Many parents struggle with their mental health. This is very concerning because their children may have more difficulties growing up. Let me tell you why.
How Does Parents’ Mental Health Affect their Child?
When parents struggle with their mental health, they are less able to take care of their children, they pay less attention to their children’s needs, and the quality of the family’s life gets worse. Parents may be harsher with their children or may be distant from them.
Children who grow up with parents who struggle with their mental health, experience more stress. Growing up with a lot of stress is not good for children. These children are more likely to have worse mental health and to face difficulties growing up. They may grow up feeling insecure and experience distress.
However, it is important to note that the experiences of growing up with a parent who has mental health issues are very different. It is not the same for a child to grow up with a parent that is often hospitalized because they experience severe mental health issues, than growing up with a parent that has one episode of a mental health issue during their life.
Mothers’ Mental Health Matters from Pregnancy
Mothers’ mental health influence their child even before the child is born. When women have very high levels of stress (1) during pregnancy, their babies are more active in utero. When they are born, they are more likely to be hyperactive and irritable, and to have feeding and sleeping issues.
Sadly, 1 in 5 pregnant women or new mums develop a mental health issue. Why? Because during this period, women go through a tremendous change. Everything changes: their body, their identity, their relationship with their partner…Basically, everything.
Depression Is the Most Common Mental Health Issue for Mothers
Women may develop many mental health issues: anxiety, PTSD, mood disorders…. But the most common one is postpartum depression. It is estimated that 1 in 10 women develop postpartum depression.
When a mother is depressed, she is less responsive towards her baby. She talks less, smiles less, and is more detached from her baby. Consequently, her baby becomes less responsive and more apathetic (2). And this is bad for the baby’s development. Babies needs to be stimulated to develop fully. When a mother is depressed, she finds it difficult to stimulate her baby.
Babies of depressed mothers also interact in this way with adults that are not depressed. And because these babies are more apathetic, the adults around them tend to respond to them, in a less positive way.
Depressed mothers (3) are more likely to:
- Not engage with their babies.
- Have more difficulties interpreting their baby’s emotions.
- Find parenting more difficult.
- Experience hostility and resentment toward the baby.
- Neglect or abuse their babies.
As a consequence, their babies are more likely to:
- Experience growth and developmental delays.
- Develop an insecure attachment.
- Experience poor cognitive functioning.
- Suffer affective disorders later in life.
- Develop behavioural problems.
Fathers’ Mental Health Also Matters
Fathers’ mental health (4) and how it affects their children is a relatively new area of research because until quite recently fathers were not as involved in their children’s life. We now know that fathers’ mental health also matters. When fathers struggle with their mental health, their children tend to be negatively affected.
Postpartum depression is the mental health issue that is most common amongst fathers and the one that has been examined the most. It is estimated that 1 in 10 fathers experience postpartum depression.
Children (5) of depressed fathers are more likely to:
- Have a difficult temperament
- Experience long term mental health issues
Do Mothers’ and Fathers’ Mental Health Matter Equally?
We know that the mental health of mothers and fathers influence their children’s development. But it seems that this effect is not the same.
It seems that in the case of the mothers, it is their mental health that directly influences their children. Whereas in the case of fathers, it is not so much their actual mental health that influences the children, but the socioeconomic difficulties (6) that usually go hand in hand with the fathers’ mental health issues.
Indeed, parental mental health issues rarely happen on their own. Parents who struggle with their mental health, often also experience unemployment, financial difficulties, family conflict, or may use drugs and alcohol.
In general, it is worse for children when their mothers have mental health issues, than when their fathers are the ones struggling with their mental health. However, as you can imagine, the worst situation for a child is when both parents have mental health issues.
Parents Influence Each Other
Mothers’ mental health influence fathers’ mental health and vice versa. And they both influence the child’s mental health. For example, fathers-to-be (7) are more likely to be depressed and anxious when their pregnant partner is depressed. Roughly a quarter of mothers with postnatal depression (8) have a depressed partner.
The opposite dynamic may also happen. Sometimes when the mother is depressed, the father may take increased responsibility to compensate the mother’s poor parenting (9). Mothers may do the same when the father is depressed.
How Can Parents Take Care of their Mental Health?
- Learn about mental health and parenting
- Talk to others about how they are feeling
- Seek advice from a mental health professional
- Eat well
- Do some exercise
- Stay connected with friends and family
Finally…
If you are struggling with your mental health do not struggle in silence and do not go through it alone. Get in touch with me, our therapists are here to help you.
