124. When He Changes After the Baby: Understanding Paternal Postpartum Depression

Hey Doc,

Father's Day has me thinking about something we don't talk about nearly enough.

Men can experience postpartum depression too.

In this episode, I'm diving into paternal postpartum depression, why it often goes unrecognized, and how it can show up in ways that look very different from what we typically expect. Because when a husband suddenly becomes withdrawn, irritable, distant, or seems completely disconnected after a baby arrives, the internet is usually quick to label him as lazy, selfish, or worse.

Sometimes that's true.

Sometimes it's not.

As an OB/GYN and perinatal mental health specialist, I was surprised when I first learned that about 10% of new fathers experience postpartum depression, and that number jumps dramatically when their partner is struggling too.

This conversation isn't about excusing harmful behavior.

It's about understanding the difference between a struggling partner and a bad one.

It's about making room for nuance.

And it's about protecting something I care deeply about: your marriage.

In This Episode:

• What paternal postpartum depression actually looks like
• Why men's symptoms often show up differently than women's
• The hormonal changes fathers experience during pregnancy and postpartum
• How social conditioning affects men's mental health
• The danger of labeling every struggling husband as "trash"
• Why understanding creates opportunities for healing
• My philosophy: Self first. Marriage second. Kids third.

This is a conversation about compassion, awareness, and giving families the tools to thrive together.

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Transcript

 Hey, doc. Father's Day was on Sunday, and as usual, in my very pro-man, pro-husband way, I'm going to talk about dads and the fact that they can have postpartum depression too. They can have mental health challenges too, and how it looks differently than when we experience it. not in an attempt to excuse bad behavior, but in an attempt to help with understanding and grace, and hopefully to improve the relationship between you and your husband if this is something that he may have experienced, to educate you and him, because maybe it will be a revelation to him as well.

And just to shed a little bit of light  on what this is all about, and battle the sometimes very loud voices of, "All, all men are trash." Because, you know, those voices are very loud out there. So International Father's Mental Health Day is actually the day after Father's Day, and it is dedicated to breaking the stigma around men's mental health wellness, particularly highlighting postpartum depression. this was something that I learned about when I was doing my perinatal mental health certification, and I was very surprised

Because I didn't know this was a thing. You know, I'm an OBGYN. I don't mess around with men in that way, in a medical standpoint. and I have never wanted to be a doctor f- for men. So any medical problems outside of the ones that that my father may have had or anything like that, I, I had no knowledge of it.

But I don't remember this in medical school either. You know? I learned so many things during that certification that were quite shocking, and this was one of them. So just a few stats. about 10% of new dads experience paternal postpartum depression, and that number jumps to 50% if their partner is also struggling.

And I think the thing that is the most important to recognize, and this is the part that battles the all men are trash narrative, is that postpartum depression, any of these postpartum mental health challenges look differently in men, just like they look differently in Black women. So it is another form of intersectionality that has to be taken into consideration, and, you know, usually when we talk about intersectionality, men are not, not usually not the focus because our world is set up for them to succeed, for their needs, et cetera, except in this one way.

And they are as much victims of society as we are, even though it benefits them, because in this instance, the conditioning we have as Western society is that men are supposed to be a certain way. You're supposed to be strong. You're supposed to be the provider. You're not supposed to be scared about expanding your family.

You're not supposed to be scared that your wife is going through this body-altering phenomenon. You're not supposed to faint when you see the child coming out, even though I see it happen. I've had people go to the ER for head trauma after they've passed out during a delivery. All of those things are not, quote unquote, "societally acceptable."

So the way that they manifest their symptoms are also a result of that, because what can look like stonewalling, being distant, not contributing, locking himself up in his den and playing video games, those could be signs of postpartum depression. But if you go in some of our Facebook groups, and you say, "This is what's happening.

I have a newborn. My husband doesn't come around. He doesn't help. He's just locked up doing XYZ," you would get 50-something comments about, " He's trash. Leave him. Get a shark lawyer. Men are this, and men are that." And There may be one or two other lady docs that get in there and is like, "Well, is he depressed?"

