Postpartum depression can affect dads

About 10 per cent of fathers experience depression before or after the birth of a child, according to anew review of studies.

It is well known that maternal depression, both prenatal and postpartum, is common and can harm both the mother, the family and the child's development. Less is known about the prevalence, risk factors and effects of depression among new fathers.

To find out more, pediatrics professor James Paulson and co-author SharnailBazemore of the Eastern Virginia Medical School in Norfolk, Va., reviewed 43 studies involving 28,004 participants looking at depression in fathers between the first trimester and the first year after the birth of a child, when parents may feel disconnected from the newborn and overwhelmed.

"It's not a really pleasant creature most of the time during early infancy," Paulson said. "It's a red, screaming poop machine that just wants to be fed and doesn't really give anything back, not right away.You can see how that's really stressful for a father who might not be able to get in there and get involved or have the kind of role they envisioned."

The findings included:

• The overall estimate of paternal depression was 10.4 per cent comparedwith an estimated 4.8 per cent among men in the general population over a year.
• The three- to six-month postpartum period showed the highest rate (25.6 per cent) and the first three postpartum months showed the lowest rate (7.7 per cent).
• There was a "moderate correlation" between depression in fathers and mothers.

The prevalence finding "suggests that paternal prenatal and postpartum depression represents a significant public health concern," the study's authors concluded.

Psychosocial causes such as lack of social support, marital strain, isolation and financial burdens are consistently linked with depression in moms and can affect dads just as much, Paulson said.

The parents aren't the only ones affected. When fathers or mothers are depressed, children tend to have more emotional and behavioural problems by the time they are preschoolers, and an increased rate of psychiatric disorders by age seven, Paulson noted.

Parental stressors

The research suggests dads also experience the stressors of having children and alsolie awake at night helping to care for the infant, saidCindy-Lee Dennis, a professor of nursing at the University of Torontowho studies the prevention and treatment of postpartum depression in women.

Dennis said typical symptoms occur almost every day for almost two weeks, such as:

• Not feeling happy.
• Feeling sad.
• Not enjoying activities you typically enjoy.
• Changes in appetite.
• Changes in sleep.

Depression is often associated with anxiety, such as worry over the care of the infant, she added.

Screening, treatment for families

"Fathers need to start looking at themselves in the postpartum period and understand that the symptoms that they're experiencing are not necessarily normal," Dennis said.

At a music class forbabies in Toronto, father Trevor Birchsaid he can understand how anxiety in the first few months could trigger depression in men.

"If there was a cough or if he choked on something, you know, I was really kind of anxious about that," Birch recalled. "So I can see if people are already struggling with anxiety and depression and those kind it things it could be something that might even bring it on."

The researchers suggested that depression in one parent should alert health-care professionals to pay attention to the other parent.

Paulson said that prevention and treatment efforts for depressed parents might focus on the couple and family rather than the individual.

There will be a stigma associated with having depression in the postpartum period, and researchers need to look at how to overcome thesebarriers, and to target treatment and supportsuch as cognitive-behaviour therapyfor fathers, Dennis agreed.

Focusing on new parents together could help to identify parental depression earlier and increase understanding of how the condition conveys risk to infants and young children, the team concluded.