Supporting New Fathers: An Overview of Paternal Mental Health Statistics, Insights, and Resources

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Key Facts

• 1 in 10 fathers will experience depression or anxiety during pregnancy or the first year following pregnancy. [1, 2, 3]

• Depression and anxiety are twice as common in expecting and new fathers as compared with global estimates in men. [1, 4]

• The peak onset of depression in fathers is 3-6 months following the birth of a baby. [1, 5, 6]

• Men experiencing anxiety or depression are more likely than women to…

  • Cite physical symptoms such as changes in appetite or sleep, fatigue, headaches, psychomotor changes (e.g. restlessness, increased heartbeat, muscle tension, pacing). [12, 13]

  • Show irritability, anger, aggression, and frustration, which can lead to isolating, withdrawing, risk-taking, avoidance, and substance use. [14, 15]

• The Edinburgh Postnatal Depression Scale (EPDS) has been validated for detecting depression in fathers, but with lower scores than for mothers. [7, 8, 9]

• Untreated paternal depression can have long-term negative impact on the child’s development and health across multiple domains, and increases the risk of Adverse Childhood Experiences. [2, 10, 11]

• There is limited data about the prevalence rate of paternal depression based on race and ethnicity; additional research in this area is needed.

Maternal depression is the most important risk factor for paternal depression. [1, 2, ]

Untreated Paternal Depression

Can Increase…

• Hostility and conflict in the home, particularly with spouse / partner. [16, 17]

• Feelings of resentment toward the baby. [14]

• Negative parenting and harsh discipline, such as spanking or corporal punishment. [7, 16]

• Children’s behavioral, emotional, and conduct problems. [18, 19]

Can Decrease…

• Positive engagement with the infant – less sensitivity, warmth, playfulness, or touching – which can delay attachment with the baby. [20, 21]

• Positive interactions with older children – such as reading, singing, playing, or storytelling – which can negatively impact the child’s social and emotional wellbeing. [6, 7]

• Adherence to general safety guidelines for safe infant sleep and car seat usage. [21]

Stress

Fathers experiencing anxiety or depression often cite stress as a major contributing factor, including having a new baby in the home, adjusting to changes in sleep and household routines, adapting to new and demanding tasks and roles, struggling with financial and economic concerns, and balancing work-life concerns. Stress can increase the level of cortisol in the body, which can contribute to or exacerbate symptoms of irritability and/or depression. [2, 7, 19]

Causes and Risk Factors

• Personal or family history of depression or other mental illness [6]

• Lack of social supports and networks [2]

• Changes in hormone levels [6, 13]

• Issues or concerns about the baby:

  • Unwanted / unintended pregnancy [2]

  • Low birth weight, premature birth, infant in NICU [6]

  • Difficulties in bonding with the baby [14]

  • Feeling excluded from mother-infant bonding [22]

• Issues or concerns about the partner / spouse:

  • Maternal depression [1, 11]

  • Complications during pregnancy and/or delivery, including traumatic birth or unexpected C-section [11]

  • Relationship conflict, such as dissatisfaction, disharmony, criticism, and communication difficulties [7, 11]

Fathers experiencing anxiety or depression often say that they felt invisible or unnecessary during pregnancy, birth, and the immediate postpartum period, and that this experience contributed to them backing off even more from their partner and the baby. [11, 22]

Fathers experiencing anxiety and depression say…

[8, 11, 12, 14]

• “I did not know anything about fathers getting postpartum depression. By the time I realized I had depression, our family had nearly broken apart.”

• “Men are expected to be big and strong and stoic, to take care of everything, to be a tough guy. It was hard to acknowledge that I needed help.”

• “I don’t feel I can tell my wife about these feelings. It will make me look weak or it will sound ridiculous because she is with the kids more than me.”

• “I am constantly on the verge of bursting into tears. Work is extremely stressful now and I’m very irritable.”

• “I hate my baby’s crying, his needs, his endless discontent.”

• “Nobody tells you how hard it really is.”

• “I was so ready to be a dad, but all I can think about is how miserable I am.”

Fathers experiencing anxiety or depression use these words to describe how they are feeling.

[11, 14, 15, 22]

Treatment Can Include a Combination of…

• Adequate sleep, exercise, nutrition [19]

• Practical and emotional support [6]

• Perinatal psychoeducation [19, 6]

• Therapy or counselling [6, 7]

• Medication [7]

Cultural Considerations in Clinical Settings

• BIPOC fathers may experience unique, race-based stressors during the perinatal period that increase the risk of depression and anxiety, which should be accounted for in the clinical case conceptualization.

