Paternal depression

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Paternal depression
Other names Postpartum depression, Postnatal depression
Specialty Psychiatry
Symptoms Anxiety, extreme sadness, substance abuse, irritability, violence, risky behavior, anger attacks
Complications Relationships with partner and children
Usual onsetEarly pregnancy to years postpartum
CausesUnclear
Risk factors Prior mental disorder and drug abuse, bipolar disorder, family history of depression, psychological stress, upholding multiple social roles, lack of support
Diagnostic method Based on severity of symptoms
Differential diagnosis Baby blues
Treatment Counselling, medications, electroconvulsive therapy (ECT)
Medication Antidepressants

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 exhibits 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.

Contents

The causes of paternal depression are unclear; 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 one's partner or children may also affect its prevalence. [4] Although symptoms of feeling down, baby blues and a lack of sleep are common amongst new parents, a 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 developing an eating disorder, irritability, crying episodes, extreme sadness, bipolar 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 drunk driving. Despite common symptoms of loss of appetite and insomnia, women are more likely to display atypical behaviours such as oversleeping and overeating. [9] Fatal suicide attempts 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 Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum.png
Prevalence of depressive symptoms in men and women from pregnancy to 3-months postpartum

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 one's partner, finding difficulty adjusting to parenting, unexpected events in child development and personal 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 include stress overload, caring responsively to the children, undertaking multiple family and social roles and a decrease in direct father to child interaction. [4] Fathers of young boys are most vulnerable to paternal depression during the child's early and behavioural development. This is caused by young boys having the tendency to be hyperactive and harder to discipline. [4] This causes the father to be concerned and frustrated. There is a positive correlation between a boy's misbehaviour and depression in fathers. [4]

Prevalence

Men in the U.S.

Studies show that 14.1% of men suffer from postpartum depression. [11] Outside of the U.S. 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 strenuousness of 3 to 6 months newborn care. Fathers' mental health has received less attention than mothers', but in recent decades there has been an increase in attention to father's mental health.  A meta-analysis of 43 studies involving 28,004 participants on prenatal and postpartum depression in fathers published in 2010 found that the peak incidence of depression (25.6%) in fathers occurred between 3 and 6 months after the child's birth, though 10.4% of fathers were found to be depressed even prenatally. Cameron et al. (2016) observed an 8.4% depression rate in fathers during pregnancy and the postpartum period in a recent meta-analysis, with a maximum incidence of 13% between 3 and 6 months postpartum. [12] These differences in prevalence could be attributed to the use of different psychometric tools, different assessment methods (self-report measures tend to over-represent while clinical interviews tend to under-represent), gender differences in symptom presentation, cultural biases, for example, conflicting interpretations of depressive symptoms, social acceptance of mental health problems, or divergent expectations regarding paternal infant care responsibilities. [12]

Treatment

Treatment for paternal depression depends on the severity of it. [5] Light to moderate symptoms could be treated at home. This includes being well-rested, getting alone time, eating a well-balanced diet with adequate amounts of water and exercise, accepting social support from partner, friends and family. [13] 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.

Outlines some of the common treatment available for PPD, excluding psychotherapy and antidepressants. OLES 2.jpg
Outlines some of the common treatment available for PPD, excluding psychotherapy and antidepressants.

Treatments offered for parents with depression are similar to other mental disorders. This includes taking antidepressants or receiving psychotherapy. [16] 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. [17] Consult your health professional about medication including mood stabilizers. Other methods to recovery include electroconvulsive therapy (ECT). [18] This releases short electrical currents to the brain, allowing it to relax. It is recommended when all other procedures are ineffective. There are other alternatives to treatment. This includes self-care in the form of relaxation, massage, herbal medicine and chiropractic services. [15]

Psychotherapy

Psychotherapy aids PPD treatment by approaching it with psychological, rather than biological, intervention. [19] Many parents with PPD prefer psychological treatment as it limits any potential side effects that will influence the child. Common therapy styles include interpersonal therapy, cognitive-behavioural therapy, psychodynamic psychotherapy and non-directive counseling. [20] 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. [21] 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. [22] [23] This is given to those that experience severe PPD as it balances the chemicals in the brain that affect mood. [24] Mothers tend to avoid antidepressants with many fearing its impact on breast milk. [20] [25] However, it is an effective way in treating depression 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. [21]

