LETTER TO EDITOR

Postpartum Depression - Not a gender-specific psychiatric illness

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By Asmat Zehra 1, Aimen Fatimah 1, Mahnoor Amin1

AFFILIATIONS

  1. MBBS Student, Dow Medical College, Dow University of Health Sciences, Karachi Pakistan

DOI: https://doi.org/10.36283/PJMD12-3/013

How to cite: Zehra A, Fatimah A, Amin M. Postpartum Depression – Not a gender-specific psychiatric illness. Pak J Med Dent. 2023;12(3): 71-72. Doi: 10.36283/PJMD12-3/013

Dear Editor,

Postpartum depression (PPD), a common psychiatric complication of pregnancy, may be defined as persistent sad behavior, melancholic mood, anxiety, and lethargy within a year after childbirth1. PPD is considered an exclusively female psychiatric illness, however, recent research shows that PPD affects males too. A meta-analysis published recently reveals that around 10% of new fathers experience depressive symptoms around the time of their child’s birth, especially after 3 to 6 months of having a baby2.

There is very little data on the prevalence of paternal PPD in Pakistan. A study conducted in 2020 in Karachi estimated a prevalence of 23.8 %, out of which 25.8% experienced mild, while 2.5 % experienced severe depressive symptoms3. There is very little awareness about maternal PPD, let alone paternal PPD. This can be attributed to mental health stigma and stereotypical mindsets of the population. In our country and society, males who display vulnerability (by their feelings of incompetence, pressure, and melancholy, which are associated with the stress of responsibilities of a new family member and the added strain on their marital relationship) are considered weak or “feminine” by their peers3. These societal norms force men to suppress their feelings and continued cycles of suppression cause emotional dysregulation, resulting in frustration and anger outbursts; also causing delayed medical evaluation and treatment.

Interestingly, the main risk factor for paternal PPD is found to be maternal PPD and the father’s prior history of depression4. Other risk factors include age, education, marital satisfaction, monthly income, undesired pregnancy, pregnancy with infertility, infant gender, etc5. In patients with paternal PPD, an associated shift in hormone levels of cortisol, testosterone, and prolactin has also been observed4. At-risk mothers, and fathers, should be screened and educated about the symptoms of PPD by doctors. Paternal PPD also predisposes new mothers to stress, and depression and may even contribute to abuse2. If symptoms are observed, immediate psychiatric evaluation and management should be sought.

This article aims to highlight the fact that PPD is not a gender-specific illness and why men must speak up and pursue professional help when symptoms of PPD are displayed. The social stigma against men expressing emotions must also be eliminated to do so. This article calls for more research to explore the prevalence, risk factors, prevention, and management of paternal PPD in a country like Pakistan.

ACKNOWLEDGEMENTS

The authors would like to acknowledge and extend their gratitude to the institution.

CONFLICT OF INTEREST

All authors agreed to the publication of this manuscript.

AUTHORS’ CONTRIBUTION

AZ, AF, and MA contributed to manuscript writing and editing. All authors read and approved the final manuscript.

REFERENCES

  1. Adamu AF, Adinew YM. Domestic Violence as a Risk Factor for Postpartum Depression Among Ethiopian Women: Facility Based Study. Clin Pract Epidemiol Ment Health. 2018 May 23; 14:109-119. doi: 10.2174/1745017901814010109.
  2. Kim P, Swain JE. Sad dads: paternal postpartum depression. Psychiatry (Edgmont). 2007 Feb;4(2):35-47.
  3. Noorullah, Aisha; Mohsin, Zehra; Munir, Taliha; Nasir, Rida; and Malik, Misbah (2020) “Prevalence of paternal postpartum depression,” Pakistan Journal of Neurological Sciences (PJNS): Vol. 15: Iss. 3, Article 3.
  4. Glasser S, Lerner-Geva L. Focus on fathers: paternal depression in the perinatal period. Perspect Public Health. 2019 Jul;139(4):195-198. doi: 10.1177/1757913918790597.
  5. Wang D, Li YL, Qiu D, Xiao SY. Factors Influencing Paternal Postpartum Depression: A Systematic Review and Meta-Analysis. J Affect Disord. 2021 Oct 1; 293:51-63. doi: 10.1016/j.jad.2021.05.088.

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