While about 10% of new moms get depression, a 2005 study showed that 4% of dads had significant symptoms as well. Richard Friedman writes in the New York Times that a drop in testosterone associated with a partner's pregnancy may cause depression. But life changes may be a factor as well. Friedman writes of a male patient who lamented, "We go out a lot with friends to dinner and theater. Now I guess that's all going to end." And the biggest risk factor for male postpartum depression is having a depressed partner — dads whose partners are depressed are two and a half times more likely to suffer themselves. Friedman points out,
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?
Not only are men not encouraged to share their emotions — they're widely considered not to have as many emotions where children are concerned. Commenter Zorba on the Times' Well blog writes,
I am so relieved to see this. This connects with my long-held suspicion (that no one will validate) that MOST MEN DO NOT WANT CHILDREN. As a woman, I hear women complain all the time about how men don't get how difficult it is to be pregnant, have a baby, be a mother but these are the same women who were giving their husbands ultimatums when the men didn't want to get pregnant and even (more often than you'd think) lying and leaving off birth control to have a baby regardless of their husband's feelings. This makes me sad because I would like to think that fatherhood is something men really want but most of the men I hear about are bamboozled into it. Do men even want kinds? Is that why they get depressed?
But Zorba could just as easily say that women don't want kids, because they suffer from postpartum depression more often than men. Unfortunately, several male commenters chime in to reinforce the old stereotype that men who have kids are just giving in to their wives. Says Calmd,
Based on the comments of the women, why do women want kids anyway? After our first, my wife wanted more. I said no way. Our child is 12 but my wife still resents wish not to have more kids.
Sounds awesome. But not as awesome as this, by Penumbranian:
Children change everything irreversibly. They cost time, energy, money and space. The spatial and temporal boundaries shift, your spouse pays less attention to you, even totally ignores you. Does she still love you? Did she choose you to have children only? My wife was yelling at me: "My biological clock is ticking! With you or without you I'm going to have children!" Perhaps I had children with her only to please her, to be kept by her, not to be dumped by her.
Yes, your freedom will be lost. I know a couple who did not go to see a movie for five years after they had a child. This is widely considered normal.
If a father should talk about these and related concerns, like I did, he may be labelled as "immature" or worse, like I was.
What both of these comments underscore is the need to talk about children before you get married. When one partner wants them much more than the other, resentment and depression can easily result. Despite the words of Calmd and Penumbranian, it's not always the woman who wants kids more. However, women do bear a greater physical, and often a greater social burden in pregnancy and child-rearing. Writes D.J.,
Hmm, the men don't give birth, don't carry a child for nine months, don't have hormonal or weight fluctuations, swollen ankles, stretch marks, sleepless nights when there is no comfortable position in bed, heartburn, morning sickness, but they want to suffer from post-partum depression. Then, they usually aren't the ones nursing, or have a body trying to return to it's pre-pregnancy status. They typically aren't the ones getting up in the middle of the night to feed or calm the baby, run the rest of the household if there are other children and still have a smidgen of time for themselves. My husband was a helpful as the next one, but given everything that a man doesn't go through, it sounds like whining to me.
It's true that men don't have to go through the physical changes of pregnancy. And it's true that expectations of moms are still higher than expectations of dads. But that doesn't mean men aren't emotionally invested. A commenter who identifies himself as "a medical student and father" writes,
Fathers don't want to suffer from postpartum depression- No one wants to suffer from depression! Depression is not a ‘badge of honor' for all the hardships they have been through- depression is a terrible and crippling (sometimes fatal) disease. Its true that there is likely a different hormonal aspect to the depression but the fact of the matter is we, the scientific community, do not know what causes depression or what combination of hundreds or thousands of bio-psycho-social factors lead to a depressive episode. Whether you label it postpartum depression for women or after pregnancy depression for men, its depression.
The important point is that doctors, like everyone else should be aware of who is at risk and try to understand, treat and hopefully relieve suffering.
Doctors do need to be aware of male postpartum depression — and perhaps we all need to be more inclusive when it comes to a father's role. Many men are still trained to view involved parenting as somehow feminine, and they need to resist this training. At the same time, though, if we as a society want men to share equally in the mundane parts of parenting, the "getting up in the middle of the night to feed or calm the baby," we need to acknowledge that they share in the emotional parts as well. Male postpartum depression may feel like "whining" when women still bear the brunt of child-rearing responsibility, but treating this depression can also be a step towards accepting men's emotional investment in the family and channeling this investment into actual time spent with kids. Children may affect men more than they're currently encouraged to admit — and recognizing this would be good for everyone.