You may find these articles useful:
Love,
Ana
References
(1) DiPietro, J. A. (2012). Maternal stress in pregnancy: considerations for fetal development. Journal of adolescent health, 51(2), S3-S8. http://dx.doi.org/10.1016/j.jadohealth.2012.04.008
(2) Loveyjoy, M.C., Graczyk, P.A., O’Hare, E., & Neuman (2000). Maternal depression and parenting behaviour: a meta-analytic review. Clinical Psychology Review, 20, (5), https://doi.org/10.1016/S0272-7358(98)00100-7
(3) Jung, V., Short, R., Letourneau, N., & Andrews, D. (2007). Interventions with depressed mothers and their infants: Modifying interactive behaviours. Journal of affective disorders, 98(3), 199-205. https://doi.org/10.1016/j.jad.2006.07.014
(4) Fisher, S. D. (2017). Paternal mental health: why is it relevant?. American journal of lifestyle medicine, 11(3), 200-211.
(5) Pemberton, C. K., Neiderhiser, J. M., Leve, L. D., Natsuaki, M. N., Shaw, D. S., Reiss, D., & Ge, X. (2010). Influence of parental depressive symptoms on adopted toddler behaviors: An emerging developmental cascade of genetic and environmental effects. Development and psychopathology, 22(4), 803-818. https://doi.org/10.1017/S0954579410000477
(6) Kieran, K.E., & Mensah, F.K. (2009). Poverty, maternal depression, family status, and children’s cognitive and behavioural development in early childhood: A longitudinal study. Journal of Social Policy, 38(4), 569-588. https://doi.org/10.1016/j.infbeh.2006.07.010
(7) Field, T., Diego, M., Hernandez-Reif, M., Figuereido, B., Deeds, O., Contogeorgos, J., & Ascencio, A. (2006). Prenatal paternal depression. Infant Behaviour and Development, 29(4), 579-583.
(8) Goodman, J.H. (2008). Influences of maternal postpartum depression on fathers and on father-infant interaction. Infant mental health journal: Official publication of the world association for infant mental health, 29(6), 624-643.
(9) Hossain, Z., Field, T., Gonzalez, J., Malphurs, J., Valle, C.D., & Pickens, J. (1994). Infants of depressed mothers interact better with their non depressed fathers. Infant Mental Health Journal, 15(4), 348-357.
We have always considered that only women could experience baby blues or postpartum depression. However, recent research is challenging this belief. Fathers also have postpartum depression.
What Is Postnatal Depression?
Postpartum depression is defined as a major depressive episode (1) that occurs shortly after childbirth. The condition is most often found in women but recently, researchers have been paying attention to men.
Can Fathers have Postpartum Depression?
Yes, they can. A recent meta-analysis (a study of studies) that examined (2) over one million participants in over 30 countries concluded that men also have postpartum depression.
How Common is Postpartum Depression?
The World Health Organization (WHO) estimates that between 10% and 20% of women experience depression at some point after childbirth. This is around 1 in 10 women. It is also estimated that approximately 1 in 10 fathers (3) experience postpartum depression.
The WHO estimates that postpartum depression will become the second leading cause of disability and the most common mental illness worldwide.
It affects men and women all over the world no matter their age, educational level, race, or socieconomic status.
Paternal depression, as with women, can happen before or after the baby is born. Women usually show symptoms within four to six weeks after giving birth, but it can appear as late as three months after birth. In the case of fathers, it seems that they are more likely to experience depression during the first trimester of the pregnancy, and when the baby is between 3 and 6 months old (4).
Why Do Fathers Have Postpartum Depression?
In recent years, fathers have become much more involved in the life of their children. However, they are not receiving much support during their transition to fatherhood. This lack of support may be one of the factors explaining postpartum depression in men.
Fathers also find it difficult to access healthcare services when they are struggling because postpartum depression is still considered to be a problem that only affects women by many health care professionals.
We are also beginning to understand that men’s hormones (5) also change when they become fathers. Their testosterone levels tend to decrease. Fathers with lower levels of testosterone report having more depressive symptoms. Men not only experience a change in their hormones when they become fathers, their brain also changes. Scientists are only starting to investigate the ‘dad brain’. And it seems that their brain changes in a similar way as that of new mothers. Their brain becomes more streamlined to do what it needs to do: care for the baby.
