Before I gave birth to my daughter, I prepared for the potential of postpartum depression (PPD) like it was my full-time job. As someone who’d struggled with anxiety and depression since childhood, I assumed that a postpartum mental health condition, like postpartum anxiety or PPD, would be inevitable.

I immediately set about seeing a maternal mental health specialist during my pregnancy. She advised me to get as much rest as possible after the birth and to consider medication and therapy if my mental health took a turn for the worse. Little did I know, however, that it wouldn’t be me who would experience PPD — instead, it was my husband.

The circumstances of our daughter’s arrival in the world were exceptionally stressful. Having found out just a month beforehand that my husband had landed a new position, we knew we would have to move thousands of miles cross-country, from California to Ohio, just 10 days after our daughter’s birth. He’d just finished a graduate degree and was launching a newfound academic career, and I was navigating graduate school and work myself during a difficult pregnancy. Then, postpartum preeclampsia and other major health complications left me in the hospital for almost a week after I gave birth — all of which conspired to mean that my husband and I had to move to a new state, apartment unseen, separately from each other.

After the move, I noticed that my husband was often listless and more quiet than usual. He seemed distant and constantly fatigued, but we both chalked it up to newborn-induced sleep deprivation. Although he was an active parent, often staying up with our daughter at night, I knew something was up.

I finally broached the question of his mental health in a quiet moment after a few weeks. He admitted to me that, although he’d worked hard to keep it together for me and for our baby, he was depressed — and stressed out about…just about everything. Finances. My health. Navigating first-time parenthood. His new job. “I think I might have some kind of postpartum depression,” he told me. “But isn’t it just moms who get it?”

We were both a bit bewildered — until we learned that my husband wasn’t alone. In fact, according to a study published in the journal Psychiatryone in 10 partners of someone who has just given birth will develop postpartum depression, although some estimates range from 4% all the way to 25%. This condition is known as “paternal postpartum depression,” “paternal postnatal depression” (PPND), or, sometimes, “partner postpartum depression,” if the other partner does not identify as a father.

Paternal postpartum depression is much less well-known than maternal PPD. Like PPD, paternal PPD is hard to notice in many cases, as sleep deprivation and the financial and emotional stress of bringing a new life into the world can cause anyone’s behavior and mood to shift. But Christianne Kernes, a licensed marriage and family therapist and co-founder of the tele-health app LARKR, tells SheKnows that PPND is even more likely to go unnoticed and untreated. Because we assume that PPD is a mother’s issue, she says, “most men aren’t familiar with the signs and symptoms of PPD.” She adds that, because men are often socially conditioned to “hate talking about their feelings” or to downplay their mental health, they don’t always seek out the professional help they need.

Symptoms of paternal PPD, Kernes explains, are similar to those associated with maternal PPD — ranging from irritability and chronic fatigue to weight gain or loss and persistent feelings of sadness and despair. New parents should also watch for warning signs such as difficulty sleeping and concentrating, social isolation, problems connecting with one’s baby, and in rare cases, even suicidal thoughts.

Many of the causes of PPND, too, are similar to those associated with maternal PPD. Just as new mothers’ bodies are flooded with hormones during the process and aftermath of childbirth, men also experience hormonal shifts when they become parents. Kernes explains that “male hormonal changes may be responsible” for paternal postpartum depression, “as the production of estrogen, prolactin and cortisol increase around the time of their child’s birth.”

So, which fathers are most at risk of developing PPD after their partner gives birth? Although paternal PPD can happen to anyone, risk factors include having a partner who also has PPD, says Kernes, as well as environmental and interpersonal causes such as poverty, relationship stress and conflict, and a faltering support system. Situational circumstances — like our sudden move and the stress of a new job — can also play a role.

Atypical parenting scenarios, including single fatherhood or being a stepfather, can increase the risk of developing paternal postpartum depression as well. In our case, my husband is physically disabled and was worried about navigating parenthood without many models for how he would do so as a wheelchair user.

Recent research published in Psychiatry and The American Journal of Men’s Healthsuggests that paternal PPD deserves more in-depth study, so that new monitoring tools can be developed to assess new fathers for the condition. “Fortunately, simple talk therapy can truly work wonders when utilized with consistency,” says Kernes. “A licensed therapist can help you work through your negative thoughts and find productive ways to manage your symptoms, so that you can be the best possible parent to your newborn child.”

With therapy, prescribed medication, and a renewed dedication on both our parts to more sleep and rest, my husband’s PPD went into remission, and his symptoms eventually ceased altogether. For my part, I realized that I’d been too stressed out both physically and emotionally to consider my partner’s needs. Although this was understandable given my own stress, it was a wake-up call to improve our communication and express more empathy and understanding during a difficult time for both of us. My husband had been working so hard to be our family’s foundation that I nearly forgot that he needed emotional support, too. We also found some resources for disabled parents and stories about other people who had experienced paternal PPD, which helped him feel less alone in his new journey.

This article was originally published on SheKnows.

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