June marks Canadian Men’s Health Month – an excellent opportunity to consider the important but oft-neglected topic of perinatal depression in men.
In recent years, perinatal depression in women has become widely recognized as a significant public health issue. However, paternal/partner perinatal depression (PPND) and the mental health of new fathers/non-birthing partners receives far less attention.
PPND is defined as a major depressive episode that occurs in the father/non-birthing partner between the first trimester of pregnancy and the end of the first year of the infant’s life. It is most likely to present within three to six months of the birth of the child. It reportedly affects 10 to 12% of this population, although the rates likely underestimate the true prevalence of PPND, as depression in men is underdiagnosed and underreported.
Risk factors for PPND include a personal history of depression, couple conflict, unintended pregnancy, poor job satisfaction, financial stress and lack of social support. Sleep deprivation may also be a contributing factor. PPND is significantly more likely to occur if the mother/birthing partner is depressed, with approximately 24 to 40% of partners affected.
While depression can present as low mood with reduced activity for all genders, men are more likely to display anger, hyperactive behaviour, irritability and poor impulse control. Particularly in men, depression can be masked by interpersonal conflict, physical complaints, drug and alcohol use, and avoidant behaviour.
Men/non-birthing partners may be less likely to seek help for mental health issues after the birth of a child, ignoring symptoms or attributing them to fatigue. They may feel uncomfortable reaching out for support (possibly reflecting traditional masculine ideals such as stoicism and self-reliance). They are also less likely to visit a primary care provider, which reduces the opportunity for screening and diagnosis.
New fathers/non-birthing partners should be screened for depression, particularly in the first year and when risk factors are present. Treatment of PPND can include psychotherapy (such as cognitive behavioural therapy and counselling) and antidepressant medication.
PPND can have a negative impact on family relationships, as well as the health of mothers/partners and children. There is evidence that untreated PPND can negatively affect parenting behaviours, and child development and wellbeing.
Increased awareness, successful detection and treatment of depression in all mothers and fathers is critical to ensuring the best possible outcome for the family and children. PPND is ideally addressed by education programs, a father/non-birthing partner-inclusive model of care, support from employers, and providing more emotional and parenting support to men/non-birthing partners as they experience their new family roles.
Resources
Support Services for Partners – Pacific Post Partum Support Society
Mental Health & Substance Use Services – Island Health
Becoming a Dad and Maintaining Your Mental Health – HeadsUpGuys
For urgent support 24/7 call the Vancouver Island Crisis Line: 1-888-494-3888