• In addition, disparities in health, healthcare access, income, and local resources can place additional stress on BIPOC fathers. [23]

• BIPOC men also tend to be stigmatized in various parts of their life, including fatherhood. For example, Black fathers are stereotyped as uninvolved parents despite being the most involved fathers across racial categories. [24]

• Clinicians need to be conscious of their own biases and incorporate a holistic understanding of the father’s experience into the treatment plan to optimize clinical care.

Resources, Trainings, and Programs

Postpartum Support International has a webpage dedicated to support for fathers, which includes:

• Specialized Coordinator for Dads

• Dad Support Group Monthly

• “Just For Dads” Chat Facebook group for dads

• Video of dads sharing their experiences

Paternal Perinatal Mental Health Training by Postpartum Support International

An online and in-person training for psychotherapists, medical providers, and allied birth professionals to gain valuable knowledge of the key psychological, interpersonal, and systems-level factors related to fathers as they navigate the transition to parenthood.

Resources to learn and create connection with others:

• Basic Training for New Dads

• Bootcamp for New Dads

• Center for Men’s Excellence

• Dads With Wisdom

• Daddy Boot Camp

• Postpartum Men

• The Dovetail Project

International Father’s Mental Health Day (IFMHD)

IFMHD – the day after Father’s Day – features a social media campaign highlighting key aspects of fathers’ mental health. The stigma of experiencing emotional and mental difficulties in early parenthood is even higher for men than for women, which is why this day and social media campaign is needed to open up the conversation about fathers’ mental health. Learn More

Books about Fathers and their Mental Health

Mark Williams is a paternal mental health advocate and author. He saw his wife experience a traumatic birth, and later experienced postpartum depression himself. He suggests the following books as great resources for fathers. Read his article and watch his TEDx Talk.

• Fathers and Perinatal Mental Health: A Guide for Recognition, Treatment and Management

• Paternal Mental Health: Factoring in Fathers 

• Sad Dad: An Exploration of Postnatal Depression in Fathers

• Daddy Blues: Postnatal Depression and Fatherhood

• Dad: Untold Stories of Fatherhood, Love, Mental Health, and Masculinity

• New Fathers, Mental Health and Digital Communication

• The Postpartum Husband: Practical Solutions for Living with Postpartum Depression

• The Life of Dad: The Making of the Modern Father 

For more resources go to mmhla.org/resource-hub.

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Editorial Team

This Fact Sheet was prepared with input from Sheehan D. Fisher, Ph.D and Daniel B. Singley, Ph.D., ABPP, PMH-C.

Citations

1. Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression. JAMA, 303(19), 1961. https://doi.org/10.1001/jama.2010.605

2. Ansari, N. S., Shah, J., Dennis, C., & Shah, P. S. (2021). Risk factors for postpartum depressive symptoms among fathers: A systematic review and meta‐analysis. Acta Obstetricia et Gynecologica Scandinavica, 100(7), 1186–1199. https://doi.org/10.1111/aogs.14109

3. Leach, L. S., Poyser, C., Cooklin, A. R., & Giallo, R. (2016). Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review. Journal of Affective Disorders, 190, 675–686. https://doi.org/10.1016/j.jad.2015.09.063

4. Leiferman, J. A., Farewell, C. V., Jewell, J., Rachael Lacy, Walls, J., Harnke, B., & Paulson, J. F. (2021). Anxiety among fathers during the prenatal and postpartum period: a meta-analysis. Journal of Psychosomatic Obstetrics & Gynecology, 42(2), 152–161. https://doi.org/10.1080/0167482X.2021.1885025

5. Thiel, F., Pittelkow, M.-M., Wittchen, H.-U., & Garthus-Niegel, S. (2020). The Relationship Between Paternal and Maternal Depression During the Perinatal Period: A Systematic Review and Meta-Analysis. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.563287

6. Field, T. (2018). Paternal Prenatal, Perinatal and Postpartum Depression: A narrative review. Journal of Anxiety & Depression, 1(1). https://doi.org/10.46527/2582-3264.102

7. Fisher, S. D., & Garfield, C. (2016). Opportunities to Detect and Manage Perinatal Depression in Men. American Family Physician, 93(10), 824–825. www.aafp.org/pubs/afp/issues/2016/0515/p824.html

8. Matthey, S., Barnett, B., Kavanagh, D. J., & Howie, P. (2001). Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. Journal of Affective Disorders, 64(2–3), 175–184. https://doi.org/10.1016/S0165-0327(00)00236-6

