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Paternal depression

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Paternal Depression
Other namesPostpartum Depression, Postnatal Depression
SpecialtyPsychiatry
SymptomsAnxiety, extreme sadness, substance abuse, irritability, violence, risky behavior, anger attacks
ComplicationsRelationships with partner and children
Usual onsetEarly pregnancy to years postpartum
CausesUnclear
Risk factorsPrior mental disorder and drug abuse, bipolar disorder, family history of depression, psychological stress, upholding multiple social roles, lack of support
Diagnostic methodBased on severity of symptoms
Differential diagnosisBaby blues
TreatmentCounselling, medications, electroconvulsive therapy (ECT)
MedicationAntidepressants

Paternal depression is a psychological disorder derived from parental depression. Paternal depression affects the mood of men; fathers and caregivers in particular. ‘Father’ may refer to the biological father, foster parent, social parent, step-parent or simply the carer of the child. This mood disorder accompanies symptoms similar to postpartum depression (PPD) including anxiety, insomnia, irritability, consistent breakdown and crying episodes and low energy[1]. This may negatively impact family relationships and the upbringing of children[2]. Parents diagnosed with parental depression often experience increased stress and anxiety levels during early pregnancy, labor and postpartum[2]. Those with parental depression may have developed it early on but some are diagnosed later on from when the child is a toddler up until a young adult.  

The causes of paternal depression are unknown; however, previous experiences of mental disorders and family history can contribute to the development of paternal depression[3]. Other factors including stress overload, sleep deprivation and unhappy relationships with partner or children may also affect its prevalence[4]. Although symptoms of feeling down, baby blues and a lack of sleep is common amongst new parents, diagnosis of depression is appropriate when symptoms are severe and ongoing[5].

Most health literature provides studies and research on maternal depression and women with postnatal depression[6]. However, there is limited information about men and mental illness. Modern society and culture have changed social stigma of men with mental illness due to changes in gender role perspectives[7].

Signs and Symptoms compared to Women

When comparing the anxiety level of first-time parents, women tend to have higher levels of anxiety. This is applicable to women immediately after birth and in the first three trimesters[6]. Compared to women, men experience greater anxiety levels within the first 3 months of childbirth and develop paternal depression as the children grows older[5]. Although depression can affect individuals in different ways, there are some gender differences between parents. Women tend to have similar depressive symptoms over all three trimesters, however in men, there are significant changes between the 1st and 2nd trimester, but not between the 2nd trimester to 3 months postpartum[6]. Women are also more likely to experience symptoms such as a developing an eating disorder, irritability, crying episodes, extreme sadness, bioplar disorder and low energy levels[8].  Men are more likely to experience substance abuse, a higher frequency of irritability, anger attacks and becoming abusive and violent. Men may also partake in risk taking behaviour such as drink driving. Despite common symptoms of loss of appetite and insomnia, women are more likely to display atypical behaviours such as oversleeping and overeating[9]. Successful suicide levels are also more often associated with fathers rather than with mothers[10].

Prevalence of depressive symptoms in men and women from pregnancy to 3-months postpartum[6]

Causes

In general, the causes of maternal and paternal depression are similar. Common causes include having limited emotional and social support, experiencing financial stress, having an unsatisfying relationship with partner, finding difficulty adjusting to parenting, unexpected events in child development and current histories of mental disorders and drug abuse[3]. According to a study conducted in 2005, 65% of males identified with depressive symptoms when the child was 8 weeks old[4]. The causes of paternal depression included stress overload, caring responsively to the children, undertaking multiple family and social roles and a decrease in direct father to child interaction[4]. The implications of paternal depression largely affect the wellbeing during the child’s early and behavioural development with the research discovering that young boys are most vulnerable to it. This is caused by boys having the tendency to be hyperactive and harder to discipline[4]. This causes the father to be concerned and frustrated. However, this is adversely different for mothers. The cause and effect relationship between a boy’s behavioural development and depression in fathers is lineal with potential reasoning in the young boy’s sensitivity to his father’s discipline[4].

Prevalence

Statistics of Men in the US

Studies shows that 14.1% of men suffer from postpartum depression[11]. Outside of the US, 8.2% of men experience depressive symptoms. The observation of postpartum depression could be categorised into the time blocks of paternal depression first trimester to 6 months gestational age, >6 months to birth, immediate postpartum to 3 months postpartum, >3 to 6 months postpartum and >6 to 12 months postpartum[11]. During the period of 3 to 6 months postpartum, the highest rate of 25.6% was recorded in men whilst the lowest occurred during the first three months of postpartum at 7.7%. The high levels of depression during the 3 to 6 months postpartum period is also similar amongst women[11]. These results could be explained by the strenuosity of 3 to 6 months newborn care.

