Postpartum depression in mothers is a widely recognized condition that affects 1 in 7 women. But less known is that 1 in 10 new fathers also experience depression.

Paternal postpartum depression (PPD) is a significant mental health issue that often goes undiagnosed and untreated, largely due to a lack of public awareness and the societal pressure on men to be “strong.”

Recent studies and clinical observations found that new fathers are not immune to the emotional and psychological challenges that follow the birth of a child. Research indicates that approximately 1 in 10 new fathers experience postpartum depression. This number can jump to 50% when their partner is also experiencing postpartum depression. Unfortunately, it is estimated that only about 10% of cases in men are officially recorded, indicating a vast number of fathers are suffering in silence.

“The perinatal period is a time of significant change for new fathers,” explains psychologist Brett A. Biller, who is director of mental health at the Audrey Hepburn Children’s House at Hackensack University Medical Center. “They often experience hormonal shifts, including decreased testosterone and increased estrogen and cortisol, which are evolutionary mechanisms to increase attachment to their offspring but also make them more susceptible to depression and anxiety.”

Unlike the stereotypical image of depression, paternal PPD often manifests through outward symptoms. While new mothers may exhibit sadness and withdrawal, new fathers are more likely to show irritability, agitation, increased substance use, and aggression. These symptoms can have a profound impact on the entire family, affecting the partner relationship and increasing the risk of language deficits and behavioral issues in children.

Several factors contribute to the low rates of diagnosis and treatment for paternal PPD. Many fathers are reluctant to report their symptoms, often due to a lack of awareness that they are experiencing a legitimate health condition. The notion that they should be the rock in the home at a time when a partner and a newborn most need support leads many men to feel that they’re falling short in their family responsibilities. They often feel guilt and even shame. Societal expectations for men to be stoic providers can create a significant barrier to seeking help.

“Increased negative symptoms after the birth of a child are also related to environmental influences, such as fathers experiencing reduced sleep, increased financial pressure, significant change in the relational dynamic with their partner, and often a lack of support provided to fathers,” Biller says. “We can only wonder how pervasive paternal depression and anxiety likely are but are not recognized due to fathers being more reluctant–or unaware of how–to report and seek services to address their emotional symptoms.” 

Recognizing the Signs and Seeking Help

It is crucial for fathers, partners, and healthcare providers to recognize the signs of paternal PPD. Key symptoms include:

• Irritability, anger, and aggression
• Social withdrawal and isolation
• Increased alcohol or substance use
• Changes in sleep and appetite
• Loss of interest in previously enjoyed activities
• Physical symptoms like headaches and stomachaches

For fathers experiencing these symptoms, the first step is to validate their struggles and understand that they are not alone, stresses Biller. Seeking professional help, such as individual or group therapy, is a sign of strength and can lead to a promising prognosis for recovery. Cognitive-behavioral therapy has been shown to be particularly effective.

Trying to suppress stress takes a toll, if not at the start within the first year, according to research published in JAMA in March. That research showed a 30 percent rise of depression and other psychiatric conditions in fathers a year after a baby is born, compared to their mental health during their partner’s pregnancy and immediately after. The researchers concluded that the cumulative pressures of fatherhood, such as sleep deprivation and shifts in relationship dynamics, may take a toll over time. These findings also highlight a potential gap in postnatal support, which has traditionally been more focused on mothers in the immediate postpartum period.

Resources for New Fathers

Organizations like Hackensack Meridian Health are stepping up to address this critical need by offering programs like Productive Parent Coaching. These groups provide a safe space for fathers to validate their feelings, learn emotional management techniques, and develop essential parenting skills within a group of others with a shared experience.

“We must create a supportive environment where fathers feel comfortable seeking assistance,” Biller says.  “By publicizing and making services easily accessible, we can reduce stigma and encourage more fathers to get the help they need.”

For more information on paternal postpartum depression and available resources, please visit PostpartumDepression.org and PostpartumMen.com.

Hackensack Meridian provides Productive Parent Coaching to mothers, fathers, and expecting caregivers. New groups are now available for fathers who are interested in participating in the program exclusively with other fathers. The PPC groups emphasize validation of feelings, exploring means for managing emotions, enhancing understanding of developmental behaviors, and developing parenting skills to facilitate parenting.