Postpartum Depression Can Hit Both Mom & Dad, Sometimes at Same Time
Most people have heard that women can experience depression after the birth of a child.
But the condition is not limited to moms: New dads can experience depression in the months after their baby is born, by all accounts an enormous life change. This can even happen simultaneously, and with consequences for each of them and their new baby.
To better understand these experiences, researchers from University College London (UCL) looked at 23 past studies with data from more than 29,000 couples.
"There has been a lot of literature on maternal mental health, but we are only just starting to recognize the importance of men's health during the transition to fatherhood," said study co-author Dr. Kara Smythe.
"However, the current structure of perinatal care doesn't usually include the partner, so we felt it was necessary to look at the parental unit. And because the mental health of both parents impacts their relationship with the new-born, and the health of the newborn as well, it is an important area of enquiry," said Smythe. She's an obstetrician/gynecologist and master of philosophy/PhD student at UCL's Institute of Epidemiology and Health Care.
The research team found that about three in every 100 couples experienced late postpartum depression -- when their child was 3 to 12 months old.
For about two in every 100 couples, both parents had antenatal depression (before the child's birth) and early postpartum depression, meaning up to 12 weeks after the birth.
Previous studies have shown that for both parents a history of mood disorders increases the chance that the mother and/or father will develop a mental disorder.
Other research has shown about 10% of fathers experienced depression during their partner's pregnancy and around 9% in the first postnatal year.
"We know from previous research that when mothers are depressed, there is a higher chance for fathers to be depressed as well. Paternal perinatal anxiety is associated with maternal depression, and the risk of anxiety for new fathers increases by more than three-fold when mothers are depressed," Smythe said.
The review included studies from 15 countries. One limitation is that the countries used a variety of different screening tools.
Who's most at risk?
Mothers were more at risk of developing a prenatal or postpartum mood disorder if they had lived with early life stressors, limited social support and exposure to intimate partner violence, the study found.
In fathers, increased risk of perinatal mood disorder was associated with lower levels of education, unemployment, low social support and marital distress.
Dr. Kimberly Yonkers is psychiatry chair at UMass Medical School/U Mass Memorial Medical Center in Worcester. She noted that the review is not of diagnosed major depressive episodes but of measures of distress, which can vary depending on the day.
"The take-home message is [having a baby is] a wonderful event, but it's not a stress-free event either," said Yonkers, who was not involved in this study.
It makes sense that when a partner is ill, that increases the stress on the other partner, Yonkers said.
Also, "individuals who have had a prior history of depression are clearly at risk of having a depressive episode or depressive symptoms during periods of high stress, such as this," Yonkers said.
Solutions could include screening for mental health disorders during the months after a child is born, identifying resources that can support people and providing education so that new parents will know what to expect, Yonkers said.
The study draws attention "to something that everybody else who researches and practices in this area knows, which is that the relationship between the parents is incredibly central to each of their individual mental health," said Daniel Singley, a board-certified psychologist and founder/director of the Center for Men's Excellence in San Diego.
Intense adjustment period
This phase of life is a period of intense adjustment, Singley said.
However, he thinks the study likely undercounts the actual number of fathers or couples experiencing depression and anxiety, in part because the studies that were analyzed each had different cutoff points for depression. Another reason is that men tend to underreport depression and anxiety, according to past research.
"This is probably not giving the full picture, there are probably a lot more men who are experiencing this," Singley said.
The study also notes it did not have enough data to cite prevalence of anxiety.
Singley said there is a societal blind spot for fathers having mental health issues related to pregnancy and parenthood, while contemporary fathers are expected to do more and be supportive without the acknowledgement that they may also need support.
He thinks solutions include moving away from the idea of "maternal mental health" to "parental mental health."
From the very beginning, he said, they should hear all parents involved are super important, he said. "We want to set up our appointments in a way that accommodates how we can get mom, dad, or both dads or both moms or all the parents, whatever the constellation is, setting that expectation up front," Singley said. That would go a very long way, he added.
The findings were published June 24 in JAMA Network Open.
The U.S. National Institute of Mental Health has more on perinatal depression.
SOURCES: Kara Smythe, MD, obstetrician/gynecologist and master of philosophy/PhD student, University College London Institute of Epidemiology and Health Care, London, England; Kimberly Yonkers, MD, Katz Family Chair, Department of Psychiatry, UMass Chan Medical School/U Mass Memorial Medical Center, Worcester; Daniel Singley, PhD, board-certified psychologist and founder/director, Center for Men's Excellence, San Diego; JAMA Network Open, June 24, 2022