Contemporary Family Therapy

, Volume 37, Issue 4, pp 417–425 | Cite as

Fathers Matter: Family Therapy’s Role in the Treatment of Paternal Peripartum Depression

Original Paper

Abstract

Peripartum depression is a major health issue for parents and their children. This problem is often thought to be endemic to peripartum mothers, and in some cases have led to fatal outcomes. However fathers may also bear this burden, and paternal peripartum depression is beginning to receive warranted attention. This conceptual paper focuses on peripartum fathers and their experiences in the context of their relationships with their intimate partners, children, and healthcare providers. Family therapists are in a position to provide systemic assessment and approaches to treatment within various environments, a maximal impact platform for fathers and families affected by paternal peripartum depression. This paper will describe how peripartum depression manifests in men and how this problem might be assessed and treated through a systems lens. A multi-disciplinary model will be offered, with special attention given to the role of the family therapist. Clinical considerations and implications for future studies will also be discussed.

Keywords

Postpartum depression Fathers Family therapy Intervention Interdisciplinary treatment approach 

References

  1. Alkar, Ö. Y., & Gençöz, T. (2005). Critical factors associated with early postpartum depression among Turkish women. Contemporary Family Therapy: An International Journal, 27(2), 263–275. doi:10.1007/s10591-005-4043-5.CrossRefGoogle Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. doi:10.1176/appi.books.9780890425596.744053.Google Scholar
  3. Areias, M. G., Kumar, R., Barros, H., & Figueiredo, E. (1996). Correlates of postnatal depression in mothers and fathers. The British Journal of Psychiatry, 169(1), 36–41. doi:10.1192/bjp.169.1.36.CrossRefPubMedGoogle Scholar
  4. Atkins, D. (2004). Screening for depression: Recommendations and rationale. Internet Journal of Mental Health, 1(2), 1–10.Google Scholar
  5. Baker-Ericzén, M. J., Connelly, C. D., Hazen, A. L., Dueñas, C., Landsverk, J. A., & Horwitz, S. M. (2012). A collaborative care telemedicine intervention to overcome treatment barriers for Latina women with depression during the perinatal period. Families, Systems, and Health, 30(3), 224–240. doi:10.1037/a0028750.PubMedCentralCrossRefPubMedGoogle Scholar
  6. Baker-Ericzén, M. J., Mueggenborg, M. G., Hartigan, P., Howard, N., & Wilke, T. (2008). Partnership for women’s health: A new-age collaborative program for addressing maternal depression in the postpartum period. Families, Systems, and Health, 26(1), 30–43. doi:10.1037/1091-7527.26.1.30.CrossRefGoogle Scholar
  7. Berg, S. J., & Wynne-Edwards, K. E. (2001). Changes in testosterone, cortisol, and estradiol levels in men becoming fathers. Mayo Clinic Proceedings, 76(6), 582–592. doi:10.4065/76.6.582.CrossRefPubMedGoogle Scholar
  8. Bielawska-Batorowicz, E., & Kossakowska-Petrycka, K. (2006). Depressive mood in men after the birth of their offspring in relation to a partner’s depression, social support, fathers’ personality and prenatal expectations. Journal of Reproductive and Infant Psychology, 24(1), 21–29. doi:10.1080/02646830500475179.CrossRefGoogle Scholar
  9. Clark, M. M., & Galef, B. J. (1999). A testosterone-mediated trade-off between parental and sexual effort in male mongolian gerbils (Meriones unguiculatus). Journal of Comparative Psychology, 113(4), 388–395. doi:10.1037/0735-7036.113.4.388.CrossRefPubMedGoogle Scholar
  10. Cochran, A., & Rabinowitz, F. (2000). Men and depression: Clinical and empirical perspectives. San Diego, CA: Academic Press.Google Scholar
  11. Condon, J. T., Boyce, P., & Corkindale, C. J. (2004). The first-time fathers study: A prospective study of the mental health and wellbeing of men during the transition to parenthood. Australian and New Zealand Journal of Psychiatry, 38(1–2), 56–64. doi:10.1111/j.1440-1614.2004.01298.x.CrossRefPubMedGoogle Scholar
