Fathers’s postpartum depression and anxiety

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By Grant H. Brenner

Pregnancy, and the time after the birth of a child, for many is a time of joy, great anticipation and of course an increase in stress and anxiety. The strain placed on the family is considerable and is a time of increased risk for a range of problems. Postpartum depression and anxiety have been better studied in women than in men, as authors Dennis, Marini, Dol, Vigod, Grigoriadis and Brown note in their latest article in. Depression and Anxiety (2021) investigating postpartum difficulties from the father.

The extent of the problem

They report that approximately 17 percent of women develop postpartum depression and 15 percent anxiety, with almost 10 percent experiencing both. Risk factors included previous history of mental illness, low support, higher levels of fatigue, and infant sleep disruption.

For fathers, research has been less intense, though as we recognize the importance of fatherhood, that is changing. Recent research highlighting the role of the father-child bond and the development of paternal identity, for example, has described how men become fathers – from the moment they realize that the baby is actually real rather than an abstract idea, until recognition of responsibility. they need, to take on the role of father, to navigate complex and often contradictory emotions.

The study authors note that the existing literature finds variable degrees of postpartum problems from the father, with depression ranging from 8 percent immediately after birth, rising over 25 percent in the first 6 months and then declining again at the end of the first year. Anxiety rates range from 2 to 18 percent, with risk factors including father’s mental illness history, maternal postpartum problems, economic strain, and newborn health problems.

Postpartum depression and anxiety in the first two years after birth

However, no study has systematically looked at anxiety and depression, along with related risk factors, together. To address these questions, Dennis and colleagues used long-term data collected between 2015 and 2019 with over 2,500 fathers, 75 percent of whom met time points during the two years of study. Questionnaires were sent every three months for the first year and then twice a year for the second year to develop a longitudinal view. Although not all fathers met all the time points, the data collected were analyzed to draw valid conclusions for the general population.

The measures included the Edinburgh Postnatal Depression Rate, the State-Trait Anxiety Inventory subscales, and six areas of potential risk factors based on existing research: 1) demographic factors, 2) pregnancy-related factors, 3) psychiatric and substance use problems of substances / alcohol, 4) childhood difficulties from the father, 5) perceived quality of relationship and support with their partners and 6) factors related to the parents and the baby. Each of these six areas included a number of relevant sub-factors – for example, under the “parent-child relationship”, there was quality of breastfeeding, cohabitation, quality of parental sleep, parental satisfaction, parental role orientation and out-of-care support. children.

They found that in the first year, 569 fathers reported mild to moderate anxiety and depression. In the second year, 323 fathers reported mild to moderate depression and anxiety. Three percent of fathers reported more severe symptoms, which tended to start within the first year and continue into the second year. Depression rates started at 4 percent, increased to over 11 percent within 3 months, and then dropped to about 10 percent over the remainder of the study period. Anxiety followed a similar pattern, starting lower at 8.8 percent, rising to over 20 percent over 3-6 months, and then leveling to 20.4 percent at the end point of the 24-month study.

Risk factors for developing depression and anxiety included the baby’s low perceived health within the first 4 weeks, a previous history of father depression, anxiety raised by the father during pregnancy, a history of intimate partner violence, the need for guidance greater and previous history of paternal attention deficit / hyperactivity disorder (ADHD). Protective factors included the alliance and better fit of the partner, better social integration, greater bonding, more uninterrupted hours of sleep, and higher satisfaction of the father. Risk and protective factors were similar for the first and second year, with differences in the second year including financial strain as a risk factor and loss of the importance of uninterrupted sleep as a protective factor.

Lessons learned

Postpartum depression and anxiety occur together for a significant percentage of fathers – almost 25 percent in the first year and almost 10 percent continuing into the second year after birth, on par with depression and anxiety rates. mother. Many of the identified risk factors can be addressed through psychosocial interventions, including quality of relationship with mother and baby, treatment of previous anxiety, depression and ADHD, factors related to support and sleep, and recognition of the role of difficulty of the fathers themselves in childhood. during the postpartum period.

Biological, psychological, and relationship factors play a role, and providing good support and perhaps therapeutic interventions for fathers is expected to reduce the rate of depression and anxiety. Previous psychiatric conditions need to be identified and treated, and fathers who experienced child abuse during their childhood are likely to benefit from addressing how these issues are triggered when they have their own children, as such negative childhood experiences may predispose to anxiety and depression.

The developmental trauma of the father can also interfere with the father-child bond, leading to emotional disconnection, feelings of inadequacy, and severance of the protective bond between mother and child. Interventions to help fathers experiencing depression and anxiety are also expected to reduce maternal depression and anxiety and strengthen the overall family system. Future research will look at which interventions are most effective and how to integrate them into healthcare settings to identify and assist at-risk fathers, as well as to strengthen the overall effectiveness of parenting education and preparation for pregnancy. , childbirth and after birth. period.

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