Other Factors that Influence Postpartum Depression in Fathers
- Male gender role stress (MGRS): Men who feel the pressure to behave like a ‘typical man’, are more likely to experience postpartum depression because this pressure gets worse when the baby is born. This seems to be the main factor predicting whether a man will experience postpartum depression.
- History of paternal mental illness: this seem to be an important factor as well. When a man has had a mental illness before, he is more likely to experience postpartum depression
- Unplanned pregnancy: fathers that find themselves in this situation have more chances of developing postpartum depression.
- Lack of sleep is very much linked with paternal depression, especially among first-time fathers.
- Work-family conflict: many fathers find it difficult to find a balance between work and family.
- Marital distress: the arrival of a baby usually means that the parents’ relationship suffers. Conflict between the couple predicts depression in fathers.
- Maternal depression: when a mother experiences depression, the father is more likely to experience it as well. After all, both mother and father experience similar problems and difficulties. From a practical point of view this means that when the father or the mother is diagnosed with depression, the other one should be evaluated. This is why in 2020, the Journal of the American Academy of Pediatrics called on pediatricians to evaluate the mental health of all new parents, regardless of gender.
- Financial burden of having a baby: the cost of raising a child from birth to 18 years old in the UK is £223,356. In the US it costs $310,605 and in Spain €109,152.
- Lack of social support: fathers who feel better supported are less likely to experience depression (6)
Symptoms of Postpartum Depression in Fathers
Symptoms must be present for most of the day and last for at least two weeks. They can look different in men and women.
Men are likely to experience the following symptoms:
- Irritability, anger, sudden outbursts, or violent behavior
- Working all the time or a lot less
- Feeling frustrated or cynical
- Feeling overwhelmed, hopeless, or sad
- Loss of interest in work or favorite activities
- Acting distant or withdrawing from friends and family
- Impulsive behavior
- Engaging in risky behaviours like drinking alcohol or using drugs
- Low motivation
- Physical symptoms like muscle or stomach aches or headaches
- Poor concentration
- Suicidal thoughts
Why Does It Matter if Fathers Have Postpartum Depression?
It matters (7) because:
- Fathers matter and they deserve to be mentally healthy
- The mental health of the father influences the mental health of the baby
- The mental health of the father influences the mental health of the mother
How Is Postpartum Depression Diagnosed?
Postpartum depression is diagnosed (8) using the Edinburgh Postnatal Depression Scale (EPDS). This scale should only be administered by a mental health professional. This scale was developed to identify women who may have postnatal depression. In the past few years, it has been adapted to men. It has 10 questions, like: “The thought of harming myself has occurred to me”, “I have been so unhappy that I have been crying”, or “I have been so unhappy that I have had difficulty sleeping”. Parents must answer how often they experience these symptoms.
How Is Postpartum Depression in Fathers Treated?
Depending on the severity of the symptoms, treatment may include:
- Talk therapy, such as cognitive behavioral therapy (CBT)
- Couples therapy
- Attending support groups
- Antidepressants: they are usually recommended when depression is more severe or other treatments have not helped.
Tips for New Fathers
- Exercise regularly
- Eat well
- Do not drink or take drugs
- Sleep and rest when you can
- Do things you enjoy
- Meet with friends and family
- Discuss your feelings
- Do not try to be a super dad
- Ask for help if you find yourself struggling
Finally….
Having a baby is a beautiful experience but it is also very challenging. If you are expecting a baby or have a little baby and are finding it difficult, please reach out. We are here to help.
You may also find these articles useful:
Matrescence: Are We Finally Understanding Motherhood?
Parenting Advice: Advice for New Parents
Love,
Ana
References
(1) Depression, P., & Causes, A. T. (2015). Heterogeneity of postpartum depression: a latent class analysis. The Lancet Psychiatry, 2(1), 59-67.