  12. Cowdery, R. S., & Knudson-Martin, C. (2005). The construction of motherhood: Tasks, relational connection, and gender equality. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 54(3), 335–345. doi:10.1111/j.1741-3729.2005.00321.x.CrossRefGoogle Scholar
  13. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry. doi:10.1192/bjp.150.6.782.PubMedGoogle Scholar
  14. Davey, S. J., Dziurawiec, S., & O’Brien-Malone, A. (2006). Men’s voices: Postnatal depression from the perspective of male partners. Qualitative Health Research, 16, 206–220.CrossRefPubMedGoogle Scholar
  15. Dudley, M., Roy, K., Kelk, N., & Bernard, D. (2001). Psychological correlates of depression in fathers and mothers in the first postnatal year. Journal of Reproductive and Infant Psychology, 19(3), 187–202. doi:10.1080/02646830120073206.CrossRefGoogle Scholar
  16. Escribà-Agüir, V., & Artazcoz, L. (2011). Gender differences in postpartum depression: A longitudinal cohort study. Journal of Epidemiology and Community Health, 65(4), 320–326. doi:10.1136/jech.2008.085894.PubMedCentralCrossRefPubMedGoogle Scholar
  17. Fleming, A. S., Corter, C., Stallings, J., & Steiner, M. (2002). Testosterone and prolactin are associated with emotional responses to infant cries in new fathers. Hormones and Behavior, 42(4), 399–413. doi:10.1006/hbeh.2002.1840.CrossRefPubMedGoogle Scholar
  18. Fletcher, R. J., Freeman, E., Garfield, C., & Vimpani, G. (2011). The effects of early paternal depression on children’s development. Medical Journal of Australia, 195, 685–689. doi:10.5694/mja11.10192.CrossRefPubMedGoogle Scholar
  19. Fogarty, C. (2010). Postpartum care: Breastfeeding and mood disorders. In S. G. Shields & L. M. Candib (Eds.), Woman-centered care in pregnancy and childbirth (pp. 35–39). UK: Radcliffe Publishing.Google Scholar
  20. Freed, R. D., Chan, P. T., Boger, K. D., & Tompson, M. C. (2012). Enhancing maternal depression recognition in health care settings: A review of strategies to improve detection, reduce barriers, and reach mothers in need. Families, Systems, and Health, 30(1), 1–18. doi:10.1037/a0027602.CrossRefPubMedGoogle Scholar
  21. Gameiro, S., Moura-Ramos, M., Canavarro, M. C., Santos, T. A., & Dattilio, F. M. (2011). Congruence of the marital relationship during transition to parenthood: A study with couples who conceived spontaneously or through assisted reproductive technologies. Contemporary Family Therapy: An International Journal, 33(2), 91–106. doi:10.1007/s10591-011-9153-7.CrossRefGoogle Scholar
  22. Goodman, J. H. (2004). Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of Advanced Nursing, 45, 26–35. doi:10.1046/j.1365-2648.2003.02857.x.CrossRefPubMedGoogle Scholar
  23. Habib, C. (2012). Paternal perinatal depression: An overview and suggestions towards an intervention model. Journal of Family Studies, 18(1), 4–16. doi:10.5172/jfs.2012.18.1.4.CrossRefGoogle Scholar
  24. Harvey, I., & McGrath, G. (1988). Psychiatric morbidity in spouses of women admitted to a mother and baby unit. The British Journal of Psychiatry, 152, 506–510.CrossRefPubMedGoogle Scholar
  25. Huang, C. C., & Warner, L. A. (2005). Relationship characteristics and depression among fathers with newborns. Social Service Review, 79, 95–118. doi:10.1086/426719.CrossRefGoogle Scholar
  26. Kessler, R. C., Berglund, P., Demler, O., Koretz, J. R., Merikangas, K. R., Rush, A. J., et al. (2003). The epidemiology of major depressive disorder: Results from the national comorbidity survey replication (NCS-R). Journal of the American Medical Association, 289(23), 3095–3105. doi:10.1001/jama.289.23.3095.CrossRefPubMedGoogle Scholar
  27. Kim, P., & Swain, J. E. (2007). Sad dads: Paternal postpartum depression. Psychiatry, 4(2), 35–47.PubMedCentralPubMedGoogle Scholar
  28. Lamb, M. E. (Ed.). (1987). The father’s role: Cross cultural perspectives. New Jersey: Lawrence Erlbaum Associates.Google Scholar
