Postnatal Depression in Men

Male postnatal depression (PND), also known as male postpartum depression or perinatal depression, is a real and serious issue that affects many men, yet it remains largely in the shadows.

In my 30 years of experience as a practicing psychotherapist, I’ve heard many stories from men who’ve faced difficulties adjusting to life as a new father (as well as my own experience with stressors related to raising two children). These are successful men from a wide range of backgrounds – men in finance, professional athletes, veterans, teachers – proving that postpartum depression in men can happen to any guy.

The following story from a man I’ll call “Jim” is a typical example of what I hear in my practice.

Jim’s Story

For Jim, an orthopedic surgeon, the realization of his struggle came when he imagined himself shaking his baby. His son, 2-weeks old at the time, cried incessantly, and Jim’s frustration grew. Despite his medical knowledge, he felt like a failure when he couldn’t soothe his son. This led to severe self-criticism, anger, and disturbing thoughts of violence toward himself and his child, which overlapped with a lingering sense sadness

Jim’s experience is not unique. Many fathers who expect to excel in parenthood find themselves overwhelmed when their child actually arrives. The transition from being a supportive partner during pregnancy to an active caregiver can be jarring, especially when practical tasks, like calming a crying baby, seem insurmountable.

Men Can Get Postnatal Depression

Postnatal depression (PND) in men is often seen as a condition that affects women, but men are just as susceptible.

An estimated 10% of fathers experience depression within the first year of their child’s birth^[1], with some studies suggesting that number could be higher.^[2]

Despite this, resources and support systems are lacking, leaving many fathers without the help they need.

Although it is less studied and understood compared to postnatal depression in women, postnatal depression in men can be related to hormonal and biological changes, including:

Changes in Hormones: Changes in hormones, such as cortisol (stress hormone), estrogen, and vasopressin, which are involved in bonding and stress responses, may play a role.^[3]
Testosterone Levels: Some research has shown that new fathers may experience a drop in testosterone levels after the birth of their child^[4], though findings regarding the role of testosterone are inconclusive. Very low testosterone levels have been linked to depressive symptoms in some men.^[5]

Sleep Deprivation: New fathers often experience significant sleep disruption, which can impact mental health and contribute to depression. Postnatal depression can also negatively impact sleep quality, resulting in a vicious cycle.^[6]
Stress and Responsibility: The added stress and responsibility of a new child can potentially lead to depressive symptoms. ^[7]

Signs and Symptoms of Postnatal (or Postpartum) Depression in Men

Recognizing symptoms of male PND is crucial for timely support.^[8] Symptoms of depression in men can differ from those in women. Beyond more typical symptoms (such as feelings of inadequacy, guilt, and persistent sadness), PND in men may also manifest as:

Irritability
Anger
Escapist behaviours (overworking, too much time on social media, or substance abuse)

These symptoms can easily be overlooked or misattributed to other factors. Men might also experience:

Extreme fatigue
Loss of interest in activities they once enjoyed
Difficulty bonding with their baby.

Physical symptoms such as headaches or digestive issues can also indicate depression. Because these signs can be subtle or mistaken for other stress-related conditions, it’s important for partners and healthcare providers to remain vigilant and supportive.

Why Men Don’t Seek Help

Even when men (or their partners or others) recognize there may be an issue, fathers face unique challenges when it comes to seeking help for PND. Societal expectations often dictate that men should be strong, stoic, and self-reliant, especially during significant life changes like the birth of a child.

Moreover, many men feel they must be an unwavering support for their families. But the pressure to conform to such masculine stereotypes can exacerbate feelings of inadequacy and prevent men from acknowledging their own struggles and reaching out for support.^[9]

In heterosexual relationships, the focus is, understandably, typically on the mother during prenatal and postnatal periods, often excluding fathers from vital support and information. This can leave men feeling further isolated and unsupported, compounding their stress and leading to depression.

Continuing with Jim’s story, like many of my clients, Jim didn’t share his feelings with his partner (nor enter therapy) until months later, fearing she would think less of him. His silence, like that of many other fathers, got in the way of him receiving the support he desperately needed, which made his depression even worse.

The consequences of untreated PND in fathers can be severe, affecting not only the man himself, but also his family. Fathers play a critical role in their children’s development^[10], and their mental health directly impacts their ability to engage and support their family.

Fortunately for Jim, we were able to work on several strategies to help him discover a renewed sense of control in his life. Here are some of the tips we discussed.

Tips for New Fathers

If you’re a man experiencing PND, taking active steps is crucial for recovery and well-being.

Acknowledge your feelings without guilt or shame. Understanding that PND is a legitimate and common challenge for men is the first step toward healing.

Communicate openly with your partner (or the other parent of your child) about these difficulties.

Share where your stress is coming from, what you need from them, and be open to receiving feedback.

Talk to someone you trust about what you’re experiencing.

Whether it’s your partner, a friend, or a family member, sharing your feelings can provide relief and open the door to support.