Treatment

Treatment for paternal depression depends on the severity of it[5]. If experiencing baby blues, treatment can be done at home. This means being well-rested, getting alone time, eating a well-balanced diet with an adequate amount of water and exercise, accepting social support from partner, friends and family[12]. Joining local community groups and creating bonds with other fathers experiencing similar symptoms will decrease stress and create a sense of relief. However, treatment of mild to severe depression would require further action.

Treatment offered for parents with depression are similar to other mental disorders. This includes taking antidepressants or receiving psychotherapy[13]. Those experiencing moderate paternal depression should seek therapy from a mental health professional. This may be a psychiatrist, counselor or psychologist. However, if experiencing intense depression, medical intervention may be necessary[14]. Consult about your health professional about medication including mood stabilizers. Other methods to recovery include electroconvulsive therapy (ECT)[15]. This releases short electrical currents to the brain, allowing it to relax. It is recommended when all other procedures are ineffective.  

Psychotherapy

Psychotherapy aids PPD treatment by approaching it with psychological intervention rather than biologically[16]. Many parents with PPD prefer psychological treatment as it limits any potential side affects that will influence the child. Common therapy styles include interpersonal therapy, cognitive-behavioural therapy, psychodynamic psychotherapy and non-directive counseling[17]. Therapy could be conducted individually or couple therapy is also an option. This is practical in addressing support at home along with your relationship with your partner[18]. In general, therapy may take anywhere between a few weeks to months to be effective. However, severe symptoms will require intense psychotherapy which may take up to years[19].

Antidepressants

Pharmacological treatment such as antidepressant medication is a growing method of treatment with a recent increase in literature surrounding the topic[20][21]. This is given to those that experience severe PPD as it balances the chemicals in the brain that affect mood[22]. Mothers tend to avoid antidepressants with many fearing its impact on breast milk[17][23]. However, it is an effective way in treating depressing amongst fathers. There are several factors that the father may want to consider, this includes metabolic changes, mood changes, memory loss, drowsiness and possible side effects influencing child care. Medication needs to be under the supervision of a medical professional and is proven to be even more effective when accompanied with psychotherapy[18].

Self-care

There are a number of ways to treat PPD at home. These methods are recommended for those with moderate PPD however, severe PPD will require intensive intervention. These practices are will promote a healthier and positive lifestyle and are beneficially to anyone. Talking to loved ones, taking off alone time, getting sufficient amounts of rest, exercising regularly and eating a balanced diet[23]. Not skipping meals, making sleep a priority and getting outside will improve mental health and increase feelings of satisfaction and fulfilment[18].

Society and Culture

Main article: Mental disorders and gender
Further information: Gender roles

The increase of paternal depression could be explained by women’s increasing input into social roles[24]. Women contributing to workforce leads to more fathers becoming involved with family life. This increases the possibility of developing paternal depression. Paternal depression is a frequently neglected topic[14]. It challenges social normalities of gender roles, the stereotypes of fatherhood, masculinity and social stigma on men with mental health[24]. The progressive perception of fathers being the primary parent leads to further increase in father involvement.

National policies have not progressed with the changes in gender roles. This includes the difficulties in receiving of paternal leave and receiving custody[25]. This is influenced by the limited studies on fathers and depression. However, the recent increase of research into paternal depression shows society’s views on increasing gender equality in social roles and the changing culture on masculine and feminine concepts[7].

Stigma of Men with Mental Illness

There is often stigma around mental illness, especially those who are men. Severe stigma usually takes forms of discrimination, prejudice and stereotypes. These categorise how society view mental disorders. Paired with gender roles and the concepts of masculinity and femininity, society view men with mental impairments as weak and vulnerable and not the stereotypical alpha male[7]. This then affect how men view their own mental disability, influencing the seeking of treatment and acceptance of the illness[14]. This cause and effect relationship can create a cycle, leading men to be disheartened and ashamed of reaching out.