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. The following practices will promote a healthier and positive lifestyle and are beneficial to anyone: talking to loved ones, taking alone time, getting sufficient amounts of rest, exercising regularly and eating a balanced diet. [25] Not skipping meals, prioritising sleep and getting outside will improve mental health and increase feelings of satisfaction and fulfilment. [21]

Society and culture

The increase of paternal depression could be explained by women's increasing input into social roles. [26] Women contributing to the 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. [17] It challenges social normalities of gender roles, the stereotypes of fatherhood, masculinity and social stigma on men with mental health. [26] 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. [27] 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

How the stigma of men with mental illness influence the prevalence of seeking treatment Percentage of Men seeking help.png
How the stigma of men with mental illness influence the prevalence of seeking treatment

There is often stigma around mental illness, especially for 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 views men with mental impairments as weak and vulnerable and not the stereotypical alpha male. [7] This then affects how men view their own mental disability, influencing the seeking of treatment and acceptance of the illness. [17] This cause and effect relationship can create a cycle, leading men to be disheartened and ashamed of reaching out. According to the Australian Black Dog Institute, it is estimated that 72% of men do not seek treatment for mental disorders. [28]

Related Research Articles

<span class="mw-page-title-main">Major depressive disorder</span> Mental disorder involving persistent low mood, low self-esteem, and loss of interest

Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since.

<span class="mw-page-title-main">Mood disorder</span> Mental disorder affecting the mood of an individual, over a long period of time

A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where a disturbance in the person's mood is the main underlying feature. The classification is in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD).

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

<span class="mw-page-title-main">Postpartum depression</span> Mood disorder experienced after childbirth

Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder experienced after childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. PPD can also negatively affect the newborn child.

<span class="mw-page-title-main">Depression (mood)</span> State of low mood and aversion to activity

Depression is a mental state of low mood and aversion to activity. It affects more than 280 million people of all ages. Depression affects a person's thoughts, behavior, feelings, and sense of well-being. Depressed people often experience loss of motivation or interest in, or reduced pleasure or joy from, experiences that would normally bring them pleasure or joy. Depressed mood is a symptom of some mood disorders such as major depressive disorder and dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. It may feature sadness, difficulty in thinking and concentration and a significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection or hopelessness and may experience suicidal thoughts. It can either be short term or long term.

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<span class="mw-page-title-main">Suicidal ideation</span> Thoughts, ideas, or ruminations about the possibility of ending ones life

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<span class="mw-page-title-main">Depression in childhood and adolescence</span> Pediatric depressive disorders

Major depressive disorder, often simply referred to as depression, is a mental disorder characterized by prolonged unhappiness or irritability. It is accompanied by a constellation of somatic and cognitive signs and symptoms such as fatigue, apathy, sleep problems, loss of appetite, loss of engagement, low self-regard/worthlessness, difficulty concentrating or indecisiveness, or recurrent thoughts of death or suicide.

<span class="mw-page-title-main">Panic disorder</span> Anxiety disorder characterized by reoccurring unexpected panic attacks

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[1] [2]

  1. ↑ Dachew, Berihun; Ayano, Getinet; Duko, Bereket; Lawrence, Blake; Betts, Kim; Alati, Rosa (2023-08-16). "Paternal Depression and Risk of Depression Among Offspring: A Systematic Review and Meta-Analysis". JAMA Network Open. 6 (8): e2329159. doi:10.1001/jamanetworkopen.2023.29159. ISSN   2574-3805. PMC   10433087 . PMID   37585203.
  2. ↑ Tuszyńska-Bogucka, Wioletta; Nawra, Karolina (2014-06-26). "Paternal Postnatal Depression - a review". Archives of Psychiatry and Psychotherapy. 16 (2): 61–69. doi: 10.12740/app/26286 . ISSN   1509-2046.
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