istock.com
Source: istock.com

We have recently started a new conversation in the postpartum sphere which traditionally focused on the emotional well-being of the mother. Recently greater attention has been placed on dad's mental health with consideration of his emotional adjustment impacts, him, his marriage and his child.

There is no question that men experience depression and anxiety after the birth of a baby. They may be less likely to talk about it or admit to it to themselves but they are indeed at risk for depression and anxiety. Many brave men are beginning to share their experiences. 

But when men get depressed or anxious after the birth of their baby, and we write about it, diagnose it, or discuss it, should we call it postpartum depression? 

It may, at first glance, seem like a trivial point of distinction, but after reading articles, blogs and research studies, I am convinced we are doing men a disservice by suggesting that some may experience postpartum depression. When I say this, I am strictly referring to the specific language being used.

Men get depressed after childbirth for many reasons which parallel the risk factors that make women vulnerable: 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 their marriage is unstable and the lack of intimacy exacerbates the distress. Perhaps they are overwhelmed by the financial stress or the life-altering responsibility. They may display symptoms of social withdrawal, indecisiveness and irritability. Moreover, 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.

Even so, depressive symptoms in men often manifest differently than they do in women, contributing to widespread misdiagnosis. Firstly, their emotions are more likely to appear as fear or anger rather than sadness and hopelessness.  Additionally, they are more likely to exhibit avoidance behaviors, substance abuse, extramarital sex or domestic violence. [1]  

Thus, we see that depression after childbirth is very real—for moms and dads. There are just as many reasons why men can get depressed after the birth of their baby as women. 

But should we call it postpartum depression?

The feedback I hear is that it somehow dilutes the experience of postpartum depression specific to women and further alienates men, reducing the likelihood that they will reach out for help.

Depression is depression. Symptoms that meet the diagnostic criteria for clinical depression can impact men and women. We know that. But when symptoms of depression occur within the context of having a baby, it affects women and men differently. That's not to say one is more significant than the other. They're just different. 

Both moms and dads may struggle with issues related to their identities, their expectations, their role, their transition to parenthood, any one of which may either contribute to, or be a consequence of, depressive symptoms. There are inherently many differences between how men and women view childbirth and parenthood and even this is, of course, subject to individual experience and appraisal. The postpartum period is so fragile and so volitile and for decades it has been associated with predominantly female experiences. Something about attaching the male experience to this label doesn't feel right. It doesn't feel right on behalf of her. And it doesn't feel right on behalf of him.

Without citing scientific or academic references, I rely only on my years of intuition and clinical observation to support this claim. I simply think it will feel better and lead to an increase in identification and treatment if we use the term paternal depression, which is consistent with the language used in recent research.

For reasons that are both straightforward and extremely complex, I merely think the terminology should be different.

I think women experience postpartum depression.

I think men experience paternal depression.

And to put it simply, I just think men would rather not be told they have postpartum depression. 

Copyright 2015 Karen Kleiman, MSW, LCSW

1Paternal postnatal depression – a review
Tuszyńska-Bogucka, Wioletta (Department of Educational and Family Psychology, Maria Curie-Skłodowska University of Lublin), Nawra, Karolina (Department of Educational and Family Psychology, Maria Curie-Skłodowska University of Lublin)

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