Postnatal depression not exclusive to birthing partner

Dear Doctor: I had a hard time after my son was born. I’d had postpartum depression with my first child, so I knew what was happening. But when my husband started having issues, our doctor said postpartum depression happens to men, too. How? I thought it had to do with hormones.

Dear Reader: Postpartum depression is the severe emotional and mental struggle some women undergo in the weeks and months after giving birth. This includes feelings of anxiety, sadness, hopelessness, exhaustion, worthlessness and guilt. It’s different from what is sometimes referred to as the “baby blues” in that postpartum depression is more severe and long-lasting.

You’re correct that postpartum depression is linked to the complex hormonal shifts that occur after giving birth. However, the changes to sleep, social life, daily routine, responsibility and finances that accompany the arrival of a new baby also play a role. And it turns out that these seismic shifts affect the partner who did not give birth as well. In this case, the condition is more accurately referred to as postnatal depression. (The word “partum” refers to having given birth, while the word “natal” describes something associated with birth.)

You asked specifically about men, and an analysis in the Journal of the American Medical Association found that up to 10% of men worldwide experience paternal postnatal depression between the first trimester of pregnancy and the first year of the baby’s life. When looking at the first three-to-six-month postpartum period, that number jumped to up to 25%. That’s almost triple the 9% of men who report regular feelings of anxiety and depression. Some symptoms -- such as feeling sad, hopeless or overwhelmed -- overlap with what birthing partners often experience. Men may also withdraw from their partners and from family life, exhibit increased irritability and anger, or even aggression, become cynical or easily frustrated, and also lose their sense of purpose. Men with a history of depression or anxiety are at greater risk of developing paternal postnatal depression. It’s also more common in men whose partners have postpartum struggles.

Elizabeth Ko, MD and Eve Glazier, MD

So what’s going on? We already talked about the upheaval when an infant joins the family. But it turns out, men may also be dealing with hormonal shifts. Studies have found that during a woman’s pregnancy and after she gives birth, the father’s levels of testosterone, the so-called male hormone, can drop. At the same time, hormones associated with women, such as estrogen and prolactin, go up. So does the stress hormone cortisol. These changes, along with the neurological stresses of baby-induced sleep deprivation, can tip the scales into a bout of paternal postnatal depression. It’s a condition that affects not only the individual, but also their partner, the baby and the family as a whole.

For many men, there may be reluctance to admit that anything is wrong. The good news is that talk therapy, as well as medication, are often successful in treating the condition. It’s common to have a few rocky weeks after a new baby comes home. But if either of you are still struggling after a month or two, it’s time to talk to your health care provider about getting help.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)


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