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Paternal depression is a condition in which a first-time or seasoned father shows symptoms and signs of depression after a child is born. It is becoming increasingly recognized, though its incidence is lower than that seen in mothers.
Paternal depression is estimated to occur in 1-30% of fathers, from early gestation to one year after birth. Depression rates in fathers usually drop sharply at 12 months after birth.
Paternal depression may be due to the interaction of various factors such as:
These include loss of intimacy and sexual relationship to pre-pregnancy levels, reduced free time for recreation, increased workload at home, and negative aspects of the parent-child interaction, among others.
Biological factors may include excessive decreases in testosterone levels, which usually begin during pregnancy and continue well into the first year postpartum.
Environmental factors include financial stress, lack of positive feedback during parent-child interactions, such as the baby showing distress upon being left in the father’s care, as well as the lack of competence felt by men who have not had any good role models as father figures in their lives.
Since paternal depression has been shown to seriously affect the life of the family and of the child, it needs to be prevented where possible, and treated appropriately. Suggested measures include:
There are relatively few studies on the incidence, prevalence, and contributing factors of postnatal depression in fathers. Many of those which are available have a subject base of married, middle-class, white fathers. This makes it difficult to extrapolate the findings to men of other socioeconomic classes and cultures.
Risk factors need to be further studied, such as:
There is therefore a great need to select samples which are representative of a wider and heterogeneous population base, as well as to study paternal depression over a long-term period.
Multiple points of interview will be required using a prospective design, to follow up with fathers who have been identified to be at risk of paternal depression from the time of pregnancy onward. Such longitudinal studies are needed to bring out the course and timeline of paternal depression, as well as its impact on their children and spouses.
International studies will help determine the causative and contributing factors that are similar between different cultures and countries. Identifying such factors can assist in providing better diagnosis and treatment for all fathers at risk.
The symptoms and signs that are assessed in most studies rely on self-reporting using various scales or questionnaires. These need to use validated tools and thresholds so that their findings can be useful to other scientists.
Additionally, biological changes and psychological adaptations should be studied to clarify the mechanism of bonding between fathers and their infants. This may require laboratory testing to fill out our knowledge of how the male brain imprints the image of the baby and responds to it.