When Mikael Cummings, a 25-year-old entrepreneur in Brooklyn, found out he was going to be a father in March, he felt instant feelings of excitement. But shortly after when his daughter was born, those feelings were overrun by fear, anxiety, and stress. It infiltrated his relationship to his work, seeding self-doubt in his skills and his confidence in doing the job. When Cummings confided in his therapist about the changes in his mental health, she suggested he might be suffering from something he hadn’t considered: postpartum depression.
Postpartum depression is an episode of major depressive disorder occurring soon after the birth of a child. And while it’s frequently reported in mothers, recent research reveals the medical condition can also occur in fathers. According to one 2019 study, about 10 percent of men may experience postpartum depression within the first year of their child’s birth, with the highest prevalence occurring between 3 and 6 months postpartum.
Dr. Sarah Allen, a clinical psychologist in Chicago, believes the number of men suffering from PPD might be higher, but the condition is underreported. “First women were recognized as having postpartum depression. And then we realized it wasn’t just depression, there was anxiety, OCD, and other things affecting them, she said. “Now the latest wave is recognizing that dads have it, too.”
It checks out, considering as many as 1 in 6 men experience high levels of anxiety in the postpartum period. In her 26 years of practice, Allen has witnessed fathers of young children suffer an increased risk of depression and anxiety while working with families, despite research on the subject mostly occurring only in the last decade. “As more research and information comes out about this, we’ll be more effective in addressing the issue,” she added.
Workplaces have become increasingly invested in mental health in recent years, mostly focusing on work/life balance, therapy, and paid sick days. But family leave is just as important. While we’re having more open conversations about PPD at work, they often focus on mothers—but all parents are susceptible.
Getting to the root
“People don’t really think about men when it comes to PPD because there is a lot of literature on the hormonal triggers for women in postpartum depression,” said Dr. Katie Morel, a clinical psychologist in New York City. Delivering a baby, she added, results in the biggest hormone drop in any lived experience, and we often associate that drop with postpartum depression. But hormones aren’t the only cause of PPD. There are other contributing factors—which apply to men, too.
According to 2017 research, men may develop lower levels of testosterone during their partner’s pregnancy. Other reasons men might develop PPD include feeling detached or overwhelmed, a history of depression or anxiety, a lack of sleep, and absorbing some of their partner’s depression.
PPD’s different symptoms
The symptoms of postpartum depression and anxiety can look different in men than it does in women, but there’s still overlap. “For men it’s a lot of frustration and irritability. It can also come out of anger, whereas I think with women, they also feel anger and rage postpartum, but we are trained as women not to show that as much,” Allen said.
Research shows men may experience more physical symptoms like fatigue, insomnia, lack of energy or motivation and changes in appetite, while women often exhibit more outwardly emotional expressions, such as crying and feelings of sadness.
During the first months of becoming a new father, Cummings described the changes in his body as a physical sickness. “I wasn’t eating, I wasn’t working out, I didn’t feel motivated to get dressed in the morning. It was probably the weakest I’ve ever felt in my life,” he said, noting there was also a shift in his confidence. He described himself as “just functioning” during that time and making it appear as if he was fine. “I was masking how I actually felt because nothing I felt could trump how my partner felt,” he said. “I kept reminding myself that she literally just pushed out another human and my body isn’t changing the way that her body was.”
When new fathers return to work, these symptoms could impact their performance—say, by having a harder time hitting deadlines, feeling more likely to snap at teammates, or struggling to remain motivated.
“I think a lot of society has taught men that they shouldn’t be talking about these things. There’s a lot of shame with men to bring up the fact that they are struggling, too,” Allen said.
Addressing a silent crisis
Optimistically, postpartum depression can be treated with help. Allen believes screening new fathers can help identify the symptoms in men early on. In 2020, an article in the Journal of the American Academy of Pediatrics called on pediatricians to screen both new mothers and fathers for perinatal depression during their child’s check-up visits. From there, they can make appropriate referrals for treatment when necessary. That approach fills a critical care gap: when PPD screenings remain solely the responsibility of obstetricians, men are left undiagnosed.
In the workplace, it also makes equitable family leave all the more important. In addition to screenings, paid paternity leave can provide fathers suffering from PPD adequate time to get acclimated to their new life. “Some of the symptoms of depression could directly impact work quality or work quantity,” said Morel, noting a lack of motivation, decreased interest in doing most things, negative thoughts about oneself, and sleeping less than usual. “I think all of these things would make it difficult to function at work, let alone just function in general.”
“It really isn’t good for people’s stress levels to have to deal with having this big transition, not having sleep, and then managing work,” Allen said. When new fathers are expected to prioritize work-life balance, the bulk of child care becomes the responsibility of new mothers—a common cause of PPD in women. Ultimately, providing resources for men, like screenings and paid paternity leave, helps both parents reduce the risks associated with depression and anxiety during the postpartum period.