9. Edmondson, O. J. H., Psychogiou, L., Vlachos, H., Netsi, E., & Ramchandani, P. G. (2010). Depression in fathers in the postnatal period: Assessment of the Edinburgh Postnatal Depression Scale as a screening measure. Journal of Affective Disorders, 125(1–3), 365–368. https://doi.org/10.1016/j.jad.2010.01.069

10. Singley, D. B., Cole, B. P., Hammer, J. H., Molloy, S., Rowell, A., & Isacco, A. (2018). Development and psychometric evaluation of the Paternal Involvement With Infants Scale. Psychology of Men & Masculinity, 19(2), 167–183. https://doi.org/10.1037/men0000094

11. Pedersen, S. C., Maindal, H. T., & Ryom, K. (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(3), 15579883211024376. https://doi.org/10.1177/15579883211024375

12. Rabinowitz, F. E., & Cochran, S. V. (2008). Men and Therapy: A Case of Masked Male Depression. Clinical Case Studies, 7(6), 575591. https://doi.org/10.1177/1534650108319917

13. Dziurkowska, E., & Wesolowski, M. (2021). Cortisol as a Biomarker of Mental Disorder Severity. Journal of Clinical Medicine, 10(21), 5204. https://doi.org/10.3390/jcm10215204

14. Eddy, B., Poll, V., Whiting, J., & Clevesy, M. (2019). Forgotten Fathers: Postpartum Depression in Men. Journal of Family Issues, 40(8), 1001–1017. https://doi.org/10.1177/0192513X19833111

15. Molloy, S., Singley, D. B., Ingram, P. B., Cole, B. P., & Dye, A. R. (2021). ¡Qué Padre! Measuring Latino Fathers’ Involvement with Infants. Family Relations, 70(5), 1449–1464. https://doi.org/10.1111/fare.12543

16. Davis, R. N., Davis, M. M., Freed, G. L., & Clark, S. J. (2011). Fathers’ Depression Related to Positive and Negative Parenting Behaviors With 1-Year-Old Children. Pediatrics, 127(4), 612–618. https://doi.org/10.1542/peds.2010-1779

17. Ramchandani, P. G., Psychogiou, L., Vlachos, H., Iles, J., Sethna, V., Netsi, E., & Lodder, A. (2011). Paternal depression: an examination of its links with father, child and family functioning in the postnatal period. Depression and Anxiety, 28(6), 471–477. https://doi.org/10.1002/da.20814

18. Schmitz, K., Jimenez, M. E., Corman, H., Noonan, K., & Reichman, N. E. (2024). Paternal depression in the postpartum year and children’s behaviors at age 5 in an urban U.S. birth cohort. PLOS ONE, 19(4), e0300018. https://doi.org/10.1371/journal.pone.0300018

19. Charandabi, S. M.-A., Mirghafourvand, M., & Sanaati, F. (2017). The Effect of Life Style Based Education on the Fathers’ Anxiety and Depression During Pregnancy and Postpartum Periods: A Randomized Controlled Trial. Community Mental Health Journal, 53(4), 482–489. https://doi.org/10.1007/s10597-017-0103-1

20. Lucassen, N., Tharner, A., Prinzie, P., Verhulst, F. C., Jongerling, J., Bakermans‐Kranenburg, M. J., van IJzendoorn, M. H., & Tiemeier, H. (2018). Paternal history of depression or anxiety disorder and infant–father attachment. Infant and Child Development, 27(2). https://doi.org/10.1002/icd.2070

21. Field, T. (2010). Postpartum depression effects on early interactions, parenting, and safety practices: A review. Infant Behavior and Development, 33(1), 1–6. https://doi.org/10.1016/j.infbeh.2009.10.005

22. Xue, W. L., Shorey, S., Wang, W., & He, H.-G. (2018). Fathers’ involvement during pregnancy and childbirth: An integrative literature review. Midwifery, 62, 135–145. https://doi.org/10.1016/j.midw.2018.04.013

23. Brondolo, E., Gallo, L. C., & Myers, H. F. (2009). Race, racism and health: disparities, mechanisms, and interventions. Journal of Behavioral Medicine, 32(1), 1–8. https://doi.org/10.1007/s10865-008-9190-3

24. Jones, J., & Mosher, W. D. (2013). Fathers’ involvement with their children: United States, 2006-2010 (DHHS Publication No. 20141250). National Health Statistics Reports, 71, 1–21. www.cdc.gov/nchs/data/nhsr/nhsr071.pdf