paternal postpartum depression (PPD)

Paternal postpartum depression (paternal perinatal depression) is a mental health condition that affects about 10% of fathers worldwide (1):

• paternal perinatal depression is defined as depressive symptoms that develop in fathers during their partner’s pregnancy and/or during the first year of their infant’s life
• involves depressive symptoms that develop within 1 year after the birth of an infant

Evidence from a systematic review and meta-analysis indicates that paternal mental distress is a potentially modifiable predictor of child development (2):

• reducing mental distress in fathers perinatally is thus an important target for preventative interventions aiming to support fathers during the transition to parenthood and promote the health and well-being of next-generation offspring

Risk factors for the development of paternal postpartum depression/paternal perinatal depression

• history of depression
• sleep deprivation
• financial problems
• difficulty adjusting to the new role of fatherhood
• relationship stress

Features of paternal postpartum depression/paternal perinatal depression

• possible features are similar to those if postpartum depression in a woman and include:
  • persistent feelings of sadness or anxiety
  • loss of interest in previously enjoyed activities
  • poor sleep, fatigue
  • changes in appetite,
  • difficulty concentrating
  • other possible features are more common among fathers than mothers are include:
    • irritability
    • anger
    • seeking distraction through increased work or screen time,
    • drug and alcohol use

Diagnosis and management

• screening surveys administered by clinicians can identify fathers who are at risk of or experiencing paternal perinatal depression (1)
  • reliable screening tools include
    • Edinburgh Postpartum Depression Scale (EPDS), a 10-item self-report measure;
    • Patient Health Questionnaire (PHQ-9), a 9-item self-report measure;
    • Gotland Male Depression Scale (GMDS)
  • because paternal perinatal depression may develop after an infant is born, screening is often performed 3 to 6 months into the postnatal period

Management options:

• social support from family and friends is helpful and may be sufficient for some fathers with paternal perinatal depression
• in-person or online paternal support groups may be of benefit
• in circumstances where a father with paternal perinatal depressive has symptoms that negatively affect their quality of life and/or interactions with their partner or infant should seek help from a mental health clinician who ideally is familiar with the stresses experienced by new fathers
  • therapy (such as cognitive behavior therapy) and antidepressants (such as serotonin reuptake inhibitors) may be recommended.

Notes:

• paternal perinatal depression can have negative effects on the entire family, including decreased bonding and attachment of fathers with their children, increased maternal postpartum depression, and relationship stress
• paternal perinatal depression has also been associated with increased risk of emotional and behavioral problems in children during infancy and childhood (1)

Reference:

1. Garfield C. What Is Paternal Perinatal Depression? JAMA. Published online September 04, 2025.
2. Le Bas G et al. Paternal Perinatal Depression, Anxiety, and Stress and Child Development: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2025 Aug 1;179(8):903-917.