Postpartum depression (PPD) refers to the onset of depressive symptoms shortly after the arrival of a newborn baby. Typically, the term is linked to mothers, as the burden of delivering a baby as well as the immense hormonal changes during pregnancy and childbirth may predispose women to depression both before and after childbirth. However, an equally pressing issue is PPD in fathers, which is often overlooked both in research and clinical screenings as fathers are not seen having as direct of a role in childbirth as mothers. A closer look into PPD in fathers is needed to fully investigate and prevent depression in new fathers (Albicker, 2019).
Studies have shown approximately 1 in 10 fathers experience PPD in the first year after a child is born. Typically, PPD was highest when the baby was 3-6 months old but can also develop insidiously over a year instead of right after childbirth. Depression was not limited to just after childbirth, as depression in fathers was also seen during pregnancy, with the highest risk being in the first trimester (Rao, 2020). The symptoms of PPD in fathers are similar to those of mothers, with a few exceptions. Fathers typically showed fewer outwardly emotional responses, like crying. However, there were also male-specific symptoms of depression, like rage, irritability, alcohol abuse, sleep disorders, violent and impulsive behavior, and withdrawal from relationships (Horsager-Boehrer, 2021).
There are several risk factors for PPD in fathers. One is hormonal changes, which are associated with depressive symptoms. For example, new fathers show lower levels of testosterone, which results in lower levels of aggression and higher sensitivity to a crying baby. Although lower levels of testosterone may strengthen a father’s attachment to his child, they are also associated with depressive symptoms in men (Scharff, 2019). Low self-efficacy, or the lack of ability to succeed in any given task, was also associated with PPD in men. The locus of control was important as fathers who did not feel like they were capable of raising a baby were more predisposed to depressive symptoms (Albicker, 2019). The strongest predictor of PPD in men was the past history of depression and anxiety. For example, comorbid anxiety was often observed in men with PPD, with over 18 percent of fathers experiencing high levels of anxiety after childbirth and over 3 percent having been diagnosed with GAD and another 3 percent having been diagnosed with OCD (Scharff, 2019). Depression in the mother was also associated with higher frequency of PPD in men. Other risk factors of PPD in men included feeling disconnected from mother and baby, psychological adjustment to parenthood and sleep deprivation (Horsager-Boehrer, 2021).
PPD in fathers can have an effect on the development of children. Depression in fathers is associated with less attention to babies, less frequent health visits, higher risk of behavioral problems and poor family or marital relationships (Horsager-Boehrer, 2021). Infants of depressed fathers also exhibit higher levels of stress as well as delay in psychological and emotional development (Scharff, 2019). For these reasons, research into PPD in men is essential to ensure the livelihood of the infant as well as the family as a whole.
However, PPD in men is not a high priority in many clinical or research settings. PPD in women is a well-researched field, whereas little research exists for PPD in men. The limitation of current studies into PPD in men is that they only look into fathers in the first year after childbirth, but not in comparison to a matched sample of men without a newborn child. Therefore, it is hard to determine that the baby played a role in the onset of depression in these men (Albicker, 2019). In clinical settings, fathers are mostly under-diagnosed and under-treated for PPD. Often during regular well-child visits, screenings for PPD are only done for mothers. Men are also less likely to seek health care services due to feelings of masculinity, shame and stigmatization of mental illness (Albicker, 2019).
Therefore, future studies must include a more comprehensive look into the risk factors and effects of PPD in men. For example, to determine if a newborn increases the chances of depression in men, it is necessary to include a study with a control group to compare new fathers with a control group of men without babies. Health care services must also increase regular screenings for new fathers and reduce the stigma around receiving mental health services in men. More research must also be done on the possible treatment methods for men with PPD, such as antidepressants, cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT).
Albicker, J., Hölzel, L. P., Bengel, J., Domschke, K., Kriston, L., Schiele, M. A., & Frank, F. (2019). Prevalence, symptomatology, risk factors and healthcare services utilization regarding paternal depression in Germany: Study protocol of a controlled cross-sectional epidemiological study. BMC Psychiatry, 19(1). https://doi.org/10.1186/s12888-019-2280-7
Escriba-Aguir, V., & Artazcoz, L. (2010). Gender differences in postpartum depression: A longitudinal cohort study. Journal of Epidemiology & Community Health, 65(4), 320–326. https://doi.org/10.1136/jech.2008.085894
Horsager-Boehrer, R. (2021, August 17). 1 in 10 dads experience postpartum depression, anxiety: How to spot the signs: Your pregnancy matters: UT southwestern medical center. Your Pregnancy Matters | UT Southwestern Medical Center. Retrieved February 16, 2023, from https://utswmed.org/medblog/paternal-postpartum-depression/
Rao, W.-W., Zhu, X.-M., Zong, Q.-Q., Zhang, Q., Hall, B. J., Ungvari, G. S., & Xiang, Y.-T. (2020). Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys. Journal of Affective Disorders, 263, 491–499. https://doi.org/10.1016/j.jad.2019.10.030
Scarff J. R. (2019). Postpartum Depression in Men. Innovations in clinical neuroscience, 16(5-6), 11–14.
