Dads need support too!

Not only is it painful if your loved one is struggling, but we now know that dads are also vulnerable to postpartum mood problems, too. About 10% of new dads develop mood problems. Sometimes these are pre-existing conditions, and are worsened by the stress and lack of sleep that come with a new baby.

Put your oxygen mask on first!

Get support for yourself! Remember, on airplanes they tell you to put on your own oxygen mask before helping others. I always encourage my clients to bring their spouses or partners with them to counseling. You may need to seek your own counseling, if you are having a rough time.

Things to say to your partner:

❖We will get through this together. We are a team.
❖I love you. If I were sick you would be there for me.
❖This is not your fault.
❖You will get better. This is a treatable problem. I know you are doing everything you can to get better.
❖How about if I.... give the baby a bath, put the baby to sleep, draw a bath for you, bring home take out food, take the baby for a walk so you can take a nap, make you a cup of tea, clean up the kitchen.

What about the dads or partners?????

Having a baby brings changes to the whole family. Questions like, “will I be a good parent?” and “how can I best support my partner through this uncharted territory?” are normal and healthy to ask. This happens in all types of relationships; heterosexual, gay and lesbian couples, and adoptive parents. Having a baby changes things. Attention that had gone to the dad or partner now goes to the pregnancy. Fears, discomfort, and medical problems can affect intimacy. Once the baby is born, attention goes to the baby, and the couple relationship is on the back burner. We hear more these days about women’s mood problems during pregnancy and postpartum, but we hear very little mentioned about the mental health of dads and partners. Dads/partners are important, too!

Most often we are told the glowing side of parenthood; you will feel instantly bonded and fall madly in love. That may happen, but often it’s a process of getting to know this demanding stranger. There are losses associated with becoming a parent, and it’s important to acknowledge and grieve them. Our relationship with our partner changes-we’re no longer #1. If she’s (or you’ve) been drooled on, spit up on, and sucked on all day, she (or you) may be “touched out”. It’s easy to feel rejected. Remind yourself, it’s not a personal rejection. You can no longer jump in bed, take off to the movies, or go out to dinner on a whim. The baby tells you when you can sleep, eat, talk on the phone, and go to the bathroom. It’s an incredible shift in power in the family.

It is now thought that about 15% of women suffer from mood or anxiety problems during pregnancy. Some women go into the pregnancy with a past or current history, and others develop a new onset of an illness. And, as many as 1 in 6 women will have a postpartum mood or anxiety disorder.

Likewise, some dad’s may have a history, or may be experiencing a mood or anxiety disorder during the pregnancy. Depression and anxiety disorders (in particular obsessive-compulsive disorder) worsen during times of stress and sleep deprivation. It’s important for dads to assess their own risk going into a pregnancy.

What do depressed or anxious dads look like? They look like dads. You can’t tell by looking! When a mother is experiencing a prenatal or postpartum mood or anxiety disorder, her partner is at an increased risk of suffering, as well. In a study published in 2006, 10 % of fathers showed moderate to severe depression 9 months after the birth of a baby. Another study found that paternal mood and anxiety disorders in the first 2 months postpartum occurred in up to 25% of dads.

Not all depressed men or women experience extreme sadness. Often, especially in men, depression may manifest as irritability, aggression, and hostility. They may distance themselves, find distractions to avoid the family, or “check out”. This certainly contributes to relationship or marital distress. Other common symptoms may be difficulty falling or staying asleep, appetite changes, racing thoughts or constant worry, lack of joy or pleasure in things you used to enjoy. Some people feel helpless and hopeless. Having a new baby and an increased financial burden can really contribute to a feeling of being trapped. Being depressed is like having dark glasses on. Everything you see gets filtered through the lenses and gets distorted. Only the negative things get though.

Paternal depression also effects childhood behavioral and emotional development. Children 3.5 years old where found to have problems; boy children more than girls. Four year-old children of fathers with major depression were more likely to consult professionals for speech, language problems and behavioral problems. Depression in fathers is significantly associated with psychiatric disorders in their children 7 years later, in particular, oppositional defiant/conduct disorders in boys.

When there is a pregnancy loss, both moms and dads suffer. Moms go through an immediate physiological and emotional reaction. Dads often feel they need to be the “strong” one, and the “rock” to support their partner through the grieving process. Dads are often the ones taking care of details and are on “auto-pilot. In a study in the UK, 36% of dads suffered from severe anxiety at 6 weeks after a pregnancy loss. Interestingly, dads were found to have more depression than the moms at 13 months after the loss. It may be that as the mom’s depression post-loss improves, the dads fall apart. This can cause tension in the relationship. Sometimes women interpret the dads initial stoic response as a lack of caring. Couples really need to communicate to work as a team and support each other though a tragedy.

What can dads do? Get support! Get educated! Talk to your partner, friends or family, if you think they will listen. It is critical to find non-judgmental support. Getting the help you need is a sign of strength.

There are a number of websites devoted to dad support.

www.postpartumdads.org

www.postpartummen.com

www.postpartumdadsproject.org

www.bcnd.org (boot camp for dads)

There are also a number of great websites with information about prenatal and postpartum mood and anxiety disorders.

www.postpartum.net (Postpartum Support International)

www.MedEdPPD.org

What helps?

Social support is a critical element in recovery. Many find psychotherapy extremely helpful. Two very effective models of psychotherapy for depression around childbirth are Cognitive-Behavioral Therapy and Interpersonal Psychotherapy. Both are brief, practical forms of therapy. The therapist should play an active role, and not sit there and ask you how that made you feel. Shop around for a therapist who meets your needs and feels safe and comfortable. Screen prospective therapists by asking the following questions:

-Have you had any specific training in prenatal or postpartum mood or anxiety disorders?

-What model of psychotherapy do you practice? Long term psychodynamic therapy has not been shown to be appropriate for this issue.

-Can you recommend any bo

oks on the topic? The books that have been written are about women, but would be very appropriate and helpful. If a therapist can name any books on this topic, then they are not familiar with the field.

Sometimes medications for depression and anxiety are very helpful. The longer you stay anxious or depressed, the more likely you are to have future episodes. It is important for you and your family that you be well. Medication helps clean the dark glasses from the inside, while therapy helps clean the lenses from the outside. They work hand-in-hand.

It is a realistic expectation to be back to your-self again. Don’t settle for just “better.’ That’s not good enough.

Some helpful books are:

Beyond the Blues, A Guide to Understanding and Treating Prenatal and Postpartum Depression by Indman and Bennett (www.beyondtheblues.com)

The Postpartum Husband by Karen Kleiman LCSW

Mind Over Mood by Christine Padesky PhD (a workbook)

You are not alone, many families have dealt with this challenge.