many mental health providers that specialize in treating postpartum depression and helping families adjust to parenthood.

The type of provider and treatment that you seek will depend upon what you are looking for. If you would like medication, you will want to search for a psychiatrist or psychiatric nurse practitioner. For therapy, you can seek out a psychologist, social worker, counselor, or therapist. Depending upon their specialty, they may be able to provide individual, group, and/or couples therapy. Therapists may offer different approaches for treating postpartum depression depending upon their training and experience. You can inquire about what type of therapy they use to treat depression during your initial consultation.

How to Get Help for a Loved One

If you are concerned about a loved one who may be dealing with postpartum depression, you can start by bringing up your concerns to them and offering some options. You may want to suggest that they try speaking with a therapist or attending a support group to start. Some people may be nervous about getting help. If this is the case, you can offer to help set up the first appointment or go with them. You can also offer to provide childcare while they get help.

As a loved one, you can offer help but cannot force someone into treatment. If your loved one is unwilling to go, do not keep pushing. This may cause them to be more resistant. Instead, respect their feelings and remind them that you are there to help if they should change their mind.

Final Thoughts on Postpartum Depression in Men

As a new father, dealing with postpartum depression can be overwhelming. Your experience with depression may be unique to you, but you are not alone. Speaking with a therapist or loved one and prioritizing self-care can help you feel better. If you are dealing with postpartum depression, there is hope for recovery.