The narrative around postnatal depression is changing; what was once considered to be a maternal issue is now thought of as a more general parental issue, and there are many reasons why this shift is important.

Here, we are shining a light on the much-stigmatised topic of postnatal depression in fathers and co-parents, to discover why it happens, the symptoms to watch out for, the treatment options available, and more.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about postnatal depression, we’re here to help.

What is postnatal depression?

Postnatal depression is a type of depression that presents when someone has recently become a parent. Although it mainly affects around 10-20% of mothers who have recently given birth, it can be a huge issue for the other parent involved too, whether this is a father or a female co-parent.

Postnatal depression can be very serious, and can have implications for the wider family unit as well as the child themselves, so it is important that it is addressed sooner rather than later.

Can fathers and partners get postnatal depression too?

Yes. Despite the fact there are still high levels of stigma about mental health illness in men, it is true that fathers can experience postnatal depression. According to the mental health charity Mind, non-birthing partners of all genders can develop mental health issues after birth, which can include feelings of depression and anxiety. Postnatal depression refers to depression experienced by any parent, whether birthing, non-birthing, adoptive or otherwise, in the first year of having a child.

Postnatal depression can affect anyone who has adopted a child, gone through surrogacy, had a difficult IVF journey, and more. Often there is an expectation for parents to work through issues without complaint when there have been many obstacles to overcome to finally have a child, but in reality, anyone can experience postnatal depression regardless of their circumstances.

Research indicates that 18% of postpartum men report high levels of anxiety, and further studies of 447 fathers in Sweden found that 28% of men showed symptoms that scored above mild levels of depression, and 4% had moderate depression. Interestingly, less than 1 in 5 depressed fathers sought help for their issues.

In wider society it has been estimated that around 10% of fathers with no previous mental health issues show signs of depression within the first year after their partner has given birth, while other studies suggest that figures are as high as 1 in 4 fathers showing signs of depression 3-6 months after their partner gives birth. One 2022 review of nearly 30,000 couples found that in 3 out of 100 families, both parents experienced postnatal depression simultaneously, which estimates that over 100,000 babies had two parents dealing with postnatal depression at the same time.

What causes postnatal depression?

Postnatal depression is often thought to be caused by fluctuating hormones in the aftermath of childbirth. This is true, however there are many other factors at play contributing to the issue. Studies have suggested genetics, psychological factors and social life stress could all be involved in its development.

Looking at hormones specifically, recent research has discovered that hormones in fathers can also change following a birth, and can even change as early as the pregnancy period. In men, testosterone levels tend to decrease, and studies have found that, amazingly, these hormone changes are thought to help fathers form strong bonds with their children.

Lower testosterone levels can lead to lower levels of aggression and an increased sympathetic response to a crying child. Fathers also get an oxytocin boost when interacting with their child (more “happy” chemicals) which is thought to help male parents become more engaged in parenting behaviours.

While these hormonal changes are helpful for bonding with a new baby, they may also predispose new fathers to postnatal depression, since low testosterone levels have been linked to symptoms of depression in men. On top of hormonal changes, new parents must adjust to lots of other external changes, such as:

• Getting to know the new baby
• Changes in their relationship with their partner
• Changes in the couple’s romantic behaviours and sex life
• Additional daily responsibilities
• Supporting the birthing partner
• Additional financial pressure
• Societal pressure caused by the narrative that partners must be the sole breadwinner

"My feelings, or should I say lack of feelings, didn’t present themselves all at once. They crept up on me slowly, affecting how I felt until reaching the point where I broke down." - The PND Daddy blog

What are the symptoms of postnatal depression in dads?

It can be hard to identify symptoms of postnatal depression in new mothers, and even harder to identify them in fathers or co-parents since the symptoms are different. Also, during the perinatal period, there are far more check-ins with midwives, health visitor appointments, and antenatal/postnatal classes for mothers than there are for fathers, so it is easy for the signs to be missed.

While new mothers typically experience postnatal depression symptoms such as low mood, loss of interest in things they once enjoyed, insomnia, feelings of guilt, and loss of energy, new fathers with postnatal depression are more likely to exhibit avoidant or escapist behaviours like staying late at work, spending long hours on their phone, or abusing alcohol or other substances.

Studies have found that irritability, indecisiveness and a restricted range of emotions are more common in men with postnatal depression compared to women. Other signs and symptoms of postnatal depression in fathers include:

• Feelings of fear and uncertainty about the future
• Feelings of confusion and helplessness
• Feelings of guilt, for example after watching a partner go through a traumatic birth
• Withdrawal from family and other areas of life
• Feelings of cynicism, anger, hostility or indifference towards their partner
• Signs of hostility or indifference towards their baby
• Insomnia and trouble sleeping/relaxing
• Physical issues such as indigestion, diarrhoea, changes in appetite and weight, headaches, and more

What are the risk factors for developing postnatal depression?

Studies show that risk factors for postnatal depression affecting mothers include things like socio-demographic factors, family dynamics, antenatal factors, pregnancy-related outcomes, and more. The risk factors for fathers and co-parents to develop postnatal depression are different, with issues such as:

• A lack of social support after birth
• A lack of job security or stability to support the family
• Sleep deprivation after birth
• An unintended pregnancy
• A lack of information about pregnancy and birth
• Having poor relationship satisfaction
• Having unrealistic expectations of parenthood

Studies have also indicated a high rate of distress in fathers exposed to “poor foetal, neonatal, and maternal outcomes”. In other words, if a new father experiences the loss of a child, pregnancy complications, or post-birth complications, they can experience the same distress as the mother often does.

What postnatal depression treatment options are there for fathers?

You will find lots of information on treatments for postnatal depression in our article CBT for Postnatal Depression: Does it work?. If you are looking for information specific to fathers and co-parents, it is no surprise that the stigma still surrounding postnatal depression in non-birthing parents means there is a distinct lack of studies and trials concerning treatment.

Treatment options still recommended include:

• Medications, such as selective serotonin reuptake inhibitors (SSRI)
• Psychotherapy, such as cognitive behavioural therapy (CBT) and interpersonal therapy (IPT), which have been found to be effective in helping with depression
• Some studies also recommend daily morning light therapy (due to the correlation between circadian rhythm disturbance and postnatal depression) in order to regulate sleep and positively affect depression symptoms, however studies have only been carried out on women thus far

In one study named ‘What Do Dads Want?’, participants seemed to prefer individual and couple psychotherapy over medicines to treat postnatal depression, as they believed it to be more credible.

Other reviews have encouraged changes in the way that hospital staff present at birth and postpartum appointments conduct their checks for postnatal depression. It is believed they can use their skills to detect signs of postnatal depression in expectant or new fathers, and adopt an inclusive and compassionate approach to treatment by encouraging them to discuss their feelings and referring them to further support.

Nontraditional treatment options like internet communities, online therapy and group workshops have also been thought to help fathers understand postnatal depression more, particularly when there is an element of cognitive behavioural therapy involved.

When it comes to seeking therapy, if you believe you are experiencing postnatal depression you can speak to your GP about treatment options. Alternatively, you can reach out to another service (like ours) for a personalised consultation to introduce you to a therapist with experience in postnatal depression for fathers and co-parents.

“For my husband, there are still bad days, but they are fewer and farther between. He’s more patient, less grouchy. He laughs more. And he’s developed a special bond with our daughter… Parenting continues to be relentless, but now we’re better able to support each other.” - Kim Hooper, contributor to the New York Times and author of ‘All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss’

If you have a question about postnatal depression, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private mental health assessments and reviews, to finding qualified and approved mental health professionals for the support you need: join us today.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.