New fathers should also be screened for postpartum depression, study says

A growing body of recent research has shown that fathers, along with their female partners, can develop postpartum depression. Most experts estimate that about 10% of fathers will experience the condition, while about 14% of mothers will experience it.

Now, a new pilot study from the University of Illinois at Chicago suggests that men should be routinely screened for PPD. It’s part of a growing push to shift the dialogue around men’s mental health and provide a more robust stream of support for the whole family.

“To me, it feels glaringly obvious that we have created these gendered silos of care, and that has led to the exclusion of fathers today,” said Sam Wainwright, lead author of the study and assistant professor of internal medicine and pediatrics. at UIC.

Until recent decades, PPD was only associated with women, who undergo more pronounced physical and hormonal changes during the postnatal period. Treatment for the months-long depressive episode usually involves counseling or antidepressants. In August, the FDA also approved an oral drug, the first of its kind, for the specific treatment of PPD.

But men are far from immune to the emotional strain that comes with becoming a new parent. Research has shown that fathers can even suffer from declining testosterone levels after the birth of their child, which is accompanied by mood swings. The onset of paternal PPD typically begins three to six months after delivery.

According to the study, PPD in fathers is also a risk factor for impaired quality of life and developmental and relationship damage in families.

“Often fathers feel overwhelmed by the new experience,” says Sheehan Fisher, a psychologist at Northwestern Memorial Hospital. “They’re trying to figure out how to adapt, but they don’t have a blueprint on how to be a father.”

The study surveyed 24 new fathers and found that 30% screened positive for PPD. Wainwright suspects this number is higher than average because 87% of participants are identified as belonging to a racial or ethnic minority group, which may predispose patients to mental health problems due to institutionalized economic disparities.

Regular screening of men at well-baby checkups could prevent the condition, Wainwright said.

“For me, it’s about taking a stand and saying to men, ‘You matter, your health matters,’ and not just because it’s a maternal health goal,” he said.

Previously, Wainwright’s work focused primarily on women’s health. The UI Two-Generation Clinic, which conducted the study, provides one-stop postpartum care for mothers and pediatric checkups. It primarily targets economically marginalized communities of color.

But clinic staff soon felt that fathers were being abandoned, despite their well-being being vital to the overall health of families. According to Wainwright, the only conversations about a child’s father during checks are generally about domestic violence.

“The vast majority of men will never do anything other than love their spouse and their child, even if they are not married,” he said. “It’s as if the attitude of our system assumes that men are a source of violence and not much else.”

The fathers who participated in the study ranged from one to fifteen months postpartum. Researchers screened the fathers with the Edinburgh Postnatal Depression Scale questionnaire, which is used on mothers.

Social workers also interviewed the fathers, many of whom were young, new parents who feared they did not have the right parenting skills. Most experienced a significant lack of sleep and noted severe feelings of fatigue. Several people said the demand for economic support conflicted with the desire to meet the increased needs of the mother and baby.

“They’re really focused on making sure she’s okay, and so they tend to neglect their own well-being and mental health,” Fisher said.

According to Amanda Atkins, a Chicago-based therapist certified in perinatal mental health, men are generally less likely to seek help for mental health issues. Although she often works with mothers with PPD, fathers with the condition rarely seek treatment at her office. Stigma surrounding men’s health can serve as a deterrent, she said.

“I think a lot of times the man feels like there’s no room to feel depressed,” Atkins said. “I think we see guys just pushing there and saying, ‘I have to be strong.’”

It is also thought that PPD manifests differently in men, who experience irritability and aggression more often. One study found that depressed fathers are less likely to read to their 1-year-old and more likely to spank them. Experts say the actual number of fathers with PPD could be higher than 10% due to the varying symptoms.

“I think if we as a society can just normalize (PPD) more, we’ll be more in tune with it,” Atkins said.

For Wainwright, the research illustrates the need for a radical change in healthcare, with fathers actively involved in postpartum check-ups. A one-stop system such as that of the Two Generation Clinic could ensure that the entire family receives sufficient support.

PPD screenings also serve as an opportunity to connect with young men about other aspects of their health, Wainwright said. More than half of the participants did not have a GP before the study. However, two of them requested mental health care and three established a new primary care with a doctor.

“Fathers are an essential part of children’s lives, of a family’s life, and they are important for their own good. And this is a time when you can reach them,” Wainwright said.

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