  29. Leiferman, J. A., Dauber, S. E., Heisler, K., & Paulson, J. F. (2008). Primary care physicians’ beliefs and practices toward maternal depression. Journal of Women’s Health, 17(7), 1–8. doi:10.1089/jwh.2007.0543.CrossRefGoogle Scholar
  30. Letourneau, N., Duffett-Leger, L., Dennis, C., Stewart, M., & Tryphonopoulos, P. D. (2011). Identifying the support needs of fathers affected by post-partum depression: A pilot study. Journal of Psychiatric and Mental Health Nursing, 18(1), 41–47. doi:10.1111/j.1365-2850.2010.01627.x.CrossRefPubMedGoogle Scholar
  31. Letourneau, N., Tryphonopoulos, P. D., Duffett-Leger, L., Stewart, M., Benzies, K., Dennis, C., & Joschko, J. (2012). Support interventions needs and preferences of fathers affected by postpartum depression. Journal of Perinatal and Neonatal Nursing, 26, 69–80. doi:10.1097/JPN.0b013e318241da87.CrossRefPubMedGoogle Scholar
  32. Löwe, B., Unützer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004). Monitoring depression treatment outcomes with the Patient Health Questionnaire-9. Medical Care, 42(12), 1194–1201. doi:10.1097/00005650-200412000-00006.CrossRefPubMedGoogle Scholar
  33. Madsen, S. A., & Juhl, T. (2007). Paternal depression in the postnatal period assessed with traditional and male depression scales. Journal of Men’s Health and Gender, 4(1), 26–31. doi:10.1016/j.jmhg.2006.10.017.CrossRefGoogle Scholar
  34. Mahalik, J. R., Good, G. E., & Englar-Carlson, M. (2003). Masculinity scripts, presenting concerns, and help seeking: Implications for practice and training. Professional Psychology: Research and Practice, 34(2), 123–131. doi:10.1037/0735-7028.34.2.123.CrossRefGoogle Scholar
  35. Matta, D. S., & Knudson-Martin, C. (2006). Father responsivity: Couple processes and the coconstruction of fatherhood. Family Process, 45(1), 19–37. doi:10.1111/j.1545-5300.2006.00078.x.CrossRefPubMedGoogle Scholar
  36. 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. doi:10.1016/S0165-0327(00)00236-6.CrossRefPubMedGoogle Scholar
  37. Matthey, S., Barnett, B., Ungerer, J., & Waters, B. (2000). Paternal and maternal depressed mood during the transition to parenthood. Journal of Affective Disorders, 60(2), 75–85. doi:10.1016/S0165-0327(99)00159-7.CrossRefPubMedGoogle Scholar
  38. McDaniel, S. H., Doherty, W. J., & Hepworth, J. (2013). Medical family therapy: A biopsychosocial approach to families with health problems. New York, NY: Basic Books.Google Scholar
  39. Medina, A. M., Lederhos, C. L., & Lillis, T. A. (2009). Sleep disruption and decline in marital satisfaction across the transition to parenthood. Families, Systems, and Health, 27(2), 153–160. doi:10.1037/a0015762.CrossRefPubMedGoogle Scholar
  40. Mehta, D., Newport, D. J., Frishman, G., Kraus, L., Rex-Haffner, M., Ritchie, J. C., et al. (2014). Early predictive biomarkers for postpartum depression point to a role for estrogen receptor signaling. Psychological Medicine, 44(11), 2309–2322. doi:10.1017/S0033291713003231.CrossRefPubMedGoogle Scholar
  41. Melrose, S. (2010). Paternal postpartum depression: How can nurses begin to help? Contemporary Nurse, 34(2), 199–210. doi:10.5172/conu.2010.34.2.199.CrossRefPubMedGoogle Scholar
  42. Mezulis, A. H., Hyde, J. S., & Clark, R. (2004). Father involvement moderates the effect of maternal depression during a child’s infancy on child behavior problems in kindergarten. Journal of Family Psychology, 18(4), 575–588. doi:10.1037/0893-3200.18.4.575.CrossRefPubMedGoogle Scholar
  43. Miller, L. (2002). Postpartum depression. Journal of the American Medical Association, 287(6), 762–765. doi:10.1001/jama.287.6.762.CrossRefPubMedGoogle Scholar
  44. O’Brien, R., Hunt, K., & Hart, G. (2005). ‘It’s caveman stuff, but that is to a certain extent how guys still operate’: Men’s accounts of masculinity and help seeking. Social Science and Medicine, 61(3), 503–516. doi:10.1016/j.socscimed.2004.12.008.CrossRefPubMedGoogle Scholar
