postpartum depression in dads

When I meet with expectant parents prenatally or teach a childbirth class, we discuss impacts on marriage, general adjustments and also postpartum depression for the person giving birth. But I will now raise the issue for dads/partners regardless of gender as well. OK - it's not really the same - for postpartum women the depression is generally biochemical, and it was pointed out to me that a new name should be given so as not to take away focus on PPD in birthing women. However, I do think it's helpful for people to know that depression, no matter the cause, can happen for either partner (and has also been noted in adoptive parents) upon such a huge life event. I suggest to everyone, but especially those with a tendency toward depression (or sensitivity to hormones), to have a plan in place in case it becomes an issue. Most people going through even minor depression, combined with sleep deprivation etc., find it overwhelming to have to start from scratch if they need to find a support group or therapist.

from the New York Times:

Mind
Postpartum Depression Strikes Fathers, Too


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By RICHARD A. FRIEDMAN, M.D.
Published: December 7, 2009

The pregnancy was easy, the delivery a breeze. This was the couple’s first baby, and they were thrilled. But within two months, the bliss of new parenthood was shattered by postpartum depression.

A sad, familiar story. But this one had a twist: The patient who came to me for treatment was not the mother but her husband.

A few weeks after the baby arrived, he had become uncharacteristically anxious, sad and withdrawn. He had trouble sleeping, even though his wife was the one up at night breast-feeding their new son. What scared her enough to bring him to my office was that he had become suicidal.

Up to 80 percent of women experience minor sadness — the so-called baby blues — after giving birth, and about 10 percent plummet into severe postpartum depression. But it turns out that men can also have postpartum depression, and its effects can be every bit as disruptive — not just on the father but on mother and child.

We don’t know the exact prevalence of male postpartum depression; studies have used different methods and diagnostic criteria. Dr. Paul G. Ramchandani, a psychiatrist at the University of Oxford in England who did a study based on 26,000 parents, reported in The Lancet in 2005 that 4 percent of fathers had clinically significant depressive symptoms within eight weeks of the birth of their children. But one thing is clear: It isn’t something most people, including physicians, have ever heard of.

At first, my patient insisted that everything was just fine. He and his wife had been trying to conceive for more than a year. He was ecstatic at the prospect of fatherhood, and he did not acknowledge feeling depressed or suicidal.

Suspicious of his rosy appraisal, I pushed a little.

It turned out that he had just taken a new high-pressure job in finance six months before the birth of his son. Though he was reluctant to admit it, he clearly had more than a little concern about his family’s financial future.

And he was anxious about his marriage and his new life. “We go out a lot with friends to dinner and theater,” he said wistfully, as I recall. “Now I guess that’s all going to end.”

He had spent the nine months of pregnancy in a state of excitement about being a father without really registering what a life-transforming event it was going to be.

Unlike women, men are not generally brought up to express their emotions or ask for help. This can be especially problematic for new fathers, since the prospect of parenthood carries all kinds of insecurities: What kind of father will I be? Can I support my family? Is this the end of my freedom?

And there is probably more to male postpartum depression than just social or psychological stress; like motherhood, fatherhood has its own biology, and it may actually change the brain.

A 2006 study on marmoset monkeys, published in the journal Nature Neuroscience, reported that new fathers experienced a rapid increase in receptors for the hormone vasopressin in the brain’s prefrontal cortex. Along with other hormones, vasopressin is involved in parental behavior in animals, and it is known that the same brain area in humans is activated when parents are shown pictures of their children.

There is also some evidence that testosterone levels tend to drop in men during their partner’s pregnancy, perhaps to make expectant fathers less aggressive and more likely to bond with their newborns. Given the known association between depression and low testosterone in middle-aged men, it is possible that this might also put some men at risk of postpartum depression.

By far the strongest predictor of paternal postpartum depression is having a depressed partner. In one study, fathers whose partners were also depressed were at nearly two and a half times the normal risk for depression. That was a critical finding, for clinicians tend to assume that men can easily step up to the plate and help fill in for a depressed mother. In fact, they too may be stressed and vulnerable to depression.

And there is the child to think about. Research has clearly shown that maternal postpartum depression can impair the emotional and cognitive development of infants. A father could well buffer the infant from some of the adverse effects of maternal depression — but that is a tall order if he too is depressed.

Dr. Ramchandani, who also followed children for three and a half years after birth, reported that they were affected differently depending on which parent was depressed. Maternal postpartum depression was associated with adverse emotional and behavioral effects in children regardless of sex; depression in fathers was linked only with behavioral problems in boys. (The study did not report on possible effects when both parents were depressed.)

As for my patient, he recovered within two months with the help of psychotherapy and an antidepressant. Afterward, he summed up the situation in just 10 words: “And I thought only women get this kind of thing.”

All too many doctors think so too.

Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.

Mothers Act

Let your Congress people know (next vote is in the Senate, I believe) if you think access to mental health support is important for women experiencing depression (or psychosis) during pregnancy or after birth...it EASY - just click on the link below

Sign the petition in support of The Melanie Blocker Stokes MOTHERS Act!

written by Susan Dowd-Stone

Last year the Depression and Bipolar Support Alliance based in Chicago IL, created a fantastic online petition in support of the Melanie Blocker Stokes MOTHERS Act. The online petition generated over 24,000 signatures – in record time – to send an urgent message to Congress in support of the legislation. Thanks to the consistent efforts of Gloria Pope, Advocacy, Public Policy and Training Director for DBSA, the online petition has been reintroduced as of March 9, 2009 again in partnership with Postpartum Support International.

By clicking on this link (or copying and pasting it in to your browser) http://capwiz.com/ndmda/issues/alert/?alertid=12832296 , you will be taken to an advocacy alert page on the DBSA website where you can scroll down, enter your zip code and generate letters of support for The Melanie Blocker Stokes MOTHERS Act to your Congressman, Senators and committee chairs. It could not be any easier!

While U.S. Senator Robert Menendez and Congressman Bobby L. Rush have lent their power and tireless advocacy to the creation of protective postpartum depression legislation for years, our support and constituent advocacy will add the force of the people’s will to their upcoming efforts. When well coordinated, the internet offers a constituent megaphone not previously available. Fifteen seconds of your time could forever change a nation’s view of these disorders!

The petition can track results from states and even constituencies within the state based on zip code, so will give us great information on where we need to target continuing advocacy efforts. By consolidating the petition on one website, our results are more reliable as truly representative of individual supporters.

With the legislation expected to go for a full house vote within the month before proceeding to the senate, this is a great time to go on the record in support of this critical legislation. Please visit the website and add your signature or individualize your letter today!! Then forward this link to everyone you know – colleagues, friends, family members and community organizations, so our legislators continue to understand the enormous bipartisan support that exists for this bill! We cannot wait any longer for this life-saving legislation to pass! Help make it happen THIS YEAR!!