A scene from the life of a new dad as told by counselor Joe Butler: Dad picks up baby. Baby starts to cry. Dad tries to comfort baby. Baby starts to scream.
Mom swoops in. Baby stops crying. Mom begins to nurse baby. Dad sulks. "I am the un-breast," he thinks. "I have nothing to offer."
Butler, who works for Family Services of King County, didn't have a particular dad in mind when he described that fictional yet familiar scene; he had all dads in mind. Feeling "marginalized" is a common emotion for new dads - and one of the triggers for postpartum depression in men.
Long recognized as condition that can strike women in the months following birth, postpartum depression is now acknowledged to afflict men, too. A 2006 study in the journal Pediatrics reported that 10 percent of fathers suffer from moderate to severe postpartum depression - a percentage nearly as high as the 14 percent of women who suffer the baby blues.
"Men need to know that this can happen to them, and that if it does happen to them, there are other people out there experiencing it, too," says Dr. Will Courtenay, a Berkeley, Calif., psychotherapist who publishes the SadDaddy.com about postpartum depression among dads. "Men don't need to suffer alone in silence."
A serious problem
While the experience is equally painful, postpartum depression in men and women differs in at least two key ways. First, hormones do not play a role with dads. Second, men don't exhibit that classic sign of postpartum depression: sadness.
"Oftentimes in men, we see increased irritability and conflict with others, withdrawal from friends and families, engaging in reckless behavior," says Courtenay. "That's how men [respond]. They don't see themselves with what we call depression."
That's a dangerous blind spot. If dads can't see that they're depressed, they're less likely to seek help from friends, family, therapists or support groups.
Yet that's only half the problem. Even if dads do recognize their depression, men are less likely than women to seek outside help. "Men underestimate their needs," Courtenay says. "If a man says ‘I can ride this out on my own,' he may have passed the point of no return."
If so, the consequences can be severe: everything from divorce to substance abuse to suicide. In addition, studies have shown that infants whose fathers experienced postpartum depression can exhibit developmental delay and behavioral problems, says Courtenay.
Triggers for depression
Not everything is different about the way moms and dads experience postpartum depression. "Sleep deprivation is probably one of the biggest triggers in both men and women," says Courtenay. Marital problems are another mutual trigger - and sometimes an outcome.
Couples often underestimate just how hard the stork's arrival will rock their world. "After you have baby, it's really easy to have no time to spend together as a couple," says Veronique Burke, parenting program manager for Family Services of King County. "If you don't pay attention to that, it can take a long time for a couple to reconnect and they can end up going their separate ways."
One of the downers for dads is learning to share mom with the baby. Most men lack large social networks and count on their wives for emotional support. Then comes the baby and "the person they rely on most is gone," says Courtenay. "She's occupied with a 24/7 job."
While today's fathers are more likely to change a diaper or push a stroller than previous generations of dads, they can still feel like a third wheel, says Burke. "They often feel left out of the relationship with the baby," she says.
Our culture has a lot to do with that, says Butler. Girls grow up playing mommy while boys grow up playing GI Joe. "Moms have a head start in how babies work and how to be attuned to them," he says.
The best way for men - as well as women - to deal with postpartum depression is to anticipate it, says Burke. Identifying sources of support, working out any marital conflicts and setting aside time to spend together will make it much easier to cope if postpartum depression does strike, she says.
Butler is forming a support group called Father's First Steps. While not focused specifically on postpartum depression, it will help expectant dads deal with their new role.
Butler's advice for dads struggling with postpartum depression: Have more contact with their babies. Rather than defer to mom, dads should ask themselves, "What are the rituals and routines I can do?" he says.
Here's what Butler did: He perched his baby daughters on his shoulders, plugged in a Sade CD and got jiggy with it in the living room. They loved it. "I wound up finding out I do have something to offer the baby that's not breast-related," Butler says.
Brad Broberg is an Auburn-based freelance writer.
Originally published in the May, 2008 print edition of ParentMap.