This Isn't What I Expected

Notes on healing postpartum depression

Should We Call It Postpartum Depression?

Dads get depressed, too.

Yesterday, Katie Couric talked about postpartum depression with Dr. Craig Garfield and Craig, a father who experienced paternal depression. The research study carried out by Dr. Garfield was groundbreaking and brings attention to the needs of dads during the postpartum period. We discussed this "together" in the article in The Atlantic, "Postpartum Depression Can Happen to Any Parent", written well by Julie Beck.

Here's a link to the first segment with Dr Craig Garfield, talking about his research with Craig, a dad who experienced symptoms of depression after the birth of his baby.

Here's a link to the second segment where I speak with Katie (rapid fire dialogue. Previous segment running long. cut out most of what you were going to say and give us quick soundbites. ugh.)

Great fun. Great people. Media splashes are always frenetic and exhilarating. And personally, I'd like to thank The Katie Show for giving us the opportunity to broadcast important information about depresion after the birth of a baby and also a big shout out to both Craigs for speaking out on a topic that has gotten far too little attention from the medica, academic and the PPD community at large.

As the dust settles I do want to raise one point of clarification. Because sometimes, even with the best intentions, media sources can inadvertently misguide ...

There is no question that men can and do get depressed after the birth of a baby. We are beginning to hear and read more about it. Brave men are beginning to talk about it. We are seeing it in our clinical practices. Men get depressed. They may be less likely to talk about it. Or, less likely to admit to it. Or, less likely to recognize it. Regardless, men get depressed. This is not up for debate.

But when they get depressed after the birth of their baby, should we call it postpartum depression? 

It may, at first glance, seem like a trivial point of distinction, but more and more women are reaching out to me with a concern.

There is a reason the term postpartum depression has traditionally and exclusively been linked with a woman's experience.  Principally, it's due to the fact that the definition of postpartum depression has been linked to the unique experience of childbirth and delivery, commonly involving labor pains and a uterus.

Recently it has been pointed out by many who are in a position to educate and clarify definitions, that when depressive symptoms emerge after birth in any parent -- whether a biologic mom, an adoptive mom, a dad, a lesbian mom, biologic or non-biologic -- the depression is no less profound or excruciating. Worthy of careful consideration by researchers, clinicians, and families alike.

Still, it's interesting to note that scientists and researchers tend not to refer to these experiences as postpartum depression. Although research is still scarce with respect to fathers, most researchers refer to it as paternal depression. Or, men with depressive symptoms during the postpartum period. Or, depression in fathers.

Here's one from 2004.    Here's one from 2010.    Here's one from 2013.    Here's Dr Garfield's study 2014. 

With respect to adoptive mothers, the literature generally refers to it as post-adoptive depression or depressive symptomatology during the transition to motherhood.

Here's one from 2010.  Here's another.

Regarding lesbian moms, it's a little trickier. It appears that the research combines the non-biologic and biologic mothers and the research tends to refer to this as perinatal depression in lesbian mothers. Or, maternal depression. (And, by the way, it appears that lesbian moms are at greater risk for postpartum depression than heterosexual moms, perhaps due to less social support.)

Here's one.

I've gotten some interesting feedback since yesterday's appearance on The Katie Show. It seems that everyone is in agreement that we need to call attention to the fact that dads can get depressed after the birth of a baby. Of course they can. And make no mistake about it. They can get very depressed. Perhaps they have a family history of depression. Perhaps they have a personal history of previous depression. Perhaps they are predisposed to severe anxiety. Perhaps they are overwhelmed by the financial stress or the life-altering responsibility. Perhaps their marriage is unstable and the lack of intimacy exacerbates the distress. There are just as many reasons why men can get depressed after the birth of their baby as women (with the exception of hormones). Let's face it, sleep deprivation affects everyone. Colicky babies affect everyone. The dramatic change in lifestyle, transition to parenthood, and the unrelenting demands of a newborn, affect both mom and dad.

But should we call it postpartum depression?

The feedback I am now hearing is that it somehow dilutes the experience of postpartum depression specific to women that so many of us are working hard to carefully define and elucidate.

At the risk of oversimplifying a complicated concept, women get depressed after the birth of a baby for a multitude of reasons, to be sure, but some of those reasons are unique to women, such as breastfeeding, care-taking and relational instincts, hormonal surges, labor pains, physical complications, the birth/delivery experience, potential birth/delivery trauma, to name a few. Some examples of factors that may impact men more specifically are, economic pressures, the responsibility of caring for the family, unexpected lifestyle and role changes. This does not mean that the male experience is any less serious or significant -- to him, his family, or to the scholarly community working hard to understand and enlighten us. Surely, most would agree that from from a symptom or clinical perspective, the experience of depression may be very similar, from one person to another, from a mother, to a father. After all, depression is depression. Right?

Still, for reasons that are both straightforward and extremely complex, I just think the terminology should be different.

I think women experience postpartum depression. I think men experience paternal depression.

Can we work with that?

 

Copyright 2014  Karen Kleiman, MSW

pic credit 

Karen Kleiman is founder and director of The Postpartum Stress Center, a treatment and training center for prenatal and postpartum mood and anxiety disorders.

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