Can men get postnatal depression?

Men don’t go through pregnancy or childbirth. Their hormone levels don’t nosedive. They don’t get sore nipples. What exactly have they got to be depressed about? Quite a lot, according to research from Sweden showing that, over the past 10 years, a significant number of men have struggled with the transition to fatherhood.

This latest research tries to quantify just how many men get postnatal depression. Previous studies have found between 4% and 10% of men, while, in this smallish sample of 447 Swedish fathers who volunteered (and may therefore not represent your average dad), a surprising 28% of men had symptoms that scored above mild levels of depression. Overall, 4% had moderate depression. Fewer than one in five fathers who were depressed sought help, even though a third of those had thought about harming themselves. While women in the UK are often asked a series of questions that screen for postnatal depression (which affects up to 13% of women), the mental health of fathers is rarely assessed.

The solution

The lead author of the Swedish paper, Elisa Psouni, from the department of psychology at Lund University, says the Edinburgh Postnatal Depression Scale (EPDS) used for both women and men is not so accurate in picking up depression in fathers. Her research showed higher levels of depression in dads because it added in a score more reflective of “male” symptoms of depression such as agitation, anger, irritability, working longer hours and drinking too much.

Depression in fathers may be rising not just because researchers are looking for it, but because more new dads are struggling. Psouni believes fathers increasingly face the same dilemmas that mothers do – including trying to combine parenthood with working. Fathers who got depressed often had external pressures, such as job issues, and if their partner was depressed, their own risk of depression doubled. Lack of sleep, having twins and conflict in the relationship can all contribute.

A depressed dad will play and smile less with his child. Children are deeply affected by paternal postnatal depression with studies showing poorer measures of wellbeing and more behavioural problems at the age of seven.

Fathers who sense they may be struggling and partners, relatives or friends who notice an increase in irritability and anxiety in a man in the first year of parenthood (paternal depression is more dispersed throughout the first 12 months) should consider the possibility of paternal postnatal depression.

Cognitive behavioural therapy can help, as can antidepressants. If the depression is not recognised, says Psouni, “one of most terrible things is that you catch up with yourself a year later and realise you have been really down and struggling – and the first year of your child’s life has gone.”