You know, "Is he scared?" And even when people say things like that, their often response is, "Well, nothing, nothing changed for him. What does he have to be scared about?" Interestingly, that is not true, because they also have hormonal changes when you, the wife, are pregnant. When their child is being born, they have hormonal changes as well that contribute to this.

So besides the fact that if this man really loves you, yes, he's gonna have issues, like his entire life just changed. You may have almost died. Like this is... I'm not being dramatic, I'm an OBGYN. This, this stuff happens. He saw you in this very vulnerable state where he could not do anything about it. He saw you be wheeled out of the room in a flash because the baby's hearts were down and you had to have a stat.

He misses his best friend and some, for some of these men, his only friend, and he doesn't know what's gonna happen to his marriage. Like, all of these things are very legitimate reasons to have a little bit of a crisis, to have a little bit of anxiety. And for the same reasons, it needs to be more common for us to talk about.

It needs to be more common to talk about with our husbands and to each other that this is a possibility. And like with every time that I talk about men, husbands in this way, I give the caveat, I am not saying there are not some trashy men out there, that they are not really the ones who expect you to do everything, be barefoot and pregnant, but also be the breadwinner because you're a super specialized surgeon.

They exist out there. I'm not talking about them. I'm talking about the people who seem to have changed all of a sudden, who you would never have thought this is how they were gonna be. Y'all talked about different things, and then you just see him slowly changing, slowly withdrawing, or he may be lashing out, getting more aggressive, because that's another way mental health challenges show up in men is aggression.

Can you blame them? They are socialized that aggression is good. Crying is bad. Having feelings is being a girl. So yeah, it's gonna be lashing out. It's gonna be snapping and whatever else. Again, if there's actual physical violence, even emotional, that's a no fucking go. That's not what we're talking about right now, But these are all things that we need to consider Is this a mental health challenge? Postpartum, definitely, but outside of that, right? Because they deserve the same type of awareness and support as we do, as the glow up that the fourth trimester has gotten over the last couple years, now that perimenopause is getting.

Everybody deserves that glow up because we are living in a society that was created by a very small, particular type of generation, and we are too diverse, too evolved, too poor compared to how they were able to live, to hold on to how they used to live, what they used to believe, how they used to act.

Like, we need to, we need to drop all that shit and think about how we are going to move forward and be happier. that's why I wanted to highlight this. I'm pretty sure I've talked about this on this podcast already. Just as a reminder that men have mental health challenges, too, particularly postpartum.

And this Father's Day, as you celebrate with your husband, your partner, just know that the day after is a day to educate, to honor, to reduce the stigma around the fact that he may be having some anxiety, some depression surrounding how his family has changed as well, and maybe you can start a conversation.

Maybe you can start some reconciliation. chip away at the resentment that may be there. that's the goal, to help you strengthen your marriage, have more understanding, and be overall closer and happier because you have to take care of yourself first, then your marriage, then those kids.

They'll be fine, and they'll be worse off if the first two are not taken care of, I promise you. They cannot come first, and yes, I'm using a very cut-and-dry statement. Those kids cannot come first. I will stand eleven toes down, if I had eleven toes, on that that is truly what I believe. It is what I see for my own children. When my husband and I are not great, they get the short end of the stick. when I am not at my best, they get the short end of me. They get a short mommy who is snapping and doesn't wanna do anything. If I'm exhausted, I just sit on the couch.

My son actually said to me yesterday, or he was talking to my daughter. She asked me to do something, and he was like, "Yeah, she's not getting up off the couch to do that." I was like, "Damn, I am tired," and he knows it. So of course, we are in building stage, starting a new business, so, you know, this is, this is a special time.

But they notice. They get the raw end of it. So taking the time to care for yourself in a real way, to care for your marriage, does help them. They notice, and I don't think there's anything wrong with having that order. So I wish your husband a very happy Father's Day. 

I hope that it was a joyful day in your home and that y'all are not having any challenges, and if you are, that you are able to work through it.

Okay, Doc, I will see you on the next episode of Stethoscopes and Strollers.