Paternal depression is a condition in which a first-time or seasoned father shows symptoms and signs of depression after a child is born. It is becoming increasingly recognized, though its incidence is lower than that seen in mothers.

Paternal depression is estimated to occur in 1-30% of fathers, from early gestation to one year after birth. Depression rates in fathers usually drop sharply at 12 months after birth.

Factors which Contribute to Depression

Paternal depression may be due to the interaction of various factors such as:

• Social factors
• Biological factors
• Environmental or ecological factors

Social Factors

These include loss of intimacy and sexual relationship to pre-pregnancy levels, reduced free time for recreation, increased workload at home, and negative aspects of the parent-child interaction, among others.

Biological Factors

Biological factors may include excessive decreases in testosterone levels, which usually begin during pregnancy and continue well into the first year postpartum.

Environmental Factors

Environmental factors include financial stress, lack of positive feedback during parent-child interactions, such as the baby showing distress upon being left in the father’s care, as well as the lack of competence felt by men who have not had any good role models as father figures in their lives.

How to Cope

Since paternal depression has been shown to seriously affect the life of the family and of the child, it needs to be prevented where possible, and treated appropriately. Suggested measures include:

• Social support mechanisms such as paid paternity leave, as is available or compulsory in some European countries
• Familial and partner support and reinforcement
• Praise and practical advice during the father’s attempts to parent his family
• Education about family life, especially during pregnancy, childbirth, and early infant life, infant care, and commonly occurring infant problems.
• Support for female partners with postnatal depression is of great use in helping the man keep out of depression himself.

Directions for Future Research

There are relatively few studies on the incidence, prevalence, and contributing factors of postnatal depression in fathers. Many of those which are available have a subject base of married, middle-class, white fathers. This makes it difficult to extrapolate the findings to men of other socioeconomic classes and cultures.

Risk Factors

Risk factors need to be further studied, such as:

• Age – very young or relatively old
• Fathers who do not go to work but stay at home and take care of the family’s needs
• Ethnic and racial background
• Low financial earnings
• Stepfathering
• Single fatherhood
• Family background, such as the existence of physical or mental illness or disorder in the spouse, infant, or other family member

Sample Selection

There is therefore a great need to select samples which are representative of a wider and heterogeneous population base, as well as to study paternal depression over a long-term period.

Multiple points of interview will be required using a prospective design, to follow up with fathers who have been identified to be at risk of paternal depression from the time of pregnancy onward. Such longitudinal studies are needed to bring out the course and timeline of paternal depression, as well as its impact on their children and spouses.

International studies will help determine the causative and contributing factors that are similar between different cultures and countries. Identifying such factors can assist in providing better diagnosis and treatment for all fathers at risk.

Assessment Tools

The symptoms and signs that are assessed in most studies rely on self-reporting using various scales or questionnaires. These need to use validated tools and thresholds so that their findings can be useful to other scientists.

Additionally, biological changes and psychological adaptations should be studied to clarify the mechanism of bonding between fathers and their infants. This may require laboratory testing to fill out our knowledge of how the male brain imprints the image of the baby and responds to it.

References

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922346/
• https://www.infona.pl/resource/bwmeta1.element.springer-3819eed6-d2bd-367d-a2ae-08d53f1087ce
• https://www.ncbi.nlm.nih.gov/pubmed/20483973
• http://bjp.rcpsych.org/content/206/6/471

Further Reading

• All Paternal Depression Content

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.