Postpartum Depression/Anxiety in Men and Their Relationship

Depression is a common mental health issue. Postpartum depression/anxiety (PPD/A) in women, a common and often undiagnosed illness in biological, adoptive, or lesbian partner moms, has finally gained greater awareness by mental health professionals, obstetricians, and the general public. While many women still suffer in silence, recent efforts have given PPD sufferers a voice. PPD/A is a mental health issue and one where the person suffering has no control.

Men suffer too, and more attention is needed to understand how they suffer, and how men respond to treatment. Depression knows no gender, including postnatal depression. Researchers are still in the early stages of understanding the male experience with depression; paternal postnatal depression (PPND) research is further lacking.  Men experience depression differently than women, and we know that men are more likely to hide depression and/or to withdraw, which only serves to worsen symptoms. PPND research suggests men may develop symptoms more gradually over the course of a child’s first year, while typically (but not always) women see symptoms earlier.

The classic symptoms of depression are well known and include: depressed mood; significant weight gain or loss; restlessness; fatigue; insomnia or sleeping too much; feelings of worthlessness; difficulty with decision-making; and thoughts of suicide or death. To be diagnosed as clinically depressed, a patient must suffer from five or more of these symptoms consistently over a two-week period. Depression can be paralyzing, frightening, and interfere with one’s ability to perform daily tasks. Simply getting out of bed, showering, and getting dressed are often impossible for a depressed person.

Depression is Different for Men

In men, depression looks and feels different, and that can lead to both under-diagnosis and to men hiding their suffering. According to the National Institute of Mental Health (NIMH), on an annual basis, over 6 million men currently suffer from depression. That’s you, or your partner, or your best friend. Have you noticed a change in behavior lately in a loved one? Symptoms you might see include: increased anger; increased drinking or drug use; irritability; violence; weight loss; isolation; stress; greater risk-taking such as reckless driving or adultery; physical problems such as frequent headaches; loss of interest in sex, hobbies, and family; over-working; and suicidal thoughts. While there are a few common symptoms, men clearly experience distinctly different symptoms. Based on typical depictions of depression, it would be easy to overlook increased drinking, adultery, and over-working as depressed behavior. If you are a new father, these symptoms may be gradual, but PPND can be as serious a condition as PPD/A, with some or most of these symptoms.

Watch for Signs

When you are the depressed person, all perspective is lost. Self-diagnosis is difficult, particularly if this is your first depressive episode. It is important to watch for changes in mood or behavior, particularly if you or your partner has just had or adopted a baby. Depression is a serious illness and can be fatal. In addition to the symptoms above, here are specific behaviors to look for in yourself or your partner:

You (or your partner) withdraws sexually.

Often after childbirth there is a hiatus in the bedroom. You’re tired, mom is tired and yet the baby seems to never be tired, at least for very long. In the early days, sex may not be an issue; sleep may trump a roll in the hay. However, after the so-called fourth trimester, when couples get the doctor’s go ahead to resume sexual activity, if you find your interest dramatically decreased and if you resist intimacy with your partner and feel isolated as a result, that may be cause for concern. This can have a major effect on the relationship. Even though both people are tired, after a certain amount of time this type of sexual withdrawal can feel like rejection to his partner.

You find yourself having an extra drink or two on a more regular basis. 

If you are a semi-regular drinker who is now having a beer or three with dinner and/or a Scotch before bed, you may be suffering from depression. Along the same lines, if you are a recreational drug user, or have been in the past, and you begin to seek opportunities to get high regularly, you are checking out of your reality. As a new father, this behavior would be especially troubling and cause for concern. Your faculties are compromised at a time when you need to be more available than ever.

Your relationship is a partnership, and men who suffer from PPD/A have a difficult time engaging. They may be looking to escape reality, which can harvest resentment from his partner. While this behavior seems simply irresponsible on the surface, when accompanied by other symptoms, it may be male depression.

You work. All the time. 

Suddenly, staying late at the office becomes the norm. For a new father, this would be an especially noticeable symptom. Most new dads want to bond with their baby. If you are voluntarily over-working without an objective increase in work load, ask yourself why? Also ask yourself what is really keeping you from wanting to be home with your new baby, and helping your partner or spouse with duties around the house.

Irritability is common when there is a new baby in the house. 

Typically, parents are not getting enough sleep and/or are worried about baby’s milestones. Is he rolling over yet? Did she smile or was that gas? Is my baby OK?! When your irritability becomes anger, constant and overwhelming, this can be a warning sign. It’s normal to be grumpy when you are tired. It’s not healthy to be in a constant state of heightened tension. If you see this in yourself or your partner, and feel like you are walking on eggshells, it may be depression. Tread lightly and with compassion.

If both of you are feeling excessively irritable, check in with one another. Sometimes sharing with your partner what exactly is making you irritable (like middle of the night bottle feeding) you will likely find an empathetic response. Sometimes that little bit of validation can mean so much. Just because you are the male in the relationship doesn’t mean you have to be strong all the time. The beauty of your partnership is being able to lean on one another.

Violence is a huge red flag, whether your ultimate diagnosis is depression or something else.

If you find yourself enraged and hit another, pick fights that would lead to violence, punch holes in the wall, or in any way feel out of control with physical anger, get help. You may be depressed, you may not, but violence in a relationship is never OK. Violence against loved ones, strangers, or animals, or even closet doors, is never the answer. Something is wrong if you or your partner becomes violent. Take it seriously.

If you are feeling overwhelmed to point of anger or violence, take a moment to cool off and address what is really going on. Your partner understands the pressures of being a new (or repeat) parent. Again, the cultural role of the male in the relationship being strong for both people is tough, and it is no longer the norm. Becoming violent in your relationship will yield detrimental results. If taking a moment to cool off doesn’t work, address the issue with your partner or be open to them addressing it with you. A certain amount of fear may be at play here, so be open to the suggestion of seeking help.

Know When It’s Time to Seek a Professional

Depression is an illness, and there is no shame in seeking treatment. If you had a broken arm, you’d see a doctor, you’d get a cast, you’d heal. The same should be true with any mental health issue. If you suspect that you or a loved one is suffering, get help. You are not alone. Help doesn’t just have to be for the individual, but also for the couple. An unbiased professional can help mediate each other’s feelings in a safe environment.