Depression in new fathers

The baby is four months old, and the flat in Khilgaon has not been quiet since. Relatives come every weekend. “Mashallah, he looks just like his Dada.” “How much does he weigh now?” “Is he sleeping at night?” Tareq, 34, an engineer, answers each question, makes the tea, and does the 3am bottle so Mithila can sleep.

On weekdays he finds reasons to stay late at the office, then sits in the car downstairs scrolling his phone for half an hour before going up. At the tea stall on the corner, his friend Babu studies him. “Bhai, you look like you’ve been on night duty at the power station for a month.” Tareq laughs, then doesn’t. “Everyone asks about the baby. No one asks me.”

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding depression in new fathers

Fathers can become depressed during pregnancy or in the first year after a birth. It may look like low mood, but often shows as irritability, withdrawal, working longer hours, numbness, feeling useless or trapped, drinking more, or losing interest in the baby and the marriage. Broken sleep, money worries, changes in the couple’s relationship and the expectation to be the steady one all add weight. Because the attention is rightly on mother and baby, a father’s depression is easy to miss, including by the father.

How common is depression in new fathers?

In a meta-analysis of 43 studies with 28,004 participants, about 10.4% of fathers were depressed between the first trimester of pregnancy and the end of the baby’s first year. Rates were higher three to six months after the birth, at 25.6%. Fathers’ depression was moderately linked with mothers’ depression, so when one parent is struggling, it is worth checking on the other.

Signs and symptoms of depression in new fathers

• Avoiding home, or staying late at work without need
• Irritability, anger or snapping at the baby’s mother
• Feeling numb, distant or unable to enjoy the baby
• Drinking, smoking or scrolling to get through the evening
• Sleep that stays poor even when the baby sleeps

Treatment for depression in new fathers

A psychiatrist assesses mood, sleep, alcohol, stress at work and any thoughts of self-harm, and asks how the baby’s mother is doing too. Depression in fathers is treated as depression: talking therapies such as cognitive behavioural therapy, medication where appropriate, or both; a network meta-analysis of 101 trials in adults with depression found the combination worked better than either alone. Sessions with both parents can help them share the load and talk honestly about the change a baby brings.

What getting better can look like

Tareq’s first change might be going straight upstairs after work, one night a week when Mithila’s mother takes the 3am feed, and a weekend when someone finally asks, “And how are you, baba?”, and he answers truthfully.

Common questions about depression in new fathers

Can fathers get postnatal depression?

Yes. A meta-analysis found that about 1 in 10 fathers is depressed in the period from pregnancy to the baby’s first birthday, with higher rates three to six months after birth. It often shows as irritability, withdrawal or overwork rather than sadness.

Is a father’s depression linked to the mother’s?

Research shows a moderate link: when one parent is depressed, the other is more likely to be as well. That is why doctors ask about both parents, and why care for one can help the whole family.

When to see a psychiatrist

If you have felt low, irritable or detached for more than two weeks since your baby arrived, it is worth talking to a doctor. If you have thoughts of harming yourself or anyone else, call 999.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• Paulson and Bazemore, JAMA, 2010 (PMID 20483973)
• Cuijpers et al., World Psychiatry, 2020 (PMID 31922679)