As the field of maternal mental health is growing and expanding, we are becoming more alert to the shifting family dynamics as parents and extended loved ones welcome new members of the tribe. After the initial celebrations of the shalom zachor, bris or kiddush have passed and shortly after the first car ride home in the cute new outfit selected for just this event, parents are introduced to a completely new reality. Even as couples welcome baby number two, three, or more, each birth heralds its own host of opportunity and possibilities.

Once creatively known as “postpartum fever” and later defined as “puerperal mental illness” in the late 1800’s, women have long faced the post-birth challenges of adjustment. Many women experience the “baby blues,” that rollercoaster of emotions and tears and frustration that comes with the first sleepless weeks of new baby life. For others, the emotional response to the newborn brings an unexpected challenge that is unsettling, and often frightening, for parents.

It is estimated that up to 23% of pregnant women will experience moderate to severe symptoms of depression and/or anxiety. These symptoms may look like classic depression: lack of motivation, sleeping too much, reduced appetite, and feelings of sadness or hopelessness. The symptoms may present as extreme irritability, intrusive thoughts of harm to the baby, inability to sleep due to racing thoughts, or a feeling of detachment from the baby and from current life. All these issues are commonly referred to as “postpartum depression,” or more broadly as “perinatal mood and anxiety disorders (PMAD).”

There is another aspect to this phenomenon as well. In a study of 5,000 families published in the Journal of Pediatrics in 2006, 10% of new fathers struggled with depression, which was more than twice as common as in the general adult male population in the U.S.

Imagine that! No pregnancy morning sickness, no expanding belly (though some will argue that particular point), and no hormonal surging. And yet, a significant portion of fathers genuinely struggle with the adjustment period post-birth. Some acknowledge feeling overwhelmed and disconnected; others face limited attachment with the new baby and struggle with finding stable footing as their entire world adjusts to the needs of a newborn. 

Symptoms of depression in dads may look different than depression in moms. The initial high after the baby may give way to depression, and rather than sadness, men may be more likely to be irritable, aggressive, and sometimes hostile. A partner may “check out” from the family structure or find methods of distraction, even forming negative, unhealthy habits. At a time when a new mother needs her husband most, these fathers find themselves struggling with the role they are now assuming.

Possible factors in partner depression include: feeling burdened or trapped, financial responsibilities, feeling outside the circle of attention, sleep deprivation, new relationship rules with his partner, even isolation and loneliness as a woman provides so much of the baby’s immediate needs, pulling her attention away from her spouse.

With all this going on, who is asking the fathers how they are doing? Who is checking in with dads to see what their emotional health status is? To add to the mix, it is possible that the new mother is struggling with her own emotions and/or depression, and no one thinks to check on dad who is left to pick up the pieces.

If you have a new father in the family, a brother, son or son-in-law who is now assuming this new role of fatherhood, check in with him by asking some sensitive, yet serious, questions. Start with basic health habits: “How have you been managing this new experience with the new baby? What has this change been like for you?”

Recognize that acknowledging any kind of struggle will likely have a layer of shame attached to it.  From a spiritual perspective, a parent might feel that any expression of struggle sounds like he is ungrateful for the gift he was given. Additionally, within a societal construct, men often struggle with asking for help or expressing vulnerability to the emotions they experience.

To help your friend or family member, start by asking questions, encourage honesty, and allow a safe and trusted space for the new parent to express his emotional pain. Reassure him that he is not alone, he is not to blame, and with help, he will get better.

Providing strong support, validation of the struggle, and a listening ear will help ease a man’s transition from husband to father, and will help to create healthy fathers, healthy homes, and healthy communities.

 

Dvora Entin, LCSW is the Director of JFCS Ma’oz in Philadelphia, a new initiative to engage the Orthodox community on mental health and family life issues. She moderates monthly support calls on perinatal loss (K’nafayim) and specializes in Maternal Mental Health.

 

 

 

SIDEBAR:

 

What PMAD Looks Like in Men:

 

 

 

Support for Fathers:

www.postpartumdads.org

www.postpartummen.com