26 Sep Post-Partum Depression Isn’t Just for Mom
When someone says post-partum depression, your mind immediately shifts to Mom, right? Well let’s not forget about Dad! Both men and women have biological responses to pregnancy and childbirth. Although post-partum depression occurs twice as often in women as in men, the hormonal and neural changes that occur throughout pregnancy and post-partum affect both genders.4 Most research conducted studying post-partum depression has been focused on women, but new research is emerging highlighting the changes fathers also go through. Like most biological responses, there are many factors at play.
First, let’s talk hormones. Both men and women experience hormonal changes and fluctuations throughout pregnancy and labor. For women, estrogen, progesterone, testosterone, prolactin, corticotrophin‐releasing hormone, and cortisol continuously increase throughout the 40 weeks of gestation.3 At parturition, some of these hormones drastically drop. Maternal post-partum depression can be attributed, in part, to hormonal deficiencies, specifically in progesterone, estrogen, but also cortisol.5
For men, fluctuations in testosterone and cortisol occur. Cortisol increases leading up to delivery, but decreases post-partum.6 Cortisol levels in fathers have also been found to be lower than in non-fathers.6 In addition, expectant fathers have shown greater situational cortisol reactivity, possibly to be able to care for the infant without compromising the ability to respond to an external stressor.7,8 Fathers also experience a decrease in testosterone after birth, showing about a 30% decrease from non-fathers.8 In addition, the more time fathers spend with their children, the lower their testosterone levels are.6,8-12 It is this decrease in testosterone that is thought to occur with long term bonds, such as paternal care.13
The decrease in testosterone is also what mainly attributes to depressive symptoms seen post-partum in dads. Interestingly, male testosterone levels affect not only their own depressive symptoms, but their partner’s as well. The lower the testosterone in dad, the higher relationship satisfaction was found with their partner, which means lower depressive symptoms in mom.2 In contrast, high testosterone levels in men correlate with more emotional, verbal, or physical aggression toward their partners, decreasing relationship satisfaction and increasing depressive symptoms in mom.2
Just as father post-partum depression affected partner satisfaction, it has also been shown that father post-partum depression increased when a female partner was suffering from depression. Depression of one sex is a risk factor for the development in the other.14,15 (Cough, I guess “happy wife, happy life” really is true…).
So why does testosterone decrease post-partum in men? There are different theories regarding this, and new research is still emerging, but it is thought that lower testosterone levels may help in parental care and pair bonding. In addition, father testosterone levels may sync with mother levels to provide a more cohesive and productive parenting environment, increasing relationship satisfaction and bolstering social support for the mother. Lower testosterone levels in the post-partum period may just be a normal father biological response to parenthood.2
In addition to hormonal changes, genetic vulnerability, neural circuitry, life experiences, personality, psychosocial factors, and stress also play a role in post-partum depression for mom and dad.3 For example, there are changes in neural circuitry in the perinatal period which alter mother and father behavior and helps prepare them for parental duties.3 Sex differences in brain responsiveness to infant stimuli have long been proven. Women respond with an “emotional brain,” while men respond with a “socio-cognitive brain” illustrating the emotional response from mom and the social response from dad. Neuroplasticity is prominent after the birth of a child, further illustrating the complexity and ever evolving story of post-partum life.16
It is safe to say that the story regarding male post-partum changes is far from over. As new research is conducted unveiling the differences between men and women, it is important to recognize that not only is mom going through a rollercoaster ride called pregnancy and childbirth, but so is dad. It is likely these changes aid in parenting and ensure infant survivability. It is important to remember to also make sure new parents are taking care of themselves adequately! This includes getting enough exercise and sleep, as well as making sure to talk about what is on your mind with your partner to help ensure a happy, healthy home!
REFERENCES: 1. Darby E. Saxbe, Christine Dunkel Schetter, Clarissa D. Simon, Emma K. Adam, Madeleine U. Shalowitz. High paternal testosterone may protect against postpartum depressive symptoms in fathers, but confer risk to mothers and children. Hormones and Behavior, 2017; 95: 103 DOI: 10.1016/j.yhbeh.2017.07.014. 2. University of Southern California. “Swings in dad’s testosterone affects the family — for better or worse — after baby arrives.” ScienceDaily. ScienceDaily, 5 September 2017. <www.sciencedaily.com/releases/2017/09/170905145535.htm>. 3. Poromaa IS, Comasco E, Georgakis MK, Skalkidou A. Sex differences in depression during pregnancy and the postpartum period. J Neurosci Res. 2017 Jan-Feb; 95(1-2): 719– 730.Published online 2016 Nov 7. doi:10.1002/jnr.23859. PMCID: PMC5129485. 4. Paulson JF, Bazemore SD. 2010. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta‐analysis. JAMA 303:1961–1969. 5. Skalkidou A, Hellgren C, Comasco E, Sylven S, Sundström Poromaa I. 2012. Biological aspects of postpartum depression. Womens Health 8:659–672. 6. Berg SJ, Wynne‐Edwards KE. 2001. Changes in testosterone, cortisol, and estradiol levels in men becoming fathers. Mayo Clind Proc 76:582–592. 7. Wynne‐Edwards KE. 2001. Hormonal changes in mammalian fathers. Horm Behav 40:139–145. 8. Storey AE, Walsh CJ, Quinton RL, Wynne‐Edwards KE. 2000. Hormonal correlates of paternal responsiveness in new and expectant fathers. Evol Hum Behav 21:79–95. 9. Muller MN, Marlowe FW, Bugumba R, Ellison PT. 2009. Testosterone and paternal care in East
African foragers and pastoralists. Proc Biol Sci 276:347–354. 10. Kuzawa CW, Gettler LT, Muller MN, McDade TW, Feranil AB. 2009. Fatherhood, pairbonding, and testosterone in The Philippines. Horm Behav 56:429–435. 11. Gettler LT, McDade TW, Feranil AB, Kuzawa CW. 2011b. Longitudinal evidence that fatherhood decreases testosterone in human males. Proc Natl Acad Sci U S A 108:16194–16199. 12. Edelstein RS, Wardecker BM, Chopik WJ, Moors AC, Shipman EL, Lin NJ. 2015. Prenatal hormones in first‐time expectant parents: longitudinal changes and within‐couple correlations. Am J Hum Biol 27:317–325. 13. Archer J. 2006. Testosterone and human aggression: an evaluation of the challenge hypothesis. Neurosci Biobehav Rev 30:319–345. 14. Escriba‐Aguir V, Artazcoz L. 2011. Gender differences in postpartum depression: a longitudinal cohort study. J Epidemiol Community Health 65:320–326. 15. Paulson JF, Bazemore SD. 2010. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta‐analysis. JAMA 303:1961–1969. 16. Abraham E, Hendler T, Shapira‐Lichter I, Kanat‐Maymon Y, Zagoory‐Sharon O, Feldman R. 2014. Father’s brain is sensitive to childcare experiences. Proc Natl Acad Sci U S A 111:9792–9797.