After the arrival of his third child, Drew Soleyn, a father from Kingston, Ont., found himself grappling with a cascade of emotions: frustration, isolation, waning motivation and self-doubt about his parenting.
After some time, Soleyn realized he may have been suffering from postpartum depression (PPD).
“I had a partner who had it, but I didn’t recognize the signs,” he said. “And then as a result, it became something that I was going through, too, and I thought, ‘What’s going on here? This is really, really difficult.'”
PPD is a type of clinical depression that occurs after childbirth and is followed by feelings of sadness, hopelessness, a lack of interest in activities, fatigue and changes in weight and appetite, according to the Centre for Addiction and Mental Health (CAMH). It’s also not simply a case of the ‘baby blues’, which are common mood swings experienced due to hormonal changes shortly after giving birth.
While many typically associate PPD with new mothers, fathers can also experience depression after a baby is born.
Paternal postpartum depression occurs among 10 per cent of men between the first trimester and up to one year postpartum, according to CAMH.
Soleyn is now the director of Dad Central Ontario, a nonprofit organization funded by the Public Health Agency of Canada (PHAC) that supports fathers and their role in parenting. He hopes to shed light on the topic of PPD in new fathers, as he believes it can be highly stigmatized.
“There needs to be an awareness that fathers actually struggle with this and that they actually have needs in the postpartum period as well,” he said.
Signs of PPD in men
The signs of PPD in fathers generally occur later for fathers than in mothers, according to a 2019 study published in Innovations in Clinical Neuroscience.
The researchers found that PPD has the highest prevalence within three to six months postpartum in men (in women it can be right after birth), but might also develop over a year later.
Additionally, irritability and indecisiveness may be observed more frequently in men than women.
Other symptoms include a depressed mood most of the day, insomnia, alcohol or substance abuse, violent or aggressive behaviour, weight loss, feelings of worthlessness and isolation.
“It’s a feeling of not being in control of your mood,” said Andrew Howlett, psychiatrist and service head for the Child, Adolescent and Family Mental Health program at St. Joseph’s Health Centre in Toronto. “A loss of pleasure and joy, maybe experiencing some excessive thoughts around guilt or hopelessness or even thoughts of death or in some cases suicidal ideation can also be a part of that.”
Risk factors for PPD in men
A 2021 Canadian study published in Depression and Anxiety found that almost a quarter of the 3,217 fathers enrolled reported high levels of depression and anxiety at some point during the first year of a newborn’s life.
The study said the strongest risk factors associated with paternal PPD included depression before pregnancy, anxiety in the current pregnancy, significant adverse childhood experiences, a positive attention-deficit/hyperactivity disorder (ADHD) screening and victim of intimate partner violence.
Dealing with changes in one’s work life, friendships, romantic relationships and financial stress can also contribute to the risk of PPD in fathers, Howlett said.
“The father is kind of seen as a supportive role and ensuring that others are doing well following the birth of the child, which is obviously a big event,” he said. “And this transition into parenthood it can be quite stressful and there’s a lot of change both with how they see themselves and changes within their relationship.”
Another major risk factor for men is having a partner who is struggling with depression and anxiety, he added.
When a new mother develops psychiatric problems, her male partner is at higher risk of developing mental health problems, according to CAHM. When this happens, there is a 24 to 50 per cent increased risk of depression and a 10 to 17 per cent increased risk of anxiety among men.
'Vulnerability a common challenge for men'
The reasons men can get PPD can be as varied as the individual, explained Soleyn.
However, a main driver can be the fact that men are less likely to be open and vulnerable about how they are feeling, he added.
“Many men struggle to recognize their own emotions. And I think that’s more of a generational thing … previous generations didn’t really have much focus on the need and value of all the range of emotions,” Soleyn said.
“That experience of not being able to recognize our own emotions, maybe not even having the skills to be able to share those emotions … vulnerability is a common challenge for men.“
With the invisibility of their depression, many fathers may cope on their own instead of seeking help.
Soleyn cited a 2019 study by Movember and Ipsos, which polled around 4,000 men about their transition into fatherhood.
Almost a quarter (23 per cent) of dads said they felt isolated when they first became a father. Twenty per cent of fathers said the number of close friends they had decreased in the year after becoming a father.
The study also found that having close friends is important for fathers’ mental health. For example, fathers without close friends were more likely to experience increased stress levels in the first 12 months of becoming a father. A third of dads without close friends said their stress levels increased “a lot”, compared with just under a quarter of all men with at least one close friend, the poll found.
“There’s an isolation that comes in not being as closely connected to your partner or not as closely connected to your friends or other social sports, which are great mitigation for some these symptoms,” Soleyn said.
“And so that isolation fuels more loneliness, which fuels more deeper feelings that aren’t actually expressed and addressed. And it can create a very negative cycle.”
Treatment for PPD in men
The treatment for PPD in fathers involves a combination of therapy, lifestyle changes, and, in some cases, medication, explained Howlett.
“I think even the medical and mental health community maybe not be fully aware of this experience for men,” he said. “I’d encourage men to educate themselves a bit more about it and realize that they’re not alone in their experiences, and speaking to their family physician and letting them know they may be struggling and whether they were to seek their own counseling or look for a referral.”
Screening fathers for PPD in fathers is also an important solution, according to experts.
“If a mother screened, then the father should be screened as well,” Soleyn said. “It should be standard practice.”
The Canadian Task Force on Preventive Health Care 2022re guideline Recommendations on Screening for Depression in Adults does not recommend screening for depression in perinatal and postpartum women using questionnaires. However, the organization recommends tools to help detect anxiety and depression in the postpartum period.
One of them is called The Edinburgh Postnatal Depression Scale, which is used in clinical care or for women at risk of, or showing, symptoms of postpartum depression. The guideline did not mention fathers.
Global News reached out to Canadian Task Force on Preventive Health Care about whether it recommends tools to help detect PPD in fathers, and a spokesperson said although the panel hasn’t looked at the topic for a guideline, she called it, “important.”
The spokesperson said, Dr. Eddy Lang, a panel member who led the creation of the guideline on screening for depression in pregnant and postpartum people said: “We can apply our general guidance to ask about mental health in general terms, especially if both parents are attending pre and post-partum visits.”
Soleyn believes that implementing screening measures for fathers will significantly contribute to shedding light on the realities of PPD in men.
“Parents have needs. And I think the more that fathers can be seen needing support in a transition to fatherhood, then the healthier the families become,” he said. “Fathers play an absolutely crucial role in supporting healthy child outcomes. They also play a crucial role in supporting healthy families.”
— With files from Reuters and Global News’ Noor Ibrahim