(2) Ansari, N. S., Shah, J., Dennis, C. L., & Shah, P. S. (2021). Risk factors for postpartum depressive symptoms among fathers: A systematic review and meta‐analysis. Acta obstetricia et gynecologica Scandinavica, 100(7), 1186-1199. https://doi.org/10.1111/aogs.14109
(4) Rao, W. W., Yang, Y., Ma, T. J., Zhang, Q., Ungvari, G. S., Hall, B. J., & Xiang, Y. T. (2021). Worldwide prevalence of suicide attempt in pregnant and postpartum women: a meta-analysis of observational studies. Social psychiatry and psychiatric epidemiology, 56, 711-720. https://doi.org/10.1007/s00127-020-01975-w
(5) Saxbe DE, Schetter CD, Simon CD, Adam EK, Shalowitz MU. High paternal testosterone may protect against postpartum depressive symptoms in fathers, but confer risk to mothers and children. Horm Behav. 2017 Sep;95:103-112. doi: 10.1016/j.yhbeh.2017.07.014. Epub 2017 Aug 31. PMID: 28757312; PMCID: PMC11703689.
(6) Chhabra, J., McDermott, B., & Li, W. (2020). Risk factors for paternal perinatal depression and anxiety: A systematic review and meta-analysis. Psychology of Men & Masculinities, 21(4), 593-
(7) Giallo, R., D’Esposito, F., Cooklin, A. et al. Psychosocial risk factors associated with fathers’ mental health in the postnatal period: results from a population-based study. Soc Psychiatry Psychiatr Epidemiol 48, 563–573 (2013). https://doi.org/10.1007/s00127-012-0568-8
(8) Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987 Jun;150:782-6. PMID:3651732
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Typically, women receive all the attention and medical care while pregnant. But once the baby is born…. All the attention and medical care goes to the baby, leaving the new mother more or less ignored.
Indeed, a new report just published shows that only 23% of mothers said they felt very supported by their healthcare provided during the postpartum phase.
This is a big mistake! Women need attention during the postpartum period, also known as the fourth trimester. This 12-week period after birth brings great joy, but it’s also a very vulnerable time.
Why? Because new mothers experience so many changes: their body changes, their emotions may be overwhelming, their relationship with their partner changes, they are not “free” anymore, they may be sleep deprived, they may feel isolated…. Basically, a new mom’s whole universe shifts. New mums need support.
It’s no wonder that 1 in 5 new mums are affected by mental health issues. The most common ones are postpartum depression and anxiety. Other women experience more severe conditions such as perinatal psychosis, PTSD, and mood disorders.
Many women do not experience any mental health issues but need support getting used to their new reality. Having a child is a deeply transformative experience.
One common issue that new mothers experience are infant-harm related thoughts. What are these? They are thoughts of unintentionally or intentionally harming the baby. They may come in form of:
- thoughts (e.g., “My baby might die”)
- impulses (e.g., having the urge to shake or throw the baby”)
- images (e.g., a mental picture of the baby’s head hitting the wall)
These thoughts are incredibly common among new mothers. It is estimated that nearly all new mothers have them! Yet, we don’t discuss them even though they make us feel horribly uncomfortable, guilty, and ashamed.
Fathers can also have these thoughts. There is not a lot of research on this, but it is estimated that 2/3 of dads experience them.
It is very important to note that having these thoughts does not usually mean that these mothers or fathers represent a risk to the baby. The fact that they feel horrified when having these thoughts, is a strong sign that they are not going to hurt their baby.
However, the emotions that these thoughts provoke can be very powerful and disturbing and therefore getting support is advisable. For some people, it may be enough to discuss it with a close friend or relative. Others may need professional support.
One of our goals at REC Parenting is to support mothers’ mental health during the fourth trimester. This is why we have a masterclass (you can also listen as a podcast) with Dr Caroline Boyd talking about infant-harm related thoughts. Caroline is a renowned clinical psychologist, and the leading expert in this field. Her masterclass is incredibly informative, empathetic, and full of applicable tips.
If you are expecting a baby or recently had a baby, I really encourage you to watch or listen to this masterclass. If you know anyone in this situation, do let them know about it. I promise that you won’t regret it.
To get access to this masterclass, you need to subscribe to REC Parenting. Your subscription will gives you access to our:
- 1-2-1 support
- library of masterclasses
- blog and toolkits
- special events
The good news is that to celebrate our partnership with Family Education, we are offering a 20% discount on our Crawling, Walking, and Running Plans. The discount code is: FAMILY EDUCATION.
Come and join us! Parenting is the most important job you will ever do, why not do it from a place of research and support?
If you have any questions, do not hesitate to get in touch with me: ana@recparenting.com
I would love to hear from you. And remember to submit here any questions you may have about anything parenting. We will reply to them in next week’s Q&A email.
Love,
Ana
