For two out of ten men, fatherhood is not a rosy affair. The mood is severely tested after the birth of a child and in 10% of cases we talk about postpartum depression in men. That the first months of fatherhood are happy, but also difficult – between anxiety, lack of sleep, tiredness and nervousness – is one thing, and it can be said that it is normal. The arrival of a baby, in fact, involves profound changes, there is a new role to play, greater responsibilities, balances to rediscover. However, it is another matter when anxiety, tiredness and nervousness, together with other emotional states, not only show no signs of decreasing within six months to a year, but they amplify.
«To mark the border between a situation of normal adaptation and post-natal depression are apatia perenne, distress, anxiety disorders, panic attacks, appetite disturbances or sleepeven when perhaps the child now sleeps for several consecutive hours, and above all anger crisis, aggressive attitudes, tantrums that weren’t there before. In the most serious cases it leads to substance abuse, addiction disorders, violent conduct », he specifies Stephen Porcellipsychiatrist, psychotherapist, head of the mental health area of the Santagostino medical center in Bologna.
«You have to be careful, in fact, a do not use the same parameters of evaluation of female malaise which manifests itself in a completely different way, an aspect that typically leads to underestimating the problem. An aggressive attitude, for example, may not make us think of a depression that we rather relate to tears and sadness, instead it is among the earliest symptoms ».
Male postpartum depression: why does it happen?
Why does this happen? We know that postpartum depression in mothers is the result of a complex interaction between psychological and hormonal factors. What do men have to do with hormones? “For men it is the same thing, even if in different percentages,” continues the specialist. «Certainly they don’t suffer the sudden hormonal alterations of their companions, but they too register changes; after birth we witness a drop in testosterone it’s a increase in oxytocina neurotransmitter that promotes bonding and nurturing behaviors.
«But they are the psychological factors to play the most important role. Becoming a parent is a change that involves a total redefinition of the self to which man often does not arrive adequately prepared. Women have – at least theoretically – more tools to prepare for the event, the same physical bond with the child helps them gradually adapt during the nine months, while for men it is a more abrupt transition».
How does it manifest itself?
This role transition can feel like a excessive weight of responsibility, drag feelings of inadequacy, then the fear of not being up to it, or lead to a general loss of interest. «In some cases, “anxiety of enmeshment” with the consequent desire to escape from one’s role and, sometimes, physically from the walls of the house, with excessive escapes to work», adds Porcelli.
“They are not missing scenes of jealousy towards the partner for the feelings of exclusion from that privileged relationship that the mother has with her child. It is in fact a period of great revolutions also for the intimacy of the couple: the partner’s physique has already changed, her attentions are different and sexuality is reduced when it goes well, but in most cases it disappearsat least in the early days.” Finally, worries about possible economic problems weigh heavily, it is no coincidence that we are talking about breadwinner syndrome. And the risk of mood swings is lurking.
For fathers, discomfort is first underestimated, then silenced and neglected
There is a certain predisposition to postnatal depression. “Studies show that much depends on the structure of the personality and those who already have a personal history of depression and anxiety disorders or more generally self-esteem problems are more vulnerable,” explains the psychiatrist. It has been seen that the risk is higher, then, if the partner also suffers from depression and it is not difficult to understand the reasons: a tired, sad, nervous new mother cannot fully look after the baby, so the burden falls on the shoulders of the father, to which is added the burden of seeing one’s partner suffer.
“The aggravating factor in the case of fathers is that, while mothers usually receive support from both the family and the health system with dedicated clinics and counseling centres, for fathers, discomfort is first underestimated, then silenced and neglected» continues Porcelli. «Underestimated because it is confused with something else, first kept silent by those who suffer from it, due to man’s atavistic difficulty in getting help. On the other hand, it is still present stigma around the male which is fragile, so he feels less entitled to raise his hand and ask for help. And, even once it has emerged, the problem is neglected because historically the mother has always been considered responsible for care, attention to the male world in birth paths is only recently emerging ».
Male postpartum depression: the repercussions on children
In the long run, even the little ones pay the consequences of the paternal malaise. Studies confirm that children of depressed fathers are at risk for future emotional and behavioral problems. Among the most important, the review published by theAmerican Journal of Men’s Health which brought to light that negative relationships between father and son can lead to one cognitive, behavioral, social and emotional development harmful to children.
“It is the other side of the coin of the ever-increasing importance that the paternal role has assumed in the development of children,” says the expert. «The new fathers, compared to those of past generations, are more involved and involved in every phase of the offspring’s life, but their influence in cognitive-emotional development is also much greater. The phases of attachment are fundamental, if one of the two parental figures is less present because affected by depressive symptoms, the risk of having psychological problems in adulthood increases».
How can it be cured?
The good news is that you can get out of it. The intervention strategies to combat postnatal depression are different, but the first step is always the following: don’t close in on yourself, don’t hide the problem. Talk about it, overcoming the fear of appearing fragile, perhaps by discussing it with friends (better if they share the experience of being fathers).
“It is up to those who suffer the difficult task of accepting the problem and then accepting the help,” explains Porcelli. «The partner in this has a very important role, at least if she too does not show difficulties in adapting to the new role. You should be as welcoming as possible, available to listen, put aside accusing or disqualifying attitudes, try to involve your partner in taking care of the child, reward him for the things you do well ».
When the family and friendship network is not enough, it is useful to undertake a psychotherapy course with a specialist for individual support, or for couples if deemed appropriate. “It is necessary to look for a space where you can listen freely, free from feelings of guilt, let fears, anxieties, fantasies, hopes emerge”, concludes the specialist. «When needed, then, under the guidance of the psychiatrist, one can integrate a Pharmacological treatment to reduce depressive symptoms, anxiety, relational difficulties. It is an intervention that should not be demonized, but seen as an opportunity for treatment, a further step towards the road that leads to the reconquest of one’s role”.
It can also be a passing annoyance
Postpartum depression and baby blues are not the same thing, although the terms often overlap. By baby blues we mean a mild, common and transient emotional disorder which generally resolves two, three weeks after delivery and only in rare cases can it worsen and become post-natal depression. The signals are of various types: ranging from crying to anxiety, irritability to difficulty concentrating.
To reduce the risk and better deal with the transition from man to dad, the advice is to promote his involvement and support his role from the beginning of the pregnancy, from gynecological visits to prenatal courses to all activities involving the baby.
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