Cognitive distortions are automatic thought patterns that are inaccurate and reinforce negative thinking or emotions. These automatic thoughts “distort” our thinking by leading us to believe something that is both unhelpful and untrue (Bollen et al., 2021). Psychiatrist and researcher Dr. Aaron Beck is known for first proposing the theory behind cognitive distortions in the 1960s. He would then form the central part of his cognitive theory and, later, cognitive behavioral therapy (CBT).
In his book (1963), he lists five types of cognitive distortions.
Dr. David Burns was an early student of Dr. Beck and helped popularize CBT. In his book (1980), he included more unhealthy thinking styles while also re-wording some of Beck’s distortions:
The theory underlying CBT states that cognitive distortions are associated with certain mental health disorders. These conditions include anxiety and depression. One anxiety disorder that’s largely affected by cognitive distortions is social anxiety disorder. Social anxiety disorder (SAD) occurs when individuals fear and endure discomfort or avoid social situations, such as social interaction or performances that may involve social scrutiny (Cook et al., 2019). These individuals are more likely to have negative thinking patterns that overestimate the probability and severity of negative social events and interactions. With depression, cognitive distortions were found to have a positive relationship, meaning as depression increased, cognitive distortions increased with helplessness and self-blame being the top two predictors of mental well-being (Yüksel & Bahadir-Yilmaz, 2019). Cognitive distortions were also found to mediate the relationship between trauma and suicide ideation (Whiteman et al., 2019). Researchers (2019) revealed that negative cognitions about the world and about the self were strong predictors of suicide ideation. These findings support the routine assessment of cognitive distortions and suicide ideation in survivors of trauma and of those who are experiencing anxiety and depressive symptoms.
Cognitive distortions can be combatted with CBT, which has been known to help redirect negative thought patterns into more positive ones (Beck, 1963). It can also help you challenge your negative thoughts and emotions, and encourage you to find the source of those thoughts. Fortunately, there are many resources to help you challenge your cognitive distortions and identify their root cause.
Grief is an inevitable thing people experience throughout their lifetime. You can see it in heartbreak, the death of a family member or friend, or literally just any experience in which a person is experiencing a loss. Not many people realize that there are stages of the grieving process. I mean, we do in the way the movie industry might portray it, but no movie can truly portray the real life feeling of loss given that everyone experiences things differently. Some might even say that the five stages of the grieving process are outdated, but we’ll leave that up to your own discretion. After all, everyone has their own opinion.
The first stage of grieving has to do with denial. Most, if not all, people are in disbelief that the loss they are experiencing is not real. For example, when my dog passed away a couple years ago, I totally forgot she was dead and was expecting to see her next to me the next day just for me to realize that she was gone for good. It was not an easy feeling to deal with, but it is something everyone has to deal with unfortunately.
The second stage deals with the anger of having lost a person, place, or thing. This part of the process is when you are the most snappy amongst your peers (Guttman, 2020). It could be due to the fact that you are just frustrated with having to deal with the loss in the first place. Thousands of people have experienced loss during the pandemic, and their anger might be seen through their frustration with how the government is handling such a crisis.
The third stage is where people start to bargain with themselves about their loss. According to Guttman (2020), this stage is where people start to think about the things they could have done differently to avoid the loss. For example, when I was going through my most recent breakup, I was thinking of all of the different things I could have said or done so that my ex-boyfriend would not have broken up with me. This stage leads to depression because you realize there’s nothing you could have done differently because the loss you are experiencing already happened, and you can’t change the past.
This part of the grieving process has to be the worst stage to experience. No one likes to be depressed, but it’s a phase you have to experience before things start to get a little better. This is the part of the grieving process where you start to feel all of the icky feelings you had been dreading to feel the whole time. You’re in a situation where you have lost something near and dear to you, and there’s nothing you can do to bring that feeling of familiarity with said thing. Once you move past this stage though, things really do start to look up. Dealing with this stage is no easy feat because everyone experiences things differently. Some people could struggle moving past this stage, some might find it to be easy, and some never move past this stage at all.
The final stage deals with acceptance. Accepting that there’s nothing you could have done to change the outcome, accepting that you will be okay and move on from this one day. This is not a stage everyone can get to because of how depression for losing a loved one can last an entire lifetime for some. However, when people do reach this stage, life starts to feel just a little bit better. Obviously, not the same in comparison with still having your past loved one still here with you, but at least at this point you’re starting to live your life again the best way you can.
And those are all of the stages of grieving. Although I put these stages in a particular order, it is important to note that these stages can happen in different orders as well. People work in mysterious ways, and it would be a crime to assume that these stages of grief happen in the same order every time.
What do you think? Are these outdated, or do you think they are accurate for the most part? Let us know!
Guttman, J. (2020, April 8). Understanding the Stages of Grief and Facing Tragic News. Psychology Today.https://www.psychologytoday.com/us/blog/sustainable-life-satisfaction/202004/understanding-the-stages-grief-and-facing-tragic-news