PATERNAL POSTPARTUM DEPRESSION
Introduction
Postpartum depression (PPD) affects both the father and the mother after childbirth. It is also referred to as postnatal depression. Currently, most of the studies and clinical practice have devoted much time to the maternal postpartum depression thus ignoring the psycho-social problems faced by new fathers. The lack of attention on the paternal postpartum depression (PPD) has significantly contributed to the reasons why paternal postpartum depression is widely unknown phenomenon today (Demontigny, Girard, Lacharite, Dubeau & Devault 2013).
Fathers have been significantly affected by the coming of the newborn babies into the world as much as mothers are. It could, therefore, be argued that postpartum depression affects the fathers and the mothers as well. According to Kim & Swain (2007), men are even faced with much greater problems as they have to adjust their lifestyle with the aim of providing proper living conditions for the child as well as dealing with their partner's postpartum depression. This paper provides a critical review of paternal postpartum depression supported by empirical evidence.
Discussion
Modern day perspective
In recent days, researchers are starting to appreciate that men too are affected by postpartum depression. Various studies have been conducted aimed at gaining more understanding of the paternal postpartum depression (Kim &Swain, 2007). During the postpartum period, there are several adjustments that are required to be made that often pose risks of depression to both fathers and mothers. However the majority of the studies conducted have been directed towards maternal postpartum depression and thus devoting lesser time in the understanding of the paternal postpartum depression. Thus, paternal postpartum depression has remained to be under-diagnosed, under-screened and under treated clinical condition (Kim & Swain, 2007).
Significance of Paternal postpartum depression
The paternal postpartum depression is a significant clinical condition faced by families today, and more attention needs to be devoted to the issue. According to Singh (2011) studies show that between 4% and 25% of the new fathers are faced with the risk of paternal PPD during the first 12 months of the postpartum period. Further paternal PPD increased within the first three to six months of the postpartum period. Miller & LaRusso (2011) research showed that 10% of new fathers around the world, and 14% in the US are affected by postpartum depression. The disparity in various studies could be as a result of the fact that paternal postpartum depression is relatively a new concept since traditionally it was believed only women were affected by postpartum depression. With postpartum depression traditionally being associated with mothers, the current media attention on the mental state of the fathers during the postpartum period has been quite helpful in creating public awareness on the paternal postpartum depression.
It would be worth noting that during the postpartum period, fathers just like mothers do experience significant changes and adjust to more demanding responsibilities and tasks; thus, the reason fathers are likely to be affected by postpartum depression as much as the mothers. Kim and Swain (2007) research has also associated the postpartum depression to significant weight gain or loss, diminished ability to think, feeling of guilt, lack of concentration, recurrent thoughts of death, psychomotor retardation or agitation, hypersomnia and insomnia. The symptoms of paternal postpartum depression include low energy, lack of sleep, sadness and loss of interest in social activities. Other red flags that could be interpreted as signs of paternal depression include withdrawal and disengagement from family. In consideration that men just like women are affected by postpartum depression, it is important for the fathers to recognize when they are suffering. According to Demontigny et al. (2013), a majority of the men do not understand what they are going through until it is too late. Men are thus encouraged to try to read the early signs that could indicate that they could be suffering from postpartum depression. The importance of family in overcoming postpartum stress needs to be emphasized since often the risk factors contributing to postpartum stress can be reduced through family unity. For example, spending more time as a family can reduce the risk of postpartum stress both in mothers and fathers (Miller & LaRusso 2011).
Causes and risk factors of paternal postpartum depression
Goodman (2004) reveals that researchers have not clearly explained why fathers become depressed. However, several risk factors have been identified as contributors to paternal postpartum depression. First, hormonal changes- fathers undergoing hormonal changes during the postpartum period are hypothesized to be affected by the risk of postpartum depression. Postpartum depression on fathers can be associated with hormonal changes during the postpartum period leading to increased anxiety, lack of sleep among other conditions. The hormones which have been studied include testosterone, estrogen, cortisol, thyroid hormone and progesterone (Kim & Swain, 2007).
Secondly, significant lifestyle changes, that is, profound changes in lifestyle have also been hypothesized as causes of postpartum depression on fathers. These changes are brought about by the need for caring for the baby since a newborn baby comes with additional expenses, and fathers often have the responsibility of meeting those needs. Thus, the increased expenditure and the need to maintain the previous lifestyle could end up causing postpartum depression on fathers. However, there is little evidence to support this hypothesis.
Thirdly, maternal postpartum depression does cause paternal postpartum depression. Kim and Swain (2007) research has shown a relationship between the maternal and the paternal postpartum depression and thus maternal postpartum depression is considered as one of the risk factors for the paternal postpartum depression. According to Singh (2011), the paternal postpartum depression was found to be between 1.2% and 25%, in the first year of the postpartum period. However, Singh (2011) further noted that there was a significant increase in the number of fathers suffering from postpartum depression where their partners were experiencing postpartum depression with the number increasing to range between 24% and 50%.
