About 14 percent of mothers and 10 percent of fathers suffer from moderate or severe postpartum depression, according to the study in the August issue of the journal Pediatrics.
More incapacitating than the "baby blues," postpartum depression is marked by severe sadness or emptiness, withdrawal from family and friends, a strong sense of failure, and even thoughts of suicide. These emotions can begin two or three weeks after birth and can last up to a year or longer if untreated.
"Postpartum depression in fathers was strikingly high and more than twice as common than in the general adult male population in the U.S.," write researchers including James F. Paulson, Ph.D., of the Center for Pediatric Research at the Eastern Virginia Medical School in Norfolk, Va. As a result, pediatricians must make a greater effort to screen moms and dads for postpartum depression, they say.
Postpartum Depression Does Not Discriminate
Researchers reviewed data on more than 5,000 two-parent families with children aged 9 months and found that with both parents depressed, babies were less likely to be put to bed lying on their back, ever to be breastfed, and more likely to have been put to sleep with a bottle.
Pediatricians recommend that babies be put to sleep on their backs to prevent sudden infant death syndrome.
Depressed mothers were about 1.5 times less likely to engage in preventive health behaviors such as breastfeeding and placing a child on his or her back to sleep, and/or more likely to put their babies to bed with a bottle. They were less likely to read to their babies, tell stories, or sing songs if depressed.
Depressed fathers were less likely to sing to or play outside with their child if both parents were depressed, the study showed.
"Our results suggest that where day-to-day interactions are concerned, depressed mothers and fathers engage in less positive interaction with their children, with a particular reduction in the degree of enrichment interactions, including reading, telling stories, and singing songs," the researchers conclude.
Paulson tells WebMD that as of now, there is no information on how depression is affecting a father's preventive health behaviors. "We can't look at dad's breastfeeding, that's silly," he tells WebMD. And "we don't have data on whether they are putting their babies to sleep with bottles," he says.
But the finding that depressed dads don't interact with their children is "really a critical thing and (interaction) is needed for children to develop cognitively and emotionally in a normal way," he says.
Know the Signs
While women often show signs of frank sadness when they are depressed, men may be more likely to be irritable, aggressive, and sometimes hostile when depressed, he says.
"The best thing for somebody to do when they notice signs of depression is to talk to a doctor, counselor, psychologist or social worker who can make an affirmative diagnosis that there is depression that needs to be treated," he suggests.
The new findings do not surprise New York City psychoanalyst and father Leon Hoffman, MD. Hoffman is also director of the Pacella Parent Child Center. "We see this very commonly," he tells WebMD. "It's very important for pediatricians to be on the lookout for signs of postpartum depression in men."
In addition to not interacting with their baby, a depressed dad can't be supportive of the mother, he says.
Different Reasons, Same Problem
The reasons that men experience postpartum depression may be different than the reasons for women, says Terrence Real, a couples therapist and author of "I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression."
"Generally speaking, a man may be feeling burdened or entrapped at the prospect of caring for a child or caring for yet another child," he tells WebMD. "They will feel like all the financial responsibility is on their shoulders. Or maybe men are suffering withdrawal from being tended to in their marital relationship. They are missing their wives."
So what's a concerned spouse to do?
"In a gentle or loving way say, 'I think you have been depressed since this baby,' " Real suggests. "Let him know that men do get depressed around this time and that even though postpartum depression in women grabs all the headlines, men are close behind. You want him to talk about it and depending on how severe it is, you want him to get help."
SOURCES: Paulson, J. Pediatrics, August 2006; vol 118: pp. 659--668; Leon Hoffman, MD, director, Pacella Parent Child Center. James F. Paulson, PhD, Center for Pediatric Research at the Eastern Virginia Medical School, Norfolk, Va. Terrence Real, author, I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression.
By Denise Mann
Reviewed by Louise Chang, M.D.
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