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Postnatal depression in men: new risk factors identified

May 12 2017
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It may sound strange, but it may be time to rethink postpartum depression, or postnatal depression (PND), as solely a woman’s issue. New findings out of New Zealand  suggest that men can also experience depression after the birth of a child.

In the study called “Paternal Depression Symptoms During Pregnancy and After Childbirth Among Participants in the Growing Up in New Zealand Study,” researchers have identified stress and poor marital relations as two important risk factors that raised the likelihood of the development of PND in men. Other risk factors identified include unhealthy lifestyles and a history of mental illness, as well as the experience of PND by their partner.

What Is PND: the signs and symptoms

To diagnose psychiatric conditions, medical professionals in the United States use the Diagnostic Statistical Manual Version 5 put out by the American Psychiatric Association. Internationally, the used source is the International Statistical Classification of Diseases and Related Health Problems Version 10 put out by the World Health Organization

While the two sources differ slightly, they agree that PND is not its own disease, but rather a type of depression, with a specific cause or trigger. In the case of PND, the specific trigger is the course of pregnancy with its changes in the dynamics of the couple followed by the birth of a child.

“Post Natal Depression is depression. The signs and symptoms are very similar to biological depression. The range in severity is the same. The treatment can be the same,” says Gabriela Cora, M.D., D.F.A.P.A., M.H.A., M.B.A., Medical Director for Behavioral Health at Aetna.

The Center for Disease Control lists the following signs of depression:

  • Feelings of sadness, hopelessness, depressed mood and/or
  • Loss of interest or pleasure in activities that used to be enjoyable
  • Change in weight or appetite (either increase or decrease)
  • Change in activity: being more or less active than usual
  • Insomnia (difficulty sleeping) or sleeping too much
  • Feeling tired or not having any energy
  • Feelings of guilt or worthlessness
  • Difficulties concentrating and paying attention
  • Thoughts of death or suicide

The presentation of symptoms of PND may be ambiguous at times.

“Often with the need of the child coming first, many parents have a disrupted sleep schedule,” says Cora. “A sign of depression is the inability to sleep. But when taking care of a newborn many parents may find their sleep schedules out of line.”

While some symptoms may be a result of becoming a parent, other symptoms may present themselves on their own. By itself, lack of sleep and stress add up as a trigger to more profound symptoms of depression in someone with a predisposition or vulnerability to experience depression.

The New Risk Factors

Researchers found that lifestyle factors including excessive alcohol consumption, smoking and poor diet were major behavioral factors that increased the likelihood of a depressive episode in men. If there is a history of mental illness in the man’s family, he may be biologically more susceptible to experience PND.

Stress also played a major role in increasing the probability of a depressive episode. Partners who did not have a healthy relationship were more likely to see the man develop PND. Further, if the mother experienced PND there was a higher chance that the man would also experience PND himself.

In the study, published in the Journal of the American Medical Association Psychiatry, researchers surveyed men when their partners were in the third trimester of pregnancy. Researchers followed up nine months after the baby was born to assess symptoms and any lifestyle changes.

The Partner’s Health

Generally, after a woman gives birth she will see many more doctors than her partner. This exposure to medical clinicians increases the chance of catching PND in the mother and intervening to help her out.

Other studies on depression in men during the postnatal period have shown a correlation between fathers who experience depression during this time and children experiencing behavioral issues.

“The birth of a baby is a milestone event for the whole family,” says Joanne Armstrong, M.D. “While it is one of the happiest times in the life of parents, it can also be medically and emotionally challenging for both parents. It’s important for both parents to maintain good physical and emotional health.”

The New Zealand study found that if a partner was suffering from PND then a man was more likely to develop it himself. “For partners both experiencing PND, their treatments can follow similar paths,” Cora said.

“Treatment together can turn a stressor into an ally,” Cora explained. “The two can help each other out to work through it together.” Healthy lifestyle strategies are best if executed together. Fine-tuning healthy meals, walking together, going to appointments together and discussing their needs may very well help the couple into their recovery.

PND is treatable

There is nothing wrong with experiencing PND. “A baby changes a lot in life. New parents will find new schedules and roles they must adapt to,” says Armstrong. “Given the current approach, which focuses on the health of the birth mother and baby, as a partner, keep your antenna up for your wellbeing and don’t be afraid to raise your hand and ask for help.”

Couples will need to be able to help each other to maximize their abilities to parent. But even then, it can be tough on both parties. Don’t be afraid to reach out, Cora said.

“A third party can give the couple a much needed break to catch up on sleep, eat a healthy meal, get some exercise or have some time to themselves,” Cora said. “A family member or close friend can give couples that break to take care of themselves.”