You probably assume at least some things about fatherhood—perhaps that it’s filled with joy and love and, at least at first, sleep deprivation. What you likely don’t know? That one in 10 dads experience a perinatal mood and anxiety disorder (PMAD)—that’s postpartum depression, anxiety, or obsessive-compulsive disorder (OCD), for example—after becoming a father.
Makes sense. The lessons we teach boys and men about vulnerability go something like this: Don’t be vulnerable; it’s an antithesis to strength, explains Daniel Singley, Ph.D., a San Diego-based board-certified psychologist and director of The Center for Men’s Excellence, who studies postpartum mood disorders in men. The short version of what society teaches men about fatherhood? That it’s all about providing and protecting.
“Part of the damage we’re doing to men is training them that mental health difficulty and vulnerability are not okay; that they are weakening,” Singley says.
We also often talk about PMADs in the context of women. About one in seven new moms experience one. And because of that, many men feel that a mother’s needs are the only ones that matter. “That’s damaging to men because it clearly says, ‘You and your health are secondary,’ ” Singley adds.
Of course, they’re not. And while no one’s doubting the massive physical and emotional transition to motherhood—carrying a baby, birthing said baby, and recovering from process—your health as a new father matters. And taking care of it might just be the best thing you can do for your family: “Research finds that men’s well-being can shape the health of the whole family. Both mother and baby are more likely to thrive when a father has a positive adjustment to parenthood,” says Darby Saxbe, Ph.D., an associate professor in the department of psychology at the University of Southern California.
Providing also starts with giving back to yourself. “The most important kind of provision fathers can provide isn’t keeping the lights on, it’s providing the best, healthiest versions of themselves to their families,” Saxbe says.
And since no car will drive well with flats, here’s how to spot and tackle worrisome symptoms amidst the chaos of new parenthood.
Who Gets Postpartum Mood and Anxiety Disorders?
The short answer: Anyone. Sure, there are racial disparities and inequities in terms of access to resources and care and cultural biases, but PMADs have been IDed in every culture, age, income level, and ethnicity.
That said, there are risk factors that might predispose you to one. A biggie? A family or individual history of depression, anxiety, or trauma, says Singley.
High levels of stress, a lack of social support, and sleep disturbances—which are essentially inevitable as a new parent—are risk factors, too, says Saxbe.
In the postpartum period, Singley also says that a huge risk factor for fathers to develop depression is a depressed partner, which makes social support a crucial part of feeling better.
“New dads can sometimes feel unsure of how to connect with the baby and less able to help with baby care, so that can be a unique risk factor for men as well,” Saxbe adds.
Could You Have a PMAD?
Let’s start with something simple: It’s normal to struggle with the adjustment to parenthood. It’s a big one—arguably the biggest.
Experts tend to explain that mood issues go from struggling with the adjustment to a potential bigger mood and anxiety disorder when symptoms are frequent (you’re noticing them a lot during the day), long-lasting (this has been going on more than a few weeks), and intense (thoughts, worries, or emotions are hindering your ability to do your job or spend time with your family).
“Some of the classic signs of PMADs, in both men and women, include feelings of sadness or worry, not being able to enjoy activities that are usually pleasurable, becoming socially withdrawn, and having changes to sleep, energy level, and appetite,” says Saxbe.
These signs of PMADs also tend to be more specific to men, experts say:
- Anger, frustration, or irritability. PMADs don’t always show up as sadness or anxiety and many men report these symptoms instead.
- Bodily manifestations of stress. You might notice muscle tension, headaches, stomach problems, or clench your jaw more than usual.
- Isolation and withdrawal. Just remember: You can be withdrawn while still being around people, says Singley. “The question here is not ‘Are you physically in the presence of other people,’ but rather ‘Are you still connecting with people?’ ”
- Substance use. “It’s not just drinking or drug use,” says Singley. “I think of it more broadly as an increase in ‘dopaminergic’ behaviors such as doing risky stuff, cheating, or playing more video games.”
How to Feel Better
PMADs can be overwhelming, all-consuming, and confusing but when addressed, they’re also highly treatable. Start here if you think you’re suffering:
- Treat new parenthood like a marathon. “The transition to parenthood is a major transformation that can upend your identity and your social relationships—so be patient with yourself and don’t expect this will automatically be a fun or easy experience,” says Saxbe. Caring for a newborn is depleting, so emphasize recovery (sleep, exercise, healthy eating) whenever you can, she says.
- Form a team. Parenthood isn’t a solo sport. “Babies are meant to be raised by a community, not by individuals in isolation,” says Saxbe. That means you’re going to need to get real comfortable asking for help and utilizing that help. Can’t run your usual errands? Desperately in the need of a home-cooked meal that’s anything but PB&J? Speak up.
- Work with someone who knows what they’re talking about. Communicating how you’re feeling—to a clergy person, a trusted colleague, or your partner—matters. But finding a trained mental health professional who specializes in perinatal mood issues ensures you’re working with someone who understands your situation and can provide you with the tools and techniques you need to feel better. Postpartum Support International, for one, has a provider directory with mental health professionals all over the world. If you ever have thoughts of suicide, reach out. The National Suicide Prevention Lifeline (1-800-273-8255) is available 24/7.
- Be open to medication. In addition to all of the above, medication can be helpful in the treatment of PMADs, says Saxbe. Your doctor can best help address your particular situation and what might be most beneficial to you.