Fourthly, violence is also responsible for the occurrence of paternal postpartum depression. According to Demontigny et al. (2013), violence against men has to some extent contributed to paternal postpartum depression. Though a majority of family violence related cases reported are against women, men too are known to be violated. With about one-third of the reported cases of violence are actually against men. Thus, violence against men by their partners has acted in some instances as a trigger for the postpartum depression on fathers. Other risk factors that have been identified to have a correlation with paternal postpartum depression include cigarette smoking, history of depression, unplanned pregnancy, low social support, infant’s temperament problems, low socioeconomic status, and low self-esteem (Demontigny, et al., 2013). According to Musser et al. (2013) studies have been able to identify various causes and risk factors associated with paternal postpartum depression, and thus, it could be argued that there is a majority of factors that contribute to paternal postpartum depression.
Effects of paternal postpartum depression
T (2011) research has identified various negative effects of paternal postpartum depression. Firstly, the effect on infant care and bonding; paternal postpartum depression in many cases has resulted in child neglect by the father which affects the ability of the father to provide for the child and father to child bonding. The father’s neglect of the child is associated with family withdrawal, which is one of the signs of postpartum depression (T, 2011). According to research fathers suffering from postpartum depression tend to show less positive behavior towards their children such as sensitivity, warmth, and responsiveness (T, 2011). Such fathers instead increase the negative behavior towards the children such as disengagement and hostility.
Secondly, depression to the family unit; paternal and maternal postpartum depression is known to have a correlation, and thus, it’s highly likely that when one partner is affected by postpartum depression, the other partner is also likely to be affected. Where both partners are affected, it could lead to arguments and violence in families further affecting not only the partners but other children as well as Field (2011) further argues.
Thirdly, child psychopathology; parental postpartum depression could lead to child conditions such as depression and anxiety, emotional disorders, hyperactivity and language delays. Field (2010) argues that sons of depressed fathers tend to show increased temperament and mood disorders. However, this argument is inconclusive. According to Don and Mickelson (2012) study, paternal depression in the first stages of a child’s life could contribute to language delays. Their (2012) study showed that 95% of the children with behavioral difficulties were associated with paternal depression. It is important to note that infants depend on their parents to develop emotional as well as cognitive capabilities and thus paternal postpartum depression could significantly affect a child development. However, Miller and LaRusso (2011) studies have differed with the hypothesis that paternal postpartum depression could lead to language delays. There is an argument that there are no enough facts to support such a hypothesis (Goodman, 2004). Gressier et al. (2015) showed no difference in temperament in children of non-depressed and depressed fathers. Gressier et al. (2015) argue that there is no enough evidence to support the hypothesis that children of depressed fathers are likely to show increased temperament compared to the children of non-depressed fathers.
Paternal postpartum depression is becoming more prevalent since the current generation of fathers is feeling similar economic and social stress as those experienced by the mothers. Though people don’t want to admit they are depressed especially men, it is quite important to seek treatment before the conditions worsen.
Overcoming paternal postpartum depression
In the circumstance that a father is suffering from postpartum depression, he should consider taking some of the following actions; seek a support group, try to engage more in hobbies, social activities or exercise, try meeting other fathers, and most importantly avoid negative coping strategies (Field, 2010). Taking such steps could be essential in overcoming postpartum depression.
Don and Mickelson (2012) have encouraged taking a break, seeking resources and support, spending more time as a couple and getting more involved with the child as ways of trying to overcome postpartum depression. While Miller and LaRusso (2011) have strongly advocated the need to seeking specialized treatment as a way of dealing with postpartum depression. Don and Mickelson (2012) and Miller and LaRusso (2011) have one thing in common; to recognize and accept that there is something wrong that needs to be dealt with seriously. Failure to take any action could lead to serious consequences such as poor parenting practices, marital conflicts, and impoverished family. Where a person self-treatment has failed, such a person is encouraged to seek specialized treatment such as seeking help from therapist or counselor (Miller & LaRusso, 2011).
Conclusion
The current limitations of studies associated with paternal postpartum depression are associated with the perception that postpartum depression mainly affects the mothers, and thus, a lot of resources have been directed to studying maternal postpartum depression. It is, however, important to understand that postpartum depression affects both mothers and fathers alike, and thus there is the need for more resources to be directed to the study of paternal postpartum depression with the aim of gaining more understanding in the area. Though some significant steps have been taken in the study of paternal postpartum depression, more studies need to be carried out. Parents should also understand that coming of a new baby could result in postpartum depression and should thus try to identify the early signs of the condition and if they do, then take the necessary actions to address the issue and possibly avoid the negative effects of postpartum depression. A couple should provide support to each other if one of them is suffering from postpartum depression. Lack of support from a partner could accelerate the depression (Don &Mickelson, 2012).
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