  45. Page, M., & Wilhelm, M. S. (2007). Postpartum daily stress, relationship quality, and depressive symptoms. Contemporary Family Therapy: An International Journal, 29(4), 237–251. doi:10.1007/s10591-007-9043-1.CrossRefGoogle Scholar
  46. Parfitt, Y., & Ayers, S. (2014). Transition to parenthood and mental health in first-time parents. Infant Mental Health Journal, 35(3), 263–273. doi:10.1002/imhj.21443.CrossRefPubMedGoogle Scholar
  47. Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA: Journal of the American Medical Association, 303(19), 1961–1969. doi:10.1001/jama.2010.605.CrossRefPubMedGoogle Scholar
  48. Paulson, J., Dauber, S., & Leiferman, J. (2006). Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics, 118(2), 659–668. doi:10.1542/peds.2005-2948.CrossRefPubMedGoogle Scholar
  49. Phares, V. (1997). Psychological adjustment, maladjustment and father–child relationships. In M. E. Lamb (Ed.), The role of the father in child development (3rd ed.). Hobokin, NJ: Wiley.Google Scholar
  50. Pinheiro, R. T., Magalaes, P. V. S., Horta, B. L., Pienhero, K. A. T., da Silva, R. A., & Pinto, R. H. (2006). Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil. Acta Psychiatrica Scandinavica, 113(3), 230–232. doi:10.1111/j.1600-0447.2005.00708.x.CrossRefPubMedGoogle Scholar
  51. Quevedo, L., da Silva, R. A., Coelho, F., Tavares Pinheiro, K. A., Horta, B. L., Kapczinski, F., & Pinheiro, R. T. (2011). Risk of suicide and mixed episode in men in the postpartum period. Journal of Affective Disorders, 132(1–2), 243–246. doi:10.1016/j.jad.2011.01.004.CrossRefPubMedGoogle Scholar
  52. Ramchandani, P. G., O’Connor, T. G., Evans, J., Heron, J., Murray, L., & Stein, A. (2008). The effects of pre- and postnatal depression in fathers: A natural experiment comparing the effects of exposure to depression on offspring. Journal of Child Psychology and Psychiatry, 49(10), 1069–1078. doi:10.1111/j.1469-7610.2008.02000.x.PubMedCentralCrossRefPubMedGoogle Scholar
  53. Ramchandani, P., Stein, A., Evans, J., & O’Connor, T. G. (2005). Paternal depression in the postnatal period and child development: A prospective population study. The Lancet, 365(9478), 2201–2205. doi:10.1016/S0140-6736(05)66778-5.CrossRefGoogle Scholar
  54. Seidman, S. N., & Walsh, B. T. (1999). Testosterone and depression in aging men. The American Journal of Geriatric Psychiatry, 7(1), 18–33.CrossRefPubMedGoogle Scholar
  55. Smith, K. L. W., Matheson, F. I., Moineddin, R., Dunn, J. R., Lu, H., Cairney, J., & Glazier, R. H. (2013). Gender differences in mental health service utilization among respondents reporting depression in a national health survey. Health, 5, 1561–1571. doi:10.4236/health.2013.510212.CrossRefGoogle Scholar
  56. Spector, A. Z. (2006). Fatherhood and depression: A review of risks, effects, and clinical application. Issues In Mental Health Nursing, 27(8), 867–883. doi:10.1080/01612840600840844.CrossRefPubMedGoogle Scholar
  57. Storey, A., Walsh, C., Quinton, R., & Wynne-Edwards, K. (2000). Hormonal correlates of paternal responsiveness in new and expectant fathers. Evolution and Human Behavior, 21(2), 79–95. doi:10.1016/S1090-5138(99)00042-2.CrossRefPubMedGoogle Scholar
  58. Substance Abuse and Mental Health Services Administration. (2012). Results from the 2010 National Survey on Drug Use and Health: Mental Health Findings. NSDUH Series H-42, HHS Publication No. (SMA) 11-4667.Google Scholar
  59. Wee, K. Y., Skouteris, H., Pier, C., Richardson, B., & Milgrom, J. (2011). Correlates of ante- and postnatal depression in fathers: A systematic review. Journal of Affective Disorders, 130(3), 358–377. doi:10.1016/j.jad.2010.06.019.CrossRefPubMedGoogle Scholar
  60. Wynne-Edwards, K. E. (2001). Hormonal changes in mammalian fathers. Hormones and Behavior, 40(2), 139–145. doi:10.1006/hbeh.2001.1699.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Counseling and Family SciencesLoma Linda UniversityLoma LindaUSA

Personalised recommendations