Seek professional support (this step is essential).

Check in with your family doctor, your pediatrician, or most importantly, a mental health professional who can offer talk therapy to help you better understand the issues behind the feelings you’re experiencing and develop strategies for overcoming them.

Join a support group for fathers.

Support groups can provide a sense of community and understanding from others who have gone through similar experiences.

Physical health also plays a significant role in mental well-being, so engage in regular physical activity (even 30 minutes of activity helps), maintain a balanced diet, and ensure you get enough sleep. These activities can help regulate mood and increase energy levels.

Practice stress-reduction techniques such as mindfulness, meditation, or deep-breathing exercises to manage stress and improve your overall mental health. Set realistic expectations for yourself as a new father. Understand that it’s normal to feel overwhelmed and that you don’t have to be perfect. Take breaks when needed and don’t hesitate to ask for help with childcare responsibilities.

Tips for Supporting a New Father (For Partners or Friends)

In my practice, I’ve often met with wives, partners, or friends who are concerned about a new father. Here are five tips, with examples, of what you can say to help a dad who you might be concerned about:

Acknowledge His Feelings
- “I know becoming a dad is a huge change, and it’s okay to feel overwhelmed. How have you been feeling lately?”
Encourage Open Communication
- “It’s important to talk about how you’re feeling. I’m here to listen if you need to share anything.”
Offer Practical Support
- “Would it help if I helped take care of the baby for a couple of hours so you can have some time to yourself?”
Suggest Professional Help
- “Many new dads experience what you’re going through. It might be helpful to talk to a counsellor or therapist who specializes in postpartum issues.”
Reassure Him
- “You’re not alone in this. Many fathers go through similar feelings, and there are resources and support systems available to help you through it.”

These tips aim to provide comfort, encouragement, and practical support.

Moving Forward

By addressing the unique challenges men face and providing appropriate support, we can help fathers navigate this critical period and ensure the well-being of the entire family.

Male PND is a significant issue that deserves attention and action. By breaking the silence and offering the necessary support, we can help fathers thrive in their new roles and foster healthier families.

If you think you might be affected by PND, our Depression Check can help you assess symptoms and provide further next steps.

Depression Check

Additional Resources

References:

Scarff J. R. (2019). Postpartum depression in men. Innovations in Clinical Neuroscience, 16(5-6), 11–14.
Aviv, E. C., Preston, E. G., Waizman, Y. H., Dews, A. A., Flores, G., & Saxbe, D. E. (2023). Fathers’ subjective childbirth stress predicts depressive symptoms at six months postpartum. Journal of Affective Disorders, 339, 593–600.https://doi.org/10.1016/j.jad.2023.07.064
Kim, P., & Swain, J. E. (2007). Sad dads: paternal postpartum depression. Psychiatry (Edgmont (Pa. : Township)), 4(2), 35–47.
Gettler, L. T., McDade, T. W., Feranil, A. B., & Kuzawa, C. W. (2011). Longitudinal evidence that fatherhood decreases testosterone in human males. Proceedings of the National Academy of Sciences, 108(39), 16194–16199. https://doi.org/10.1073/pnas.1105403108
Indirli, R., Lanzi, V., Arosio, M., Mantovani, G., & Ferrante, E. (2023). The association of hypogonadism with depression and its treatments. Frontiers in endocrinology, 14, 1198437. https://doi.org/10.3389/fendo.2023.1198437
Saxbe, D. E., Schetter, C. D., Guardino, C. M., Ramey, S. L., Shalowitz, M. U., Thorp, J., Vance, M., & Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network (2016). Sleep Quality Predicts Persistence of Parental Postpartum Depressive Symptoms and Transmission of Depressive Symptoms from Mothers to Fathers. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 50(6), 862–875. https://doi.org/10.1007/s12160-016-9815-7
Fang, Y., Luo, J., Boele, M., Windhorst, D., van Grieken, A., & Raat, H. (2022). Parent, child, and situational factors associated with Parenting Stress: A Systematic Review. European Child & Adolescent Psychiatry, 33(6), 1687–1705. https://doi.org/10.1007/s00787-022-02027-1
Wainwright, S., Caskey, R., Rodriguez, A., Holicky, A., Wagner-Schuman, M., & Glassgow, A. E. (2023). Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. BMC Pregnancy and Childbirth, 23(1), 675. https://doi.org/10.1186/s12884-023-05966-y
Ogrodniczuk, J.S., Oliffe, J.L., Kealy, D., Seidler, Z.E., Sharp, P., Rice, S.M. (2023). Silence and its manifestations in men’s mental illness. Nature Mental Health, 1, 446–448. https://doi.org/10.1038/s44220-023-00093-1
Koch, S., De Pascalis, L., Vivian, F., Meurer Renner, A., Murray, L., & Arteche, A. (2019). Effects of male postpartum depression on father-infant interaction: The mediating role of face processing. Infant Mental Health Journal, 40(2), 263–276. https://doi.org/10.1002/imhj.21769