What is paternal postnatal depression?

Many parents face more stress after the birth of a child. There are many challenges of introducing a new baby into your life. These challenges can include strong emotions and a lack of sleep.

Doctors tell new mothers to stay on the lookout for signs of depression after they give birth. But new fathers are also susceptible to postnatal depression. Experts estimate that paternal postnatal depression (PPND) affects 4 to 25 percent of new fathers in the first 2 months after their child’s birth. It’s more common in men who have partners with maternal postnatal depression.

PPND appears to come on more slowly than maternal postnatal depression. However, it’s possible for new fathers to have feelings of depression at any time following their child’s birth.

Experts say symptoms of PPND are similar to — but not exactly the same as — symptoms of material postnatal depression. Maternal postnatal depression is defined as a major depressive episode beginning within four weeks of a baby’s delivery. However, there is not yet diagnostic criteria established for PPND.

If you have PPND, you may feel:

  • hopeless and sad
  • tired or lethargic most of the time
  • inadequate or unable to cope
  • guilty about not being able to cope with your child’s birth or not loving your baby enough
  • unusually irritable, which can increase guilt
  • extremely hungry or not hungry at all
  • an overwhelming sense of anxiety or dread, even about small things like being alone in the house with your baby

You may also have:

  • the urge to cry or crying a lot of the time
  • obsessive or irrational thoughts that can be disturbing
  • trouble falling or staying asleep
  • intense nightmares
  • panic attacks
  • trouble making decisions
  • obsessive thoughts about your baby’s health, yourself, or other family members
  • thoughts about harming yourself or your baby
  • thoughts about death

Other symptoms include:

  • losing interest in normal activities
  • eating when you’re stressed rather than hungry
  • acting hostile or indifferent to your baby or partner
  • developing new physical issues, such as headaches or stomachaches

Other symptoms of PPND also exist. It’s important to seek help if you don’t feel like yourself.

Learn more about postpartum depression »

Experts believe a mix of biological and environmental factors cause PPND.

Biological factors

A woman experiences significant hormonal changes during her pregnancy and postnatal period. These may cause hormonal changes in the father, including drops in the levels of:

  • testosterone
  • estrogen
  • cortisol
  • vasopressin

It also increases prolactin levels. These changes may be responsible for mood changes that make men susceptible to PPND.

Environmental factors

Depression can be triggered by emotional and stressful events, including the birth of a baby. The pressures of being a father, such as increased financial responsibility and changes in lifestyle and relationships, together with a lack of sleep, concern for their partner, and more responsibilities at home can spark PPND in a new father.

New fathers are more likely to experience PPND if:

  • they have a strained relationship with their partner through the pregnancy
  • their partner has postnatal depression
  • they are a young father
  • they have a low income

A new father’s personality, social status, genetics, and mental health history can also affect his chances of having PPND.

See your doctor if you think you have PPND. Your doctor will perform a physical exam to ensure there are no underlying medical problems causing your depression.

If they believe you have PPND or another mental health disorder, they will refer you to a mental healthcare provider. A psychotherapist or psychiatrist can help diagnose your condition.

There are no official diagnostic criteria for PPND. Many mental healthcare providers will attempt to diagnose PPND with the same tools used to diagnose maternal postnatal depression.

Edinburg Postnatal Depression Scale

This tool is made up of 10 self-report items. Of them, 8 address depressive symptoms and 2 ask about anxiety. Responses are scored on a scale of 0 to 3, depending on the severity of symptoms. Doctors often use this test to screen for postnatal depression in new mothers, but research is needed to determine whether or not this test would be useful in identifying PPND.

Other questionnaires

Mental healthcare providers may use other self-report questionnaires about depressive symptoms to diagnose PPND, such as:

However, experts caution that, to arrive at a more accurate diagnosis, questionnaires administered to fathers should be scored differently from questionnaires administered to mothers. That’s because men tend to underreport their depression symptoms.

PPND, like any form of depression, can cause complications. These include:

  • weight loss
  • weight gain, which could lead to obesity, heart disease, diabetes, and other weight-related health problems
  • physical pain and illness
  • alcohol or substance abuse
  • anxiety, panic attacks, and social phobia
  • family problems, relationship trouble, and problems at work or school
  • isolation from friends, family, and social situations
  • self-mutilation, such as cutting or eating disorders
  • early death resulting from related medical conditions

Further, PPND is a significant risk factor for child mistreatment.

Common medical treatments for PPND include:


Your doctor may prescribe drugs such as:

  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • norepinephrine-dopamine reuptake inhibitors (NDRIs)
  • atypical antidepressants
  • tricyclic antidepressants
  • monoamine oxidase inhibitors (MAOIs)

In some cases, medications such as mood stabilizers, antipsychotics, and anti-anxiety drugs may be needed, depending on your symptoms.


Talk therapy, such as cognitive behavioral therapy or interpersonal therapy, can be done alone or with your partner.

Hospitalization or residential treatment

Inpatient treatment is used for severe cases of PPND and other forms of depression in which you pose immediate danger to yourself, your partner, your child, or someone else.

Special procedures

Some PPND may be treated with electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).

Home treatments

You can take steps at home to help you cope with depression. Try these:

  • Get regular exercise, which can alleviate stress and keep you physically healthy.
  • Adhere to your treatment plan.
  • Learn about your condition.
  • Learn what your triggers are.
  • Stay away from alcohol and recreational drugs.
  • Make sleep a priority.
  • Keep a healthy line of communication between you and your partner.
  • Join a PPND support group where you can share your experience and get advice from other fathers.

A PPND diagnosis can seem like a huge parenting challenge, and asking for help can be hard. But it’s important to keep moving forward to help you feel better. You should never be ashamed or embarrassed to discuss your mental health with your partner or a trained professional.

Remember, you’re not alone, and you can get help if you need it. With medical treatment and a good support system, you can manage and even get rid of your PPND. You can go on to raise a happy, healthy baby and have a good relationship with your new family.