Postpartum depression in men: As a new father, I was blindsided

What I was not prepared for was the listless mental fog that enveloped me. When I returned to the office, it was nearly impossible to concentrate. At home in the evenings, all I wanted was to play video games and be left alone. And after the pandemic hit a few months later, I plunged into a pit of emptiness and self-loathing like nothing I had ever experienced, even after a lifetime struggling with depression.

Don’t get me wrong. I adore my children (we have two now) and cherish my time with them. But first-time fatherhood left me unable to feel anything but exhausted and powerless. Although I had access to high-quality psychiatric care and never encountered serious problems at work, it would be years before I felt normal.

Perhaps to state the obvious, I am not a woman. I did not have to endure pregnancy or push another person out of my body. I never had to nurse or pump or put up with the expectation of being a perfect mother. I am ashamed to say it, but the psychic shock I experienced came even though my wife was doing most of the parenting.

Yet the pain I felt was nonetheless profound—and far more common for men than you might think. While postpartum depression among women is well-known and afflicts 13% to 19% of mothers, its incidence in men is far less understood but also quite prevalent, affecting 8% to 10% of fathers.

As many new parents will tell you, the impact on your mental health is no simple matter of sleep deprivation. For years, studies have shown that women’s brains temporarily shrink during pregnancy and after childbirth, particularly in regions associated with social cognition. The effects of first-time motherhood on the brain are so profound that algorithms can easily differentiate between brain scans of mothers and non-mothers. The well-known (albeit misunderstood) phenomenon of “mommy brain,” where new mothers report memory loss and problems focusing, may be related to these changes. 

Peter Saalfield

More recently, similar results have been identified in the brains of first-time fathers. In 2022, an international study of first-time fathers identified a noticeable reduction in the size of their cerebral cortex, the outer layer of the brain that governs higher-level functions like reasoning, problem-solving and memory. 

Although these changes have been linked to an improved ability to care for and protect a newborn in both female and male parents, they are not without danger. 

An author of the 2022 study, Darby Saxbe of the University of Southern California, recently published a follow-up paper showing that fathers whose brains lost more gray matter following the birth of their child generally reported greater feelings of bonding and attachment with the baby, but also had higher levels of anxiety and depression. (Postpartum depression in men is often characterized by irritability, anger, indecisiveness and withdrawal from relationships, work and family.)

These findings suggest that there may be a “cost of caregiving,” Saxbe tells Fortune. “The same brain adaptations that seem to support becoming a parent are also actually linking up with psychological risk.” 

Indeed, as men have expanded their role as caregivers, they may have increased their risk of depression. Back in 1965, according to the Pew Research Center, fathers generally spent only about 2.5 hours a week with their kids. That number has tripled overall and quadrupled among college-educated dads, according to recent studies. 

“Becoming a parent has always been kind of psychologically taxing for women,” Saxbe says. It may be that as fathers take an increased role in parenting, the brain changes reflected in fatherhood “are also taking a toll on their mental health.” 

First-time fatherhood roughly doubles the risk of depression, James Rilling, a psychologist at Emory University who studies fatherhood issues, tells Fortune. Fathers who are involved with their children typically experience a decline in testosterone, which also increases one’s predisposition for depression. And work-family conflict is a common source of stress for fathers that has been increasing over time, he says. Having previously suffered from depression, as I had, is a leading risk factor.

This tracks with the lived experiences of many fathers, including my own. In 2019, an international survey of new fathers found that 70% experience an increase in stress in the 12 months after the first of their first child and 56% develop at least one “negative health behavior” like exercising less, drinking more alcohol or gaining extra weight. Over a six-week period about six months after my daughter was born, I gained almost forty pounds.

Another 23% reported feeling “extremely isolated” and 20% reported losing “a number of close friends.” Whereas women may have social structures in place to navigate the transition to parenthood—think “mommy and me” yoga—men typically do not. I am comfortable talking with my friends about mental health, but parenting issues are not a frequent topic of conversation. (I hesitate to admit this, but almost none of us read any parenting books, much to the consternation of our wives.)

Of course, the experience of parenthood is highly individualized. Before the birth of our second child last year, I braced myself for another earth-shattering experience. It never came. Although friends had warned me that kid number two makes parenting exponentially more stressful, I barely noticed the effect.

Saxbe says the stress levels associated with first-time parenthood and second-time parenthood may depend on which aspect of the experience one finds most challenging. If the biggest obstacles for you are the logistics and the busy schedule, the second child might be more of an issue. But if the biggest challenge is the change to your identity and social role, the first child is likely going to be the hardest. 

For men, the shift in identity associated with becoming a parent may be a double-edged sword, she added. While research shows that women take more of a career penalty from parenthood due to stigma against working mothers, there may be a psychological cost for fathers who want to be involved in parenting because they must fight the perception that their value comes from being the breadwinner. 

“There’s a lot more emphasis on men finding value and identity through work,” Saxbe says, which can make it harder for men to feel that “their time spent giving care is valuable.”

Coming to understand my value as a father was a major part of my recovery. As I grew more confident as a parent, my sense of agency started to return. As my wife and I learned to navigate our new relationship and find a common approach to parenting, I found additional strength and confidence. For me, learning to embrace my new identity was just as critical to my recovery as therapy and medication. It is also vital to remember that an ounce of prevention can be a pound of cure. According to Jodi Pawluski, a neuroscientist specializing in postpartum mental health,  prospective fathers must do a better job preparing for the logistical and psychological challenges that accompany parenthood. It isn’t enough just to know that your world is going to be rocked. You have to know how. 

In other words, I probably should have read the parenting books. Or at least a couple. 

“Educate yourself,” she says. “Communicate with your partner about how things will look postpartum. You have a few months in pregnancy to prepare. Actually learn some stuff, plan for some things, or at least discuss them.”

Although not every single task has to be split 50-50, couples need to be proactive in figuring out what works best for them. Planning questionnaires and other resources available through groups like Postpartum Support International can be useful tools, Powluski says. But nothing beats good, old-fashioned communication with your partner. 

“Get on board, people,” she says. “Just talk about it.”