Paternal Perinatal Depression in Modern-Day Fatherhood.

Abstract

Postpartum depression in new mothers has become a widely recognized public health concern. Paternal perinatal depression (PPND) and the mental health of fathers in the perinatal period continues to receive significantly less public attention. Overall prevalence rates of up to 25% have been documented in first-time fathers. The presence of maternal depression, unsatisfactory couple relationships, and certain psychosocial and biological risk factors are associated with poor paternal bonding and increased depression risk. Depressed fathers experience excessive self-criticism, restlessness, irritability, and aggression rather than low mood. Depression in new fathers can lead to drug and alcohol abuse, food behavior disorders, and lack of impulse control. PPND leads to developmental delay, mental health disorders, and emotional or behavioral problems in the offspring. PPND may also adversely affect a child's ability to learn new information, with lasting intellectual and scholastic consequences. There currently are no official criteria to diagnose PPND, and neither are there validated screening tools available to fathers. A family-focused approach should be considered in place of the historically gender-focused mood assessment. Nontraditional interventions such as Internet communities, e-therapy, or group workshops are shown to combat a father's contextual understanding of therapy. Group therapy with integrated cognitive behavioral therapy can address masculine norms surrounding the parenting roles of fathers and can help cultivate support networks that are otherwise absent among new dads. PPND is ideally addressed by the adoption of a father-inclusive model of care that shifts the parenting paradigm and provides emotional and parenting support to men as they experience their new role as dad.