While perinatal depression in women during pregnancy and the postpartum period has become more widely acknowledged, it is less commonly recognized those who identify as men. Recent research has indicated that, in fact, 4 to 25% of fathers globally experience postpartum depression (PPD). Fathers are at highest risk for developing perinatal depression during the first trimester of pregnancy. Rates for postpartum depression in fathers are highest at 3-6 months after birth, typically due to factors such as a 4-month sleep regression or the return to work of the birthing parent, but can continue until one year postpartum which may contribute to under recognition of paternal PPD. 

Paternal PPD may also be under-diagnosed because the symptoms tend to be different than those experienced by mothers struggling with PPD. In addition to low mood, paternal PPD may manifest as:

1. Physical symptoms including headaches, muscle aches, or digestion issues.

2. Increased anger, irritability, and/or hostility.

3. More frequent impulsive or risk-taking behaviors.

4. Greater use of alcohol or substances. 

5. Withdrawing from relationships.

6. Working all of the time or finding a new hobby that keeps them out of the household.

It can often be difficult to identify signs of paternal PDD compared to a general adjustment to fatherhood, which can understandably be overwhelming and anxiety provoking. While there are biological risk factors for paternal PPD (such as hormone levels), there are also important life circumstances that may place men or male-identifying individuals at increased risk of developing PPD. These include: 

1. Lack of social support during the transition to fatherhood.

2. Discord or difficulty in the relationship with their partner.

3. Feeling disconnected or excluded from the co-parent and baby, especially during early phases of parent-infant bonding.

4. Maternal postpartum depression.

5. A personal history of anxiety and depression.

6. Medical complications during childbirth, including premature delivery.

7. Mixed feelings about the pregnancy, whether planned or unplanned.

While paternal PPD has often been studied in the context of heterosexual relationships, it is important to consider within queer relationships as well. In fact, recent research has indicated the prevalence of PPD in fathers in same-sex couples was similar to or higher than rates in research on heterosexual couples. 

At Therapists of New York, we understand how difficult the transition to fatherhood can be and that individuals may have differing responses to the intense changes that happen during this period. Receiving help is an important step for overcoming some of these challenges. If you or someone you know is struggling with paternal PPD or the general adjustment to fatherhood, click here to make an appointment for individual therapy or join our group on Becoming Fathers.