References

  1. ^ Mickelson, Kristin D.; Biehle, Susanne N.; Chong, Alexandra; Gordon, Alynn (2017-03-01). "Perceived Stigma of Postpartum Depression Symptoms in Low-Risk First-Time Parents: Gender Differences in a Dual-Pathway Model". Sex Roles. 76 (5): 306–318. doi:10.1007/s11199-016-0603-4. ISSN 1573-2762.
  2. ^ a b "Wolters Kluwer Health - Article Landing Page". pt.wkhealth.com. doi:10.1097/01720610-201302000-00009. Retrieved 2019-05-13.
  3. ^ a b "beyondblue". www.beyondblue.org.au. Retrieved 2019-05-13.
  4. ^ a b c d e O'Connor, Thomas G.; Evans, Jonathan; Stein, Alan; Ramchandani, Paul (2005-06-25). "Paternal depression in the postnatal period and child development: a prospective population study". The Lancet. 365 (9478): 2201–2205. doi:10.1016/S0140-6736(05)66778-5. ISSN 0140-6736. PMID 15978928.
  5. ^ a b c Kanopy (Firm), Recognizing and treating postpartum depression., OCLC 897768040, retrieved 2019-05-16
  6. ^ a b c d "ScienceDirect". www.sciencedirect.com. doi:10.1016/j.jad.2011.02.007. Retrieved 2019-05-13.
  7. ^ a b c Boysen, Guy A. (2017-01-02). "Exploring the relation between masculinity and mental illness stigma using the stereotype content model and BIAS map". The Journal of Social Psychology. 157 (1): 98–113. doi:10.1080/00224545.2016.1181600. ISSN 0022-4545. PMID 27110638.
  8. ^ Nierenberg, Cari; October 27, Contributing writer |; ET, 2016 03:22am. "7 Ways Depression Differs in Men and Women". Live Science. Retrieved 2019-05-13.{{cite web}}: CS1 maint: numeric names: authors list (link)
  9. ^ Silverstein, Brett; Angst, Jules (2015). "Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder". Psychiatry Journal. 2015: 1–6. doi:10.1155/2015/575931. ISSN 2314-4327. PMC 4516843. PMID 26258131.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ England MJ, Sim LJ, editors. (2009). Depression in Parents, Parenting, and Children : Opportunities to Improve Identification, Treatment, and Prevention. National Academies Press (US). OCLC 971082452. {{cite book}}: |last= has generic name (help)CS1 maint: multiple names: authors list (link)
  11. ^ a b c "ScienceDirect". www.sciencedirect.com. doi:10.1016/j.jmwh.2010.06.015. Retrieved 2019-05-13.
  12. ^ "Postpartum Depression: A Guide to Symptoms & Treatment". PsyCom.net - Mental Health Treatment Resource Since 1986. Retrieved 2019-05-16.
  13. ^ "Postpartum depression - Diagnosis and treatment - Mayo Clinic". www.mayoclinic.org. Retrieved 2019-05-16.
  14. ^ a b c Cameron, Emily E.; Hunter, Dana; Sedov, Ivan D.; Tomfohr-Madsen, Lianne M. (June 2017). "What do dads want? Treatment preferences for paternal postpartum depression". Journal of Affective Disorders. 215: 62–70. doi:10.1016/j.jad.2017.03.031.
  15. ^ Verwijk, Esmée; Comijs, Hannie C.; Kok, Rob M.; Spaans, Harm-Pieter; Stek, Max L.; Scherder, Erik J.A. (November 2012). "Neurocognitive effects after brief pulse and ultrabrief pulse unilateral electroconvulsive therapy for major depression: A review". Journal of Affective Disorders. 140 (3): 233–243. doi:10.1016/j.jad.2012.02.024.
  16. ^ "Postpartum Depression Treatment, Screening, Causes & Symptoms". MedicineNet. Retrieved 2019-05-27.
  17. ^ a b Leight, Kristin; Fitelson; Sarah Kim; Baker, Allison (2010-12). "Treatment of post-partum depression: a review of clinical, psychological and pharmacological options". International Journal of Women's Health: 1. doi:10.2147/IJWH.S6938. ISSN 1179-1411. PMC 3039003. PMID 21339932. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  18. ^ a b c Melinda (2018-11-02). "Postpartum Depression and the Baby Blues - HelpGuide.org". https://www.helpguide.org/. Retrieved 2019-05-27. {{cite web}}: External link in |website= (help)
  19. ^ "Postpartum Depression Treatment, Screening, Causes & Symptoms". MedicineNet. Retrieved 2019-05-27.
  20. ^ Payne, Jennifer L. (2007-09). "Antidepressant Use in the Postpartum Period: Practical Considerations". American Journal of Psychiatry. 164 (9): 1329–1332. doi:10.1176/appi.ajp.2007.07030390. ISSN 0002-953X. {{cite journal}}: Check date values in: |date= (help)
  21. ^ Battle, Cynthia L.; Zlotnick, Caron; Pearlstein, Teri; Miller, Ivan W.; Howard, Margaret; Salisbury, Amy; Stroud, Laura (2008-10). "Depression and breastfeeding: which postpartum patients take antidepressant medications?". Depression and Anxiety. 25 (10): 888–891. doi:10.1002/da.20299. ISSN 1091-4269. {{cite journal}}: Check date values in: |date= (help)
  22. ^ "Postpartum depression: Symptoms, causes, and diagnosis". Medical News Today. Retrieved 2019-05-27.
  23. ^ a b "Treatment". nhs.uk. 2018-10-03. Retrieved 2019-05-27.
  24. ^ a b Fisher, Sheehan D. (2016-02-16). "Paternal Mental Health: Why Is It Relevant?". American Journal of Lifestyle Medicine. 11 (3): 200–211. doi:10.1177/1559827616629895. ISSN 1559-8276. PMC 6125083. PMID 30202331.
  25. ^ Qadar, By Sana (2019-05-05). "Three fathers' experiences taking parental leave - ABC Life". www.abc.net.au. Retrieved 2019-05-13.
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