The single biggest predictor of a new dad getting hit with paternal depression — which involves a persistent slew of awful feelings such as sadness, lack of energy, worry, moodiness or changes in appetite, occurring within a year of the baby’s birth — is if his partner gets hit with it first. Some 2 to 25 percent of fathers will experience the condition, and if his partner has it, he has a 50 percent chance of going down the same rabbit hole. The same goes for prenatal or antenatal depression — the same feeling, only during pregnancy instead of after — but its presence is an equally strong indicator of postpartum depression coming on the back end for moms and dads, too.
Factor in a history of depression, stress, poor health or poor relationships, as well as being blindsided by the realities of caring for a newborn (and really, who isn’t blindsided?), and you’ve got a perfect storm for an emotional Molotov cocktail at a time when you’re the most vulnerable, and in charge of the most vulnerable stage of life. Yet, when we’re shown dads who display these symptoms, not only does the average person struggle to recognize it’s even happening, but so do doctors and mental health professionals.
New research just published in the Journal of Mental Health points to why. A study conducted at Anglia Ruskin University by psychologist Viren Swami — who himself experienced postpartum depression as a new dad — asked 406 adults between the ages of 18 and 70 to review vignettes featuring a case of postpartum depression in a man and a woman. They were asked to speculate whether anything seemed wrong with the person in question (such as “stress,” or “anxiety”), whether it appeared to be a mental health disorder, how distressing it seemed, how difficult it might be to treat the condition, how sympathetic they were toward the person and how likely they would be to recommend treatment, assuming the person were a friend.
Not only was it harder for participants to identify when the man was experiencing depressive symptoms versus the woman (90 percent correctly noted the women had it, versus 46 percent with the men), they also found it harder to see anything was wrong with the man at all. Some 97 percent of the participants identified the woman as having an issue, compared with only 76 percent regarding the man.
Mostly, the participants just thought the man was stressed or tired, and as a result, they also assumed whatever it was, it was an easier fix. They also didn’t feel too bad for the stressed-out guy, with researchers noting participants logged much lower empathy for him versus her. In other words, with women, it’s easier to tell when something is off, and it’s easier to see when reviewing symptoms presented by new mothers that it’s postpartum. We feel worse for them, and we understand it’s a more complicated issue.
But we still don’t think men can fully get in on this experience. “Our understanding of depression and mental illness generally is shaped by gender-role ideologies,” Swami tells me. “In many societies, men are socialized to be tough, stoic and self-reliant, and the experience of mental ill-health is seen inconsistent with normative expectations about masculinity. In very simple terms, men are punished when they express signs of weakness because they are seen as transgressing norms of masculinity.”
Other research backs this up: When men experience paternal depression, they face a host of complications that exacerbate things, all for reasons that range from not knowing it’s possible to not believing it’s happening. Men are reluctant to admit to bad feelings in the first place because they’ve been taught that feelings are weak and embarrassing. So when a man is extremely isolated or angry after the birth of a child, he looks for reasons that sound practical, not emotional.
A perfect example: When David Levine, a pediatrician who routinely cares for children and counsels their parents on postpartum, experienced anger and irritability after the birth of his son, he thought there was simply something wrong with the child for crying so much. Levine has written about the experience to demonstrate that even when someone is knowledgeable about the issue, it’s still much different when it happens to you through the layers of expectation about your gender:
His son, Zachary, cried constantly. As a pediatrician, Dr. Levine often comforted anxious parents and crying babies. But in his new role as a father, his medical training couldn’t rein in his obsessive fear that Zachary’s persistent crying indicated a serious medical issue. “I became fixated on the idea something was devastatingly wrong with my son.”
At work, Dr. Levine rallied engrossed in his practice. Back home in the couple’s small apartment he was irritable and even angry. “Every time I’m with him he’s crying,” Dr. Levine told his wife. “And now I’m even more convinced there’s something terribly wrong with him.”
His wife and his son’s pediatrician tried to reassure him. They didn’t succeed. “No one could persuade me that my son was fine,” he says.
Then when Zachary was but a few weeks old, Dr. Levine became convinced that the baby hated him. “He cries as soon as I walk in the door,” he told his wife who pointed out that the baby was too young to hate anyone. Feeling isolated and rejected, Dr. Levine became ‘verbally vicious’ to his wife and demeaned his son constantly. “Maybe he’s autistic,” he told her, “hammering the point home day after day.” As the weeks went by his thoughts and feelings about, and toward his son, got darker. “I hate him. I wish we’d never had him,” he told his wife.
And because men are already in a position where they know they’re supposed to be supporting their female partners who have the monopoly on baby-related anything, they have no way through the feelings, no way to talk about them and low receptivity from everyone around them. When you add in the fact that their female partner’s attention has done a 180 in the direction of the baby, making the new dad feel particularly isolated, this can manifest in the worst possible way: In resentment toward the partner and the baby.
That creates a domino effect of isolation and depression. And the effects can be devastating. “Postnatal depression in dads has a detrimental effect on dads themselves, most notably in terms of higher risk of suicide,” Swami explains. “It also has a negative impact on the well-being of their partners, including higher risk of maternal postnatal depression, as well as on father-child bonding. For example, postnatal depression in dads is associated with poorer father-child attachment, lower participation in child-rearing and lower engagement in enrichment activities with children like singing and reading. Depressed fathers are also more likely than non-depressed fathers to use physical discipline with their children and to communicate with their infants in ways that are more critical.”
The solution here at the baseline is that we need to extend depression screening so that it’s routine for new mothers and new fathers — both during and after the pregnancy. “The most practical solution is routine screening of all new fathers for depression, so that all parents are treated equally,” Swami writes. “But more generally, we need to bust the myth that dads cannot be postnatally depressed, which means educating parents and wider society about the causes and impact of postnatal depression. If men remain ‘invisible’ in terms of public perceptions of depression, they are unlikely to get the care they need.”
Part of what makes this such a particularly ironic shortcoming of the medical profession and society at large is that it’s not as if women and men’s actual experiences are so foreign. It’s not as if they can’t easily be understood. The feelings and experience of parenting new life, it turns out, are shockingly universal — the good, the bad, the indifferent. Women and men may handle them differently — men are more likely to engage in self-harm through addiction or escape, or externalize the issue as Levine did, whereas women will internalize it and blame themselves — but the tales of how women experience pre- or postnatal depression demonstrate that women are right there beside these new dads often experiencing a similar hellish isolation with the same inexplicable anger, irritation, worry and resentment.
And yet, it’s the myriad layers of misperception between us that pose the biggest challenge of all — that we still don’t really think of men as fully emotional to the degree that we do women. We especially don’t see them as emotionally invested in childrearing as women are. And that when you put these things together, when we look at a man who is exhibiting sadness, irritability and mood swings after becoming a dad, our brains will find any reason we can think of to explain it, except that he has postpartum.
Thinking otherwise would force us to reexamine deeply embedded ideas about how men feel, relate and care, and how they’re affected by the very life choices they participate in alongside us. It would force us to finally admit that we still, in large part, see all of this as a “woman’s issue,” when it’s a human one. Because technically, we still just don’t see men as fully participating.