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 A perspectives piece in the journal Pediatrics points out that
recent guidelines from the American Academy of Pediatrics (AAP) and
the U.S. Preventive Services Task Force (USPSTF) recommend that
pediatricians use well-child visits to screen mothers for postpartum
depression, yet they hardly mention fathers.
The guidance from these two respected organizations risks "being out
of touch with contemporary American families," the authors write, in
light of all the evidence emerging in recent decades showing the
importance of fathers' mental health to the wellbeing of their
children.
"Depression among new dads is a problem that too often gets
overlooked," lead author Tova Walsh, an assistant professor of
social work at the University of Wisconsin-Madison, told Reuters
Health.
"Although many new dads experience depressive symptoms, few know how
to identify the signs or talk about their struggles."
Depression symptoms in fathers in the first year after the birth of
a child are considered paternal postpartum depression, Walsh and
colleagues write. Past studies have estimated that anywhere from 2%
to 25% of fathers are affected.
But no clear diagnostic criteria specific to fathers exist, they
note.
"Depression often looks different in fathers than in mothers," Walsh
said. "In addition to the familiar symptoms of depression such as
persistent sadness, loss of interest in previously enjoyable
activities and trouble eating and sleeping, men may mask their
symptoms by throwing themselves into work or by drinking more."
Fathers with postpartum depression are also less likely than mothers
to ask for help, and a lack of awareness about paternal depression
could be making it more difficult for them to tackle the problem.
"It is time for the focus on perinatal depression within pediatrics
to include fathers too," Walsh said.
The USPSTF recommendations issued in early 2019 focus on
interventions to prevent maternal depression, Walsh's team notes.
The AAP guidance, also issued this year, acknowledged paternal
postpartum depression as a problem but called for pediatricians to
screen only mothers during visits in the first, second, fourth and
sixth months, and to "consider screening the partner as well" at the
six-month visit.
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Walsh and colleagues recommend that pediatricians help educate new
parents about paternal postpartum depression. They also call for
development of better screening tools and say pediatricians should
follow-through with referrals to make sure fathers receive
treatment.
The authors point to an evidence-based maternal mental health safety
"bundle" of best-practice recommendations from the Council on
Patient Safety in Women's Health Care as a model for developing ways
to identify and respond to paternal health issues.
Thomas A. Field, an assistant professor of psychiatry at the Boston
University School of Medicine who wasn't involved in the perspective
piece, agreed on the need for greater awareness. "You don't see a
lot of public marketing or information about male anxiety and
depression postpartum," he told Reuters Health in a phone interview.
"Postpartum depression in women used to be highly stigmatized. It's
less so now, as the awareness has improved. There needs to be more
education to make it normal for fathers to speak about depression,"
Field said.
The perception is that men don't have a very full emotional life, he
added.
"What's more accurate is they are actually quite anxious about
raising their child right. They don't always express it in ways
others perceive as anxiety, instead they come across as being
controlling."
Walsh and colleagues say they don't want to diminish the need to
identify and respond to maternal depression, but depression in any
parent is a risk to the child's wellbeing.
"We hope the article helps raise awareness that fathers, too,
struggle with depression. Family, friends, pediatric providers and
the fathers themselves have a critical role in recognizing the
symptoms and getting support," Walsh said.
SOURCE: https://bit.ly/2Zxrrpq Pediatrics, online December 26, 2019.
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