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The Australian Institute of Health and Welfare reports higher rates of depression for females than males but, like for any health condition, how depression is defined and the accuracy of diagnoses affects our understanding of its prevalence.

Depression reveals itself in different ways for men and women. Females feel more stressed, indecisive, complaintive and uneasy than males when they’re depressed, and are more likely to have sleep problems and a depressed mood. In males, depression manifests more often as anger or aggression and hyperactivity. Males with depression are more than twice as likely as females to turn to alcohol or drug abuse, and to take risks1.

When the gender differences in how depression is experienced are considered, there’s no difference in its prevalence between males and females1. Knowing the different symptoms of depression in men, and the life events that put them at greater risk, not only helps with diagnosis and treatment but also has far-reaching benefits.

 

Dads get postnatal depression too

Available data suggest that more than 8% of males experience depression around the time of birth of their children2. However, detection of depression in new or expectant fathers is likely poor because the focus of healthcare and screening programs is often on the mother and child. Low screening rates in fathers mean that the known rate of paternal perinatal depression is probably an underestimate3.

An underappreciation that perinatal depression can affect fathers (a minority of Australian males and females are aware that perinatal depression can affect males4) probably also contributes to low rates of screening and diagnosis in fathers.

In turn, perinatal depression in fathers is associated with parenting stress, disengagement with their children, child neglect, and impaired language, reading, behavioural and social development, and poor mental health in their children5.

 

Depressed dads can get angry

Perinatal depression in males may present as anger6, just like it does at other life stages.

A recent study of around 600 Australian men aged 28-32 years categorised men according to the severity of their symptoms of depression and anger and assessed various aspects of fatherhood. Men with severe depression and physical anger reported reduced bonding with their children, whereas those with any symptoms of depression and anger had poorer co-parenting relationships and felt like they had less social support than men without any symptoms6.

The men with the most severe symptoms of depression and physical anger were categorised in this group because of their self-reported agreement to statements consistent with feeling like inflicting violence against inanimate objects and people. These anger traits may place family members and others at risk of physical violence.

The very same measure of men’s anger is associated with acts of domestic violence, outside of the perinatal context7.

Help for depressed dads might make life better for everyone

There are multiple validated ways to assess the mental health of fathers before and after the birth of their children. The perinatal period seems an opportune time to identify and treat depression in men, not just for their own benefit, but for the benefit of their families and the rest of society.

 

[1] Martin et al., 2013. The Experience of Symptoms of Depression in Men vs Women. JAMA Psychiatry

[2] Cameron et al., 2016. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal of Affective Disorders 206, 189–203.. doi:10.1016/j.jad.2016.07.044

[3] Pedersen et al., 2021. “I Wanted to Be There as a Father, but I Couldn’t”: A Qualitative Study of Fathers’ Experiences of Postpartum Depression and Their Help-Seeking Behavior. American Journal of Men's Health 15, 155798832110243.. doi:10.1177/15579883211024375

[4] Smith et al., 2019. Perinatal anxiety and depression: Awareness and attitudes in Australia. International Journal of Social Psychiatry

[5] Garfield et al., 2014. A Longitudinal Study of Paternal Mental Health During Transition to Fatherhood as Young Adults. Pediatrics

[6] Macdonald, et al., Profiles of depressive symptoms and anger in men: associations with postpartum family function. Frontiers in Psychiatry Mood Disorders

[7] Barbour et al., 1998. The experience and expression of anger in maritally violent and maritally discordant-nonviolent men. Behavior Therapy

Keywords:
For health professionals
Fatherhood
Mental health

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