What Often Goes Unaddressed with Fatherhood and Mental Health
Written By: Hannah Lavan, LCSW
In this post, I am writing about the differences in the male and female emotional and physical responses to having a baby. By framing parenting in this way, I am excluding a significant portion of our communities and society at large. The population I am referring to has resources, access to healthcare, and is cisgender. I apologize for the exclusion and hope the piece is useful for the larger message.
I’ve been in the field of mental health and parent coaching for the best part of twenty years. About ten years ago I added couples to my caseload. There was a theme which kept coming up, regardless of the presenting issue or the number of years the couple had been together. Stories from the postpartum period - the weeks and months after a new baby arrived. In women, memories from this time had been seared into the psyches. The vignettes had stayed on like a collection of round white pebbles that they had kept in the pockets, sometimes putting them out of mind, but never quite letting them go completely. They were always there to be jangled when proof was required that he wasn’t up to the job of husband or father.
Eventually, those little pebbles would grow too heavy, and the pockets would be turned out right there on my coffee table before the incredulous husbands. Why this? After all these years, why is she bringing this up? In many couples there is a seismic shift in the relationship when a baby arrives, and its implications extend long after the last diaper.
For several years beginning when my youngest was a year old, I co-facilitated a New Moms group in a well-regarded Reform synagogue on the Upper Westside of Manhattan. Almost all of the participants were well college educated, professional women who had careers and heterosexual marriages. My work to that point had been with children, and I was running it with a revolving cast of young, hip, super smart female clergy women. Both of us were moms, but we didn’t frame ourselves as educators or experts. It was a mutual support group; our job as facilitators was to keep the ball in the air, so to speak. We created a weekly outline for the topics that we would discuss, from maternal role models to having sex again. Looking back, I wish we had more knowledge of the range of postpartum issues that affect women in the months after having a baby. But through the years, I learned to see the patterns and appreciate the range of experiences that make up the critical postpartum period. With more training and new professional opportunities, I increased my knowledge and understanding about the range of postpartum mental health issues, collectively known as PMADs, which include anxiety, OCD, and intrusive thoughts.
I learned that PMADs affect four of every ten women. As I became more versed in the symptoms and the feelings, I came to understand that two years earlier, after the birth of my third child, I had experienced a bout of Postpartum anxiety. I got through it without medication or therapy, but it would have helped to have known at the time that what I was feeling had a name and an etiology. It would have allowed for me to separate from the overwhelming feelings, and to cognise that anxiety was happening to me - it wasn’t who I was, or a punishment from the universe for my choices. As the one who grows the baby, births the baby, and (possibly) nurses the baby, a woman absolutely knows something is happening to her body and her hormones. We know we are not the same and that our lives have changed irrevocably. Our brains change too. In the last decade, neuroscience has revealed that women’s brains become more streamlined (I prefer that to “shrink”) after pregnancy. This change in the cortex and subcortex is understood to be evolutionarily advantageous, giving the new mother a greater ability to focus on the emotional needs of her offspring.
From time to time, I would suggest that we become a New Parent group, rather than a new moms group. But it was decided that our group was exclusively for women because, being the birthing parent, they had the biological imperative to be the primary caregiver at least in the early months. Indeed, we wanted women to be open to talk about their leaking orifices and how they felt about losing their elasticity. The other thing I remember dedicating a lot of time to in that space was venting about our partners/husbands. I have to put my hand up here and say that I was quick to volunteer my own stories of him not taking time off, and prioritizing spending time with his visiting parents over time with me and the baby. Others talked about their husbands playing golf all day or going to the movies. The most sympathy we could muster was to reflect that they, the new dads, just got demoted in the home and heart, and that may be a little tough on their fragile egos.
Later in those couples sessions, fathers were given the space to talk about their thoughts and experience of the postpartum period. They would say things like despite being entitled to family leave, they were under tremendous pressure to return to work, or that they felt at a loss when it came to what to do with the baby. Or that as they weren’t the ones doing the feeding, there was nothing to do. Many said that they felt overly scrutinized by their partners and like they could do nothing right. One man told me that a father’s number one job is to “have a perfect credit score” and therefore he was only useful when working. Others, in individual therapy, would minimize their experience because their wife had had it so much harder. Often the wife’s mother was hovering, and he felt like there wasn’t space for him to connect with the baby. Apart from the one guy who said that being a dad started when their kid could catch a ball, most men expressed a sense of having felt lost when their babies were born.
Research now shows that one in ten fathers experience depression and anxiety after the birth of a new baby. And this number is as high as forty percent if the mother is struggling with PMADs. Symptoms for men look very different than for women. It shows with a marked increase in irritability, withdrawal from family activities, significant changes in sleep (unrelated to baby), eating, and alcohol consumption. Symptoms include feelings of inadequacy specifically related to the parenting role, preoccupation with worst-case scenarios involving a child’s health or safety and longer hours and increased focus on work. With that in mind, the behavior of all those dads that we excluded from our safe space suddenly looked very different. The new moms felt that their partners were being aloof and uncaring, but what if they were insecure and overwhelmed?
While women have been overlooked in medical research forever, books have been written (usually by men) about mothering for generations. When it comes to parenthood, women are better supported by our culture. PMADs are more widely understood and more accurately represented in popular culture. Healthcare providers for both mom and baby have screening tools to assess for maternal distress. Traditionally, women have been socialized to seek out others in times of distress and ask for help when they need it. They are statistically much more likely to utilize mental health services than men. There are all kinds of in-person and online support groups for moms, but very few for dads and especially fathers of babies.
This seemed disconcerting: if men are unable to advocate for their emotional health, does it become another thing that falls to women? Then I read the new book by Dr. Darby Saxbe, a professor called, “The Dad Brain.” She, along with her team at USC and other researchers across several continents, has carried out neuroimaging studies on men before and after becoming fathers. One of her findings is that the male brain does change in the weeks and months after becoming a father. For men, the change is in their prefrontal regions, which include the part for planning, visual navigation, and mentalizing. Mentalizing, which is thinking about other people’s needs and thoughts, is key to attachment and parenting. They also found that the more a man engages with his baby, the greater the effect on the brain. They even found this could start in utero, if the father-to-be perceives a connection with the image he sees in a live ultrasound. As opposed to Female mammals who have the biological imperative, Dr. Saxbe states that males have a “facultative” relationship to their infants, and must consciously choose to parent.
While the book posits that the more engaged men are more prone to anxiety and depression, it also suggests that the experience of fatherhood is much richer for the dads who roll up their sleeves, do the hard things, and enjoy positive feedback from infants. As mothers, we can empower the men domestically by stepping back and letting them step up. Studies also show that spending time together as expectant parents during pregnancy can optimize the changes in the brain and hormones that will come after birth, and thereby increase a new dad’s ability to mentalize his infant and wife.
If we are no longer in the peri- or postnatal stage, all is not lost. If those early months were rocky, review them either by yourself or with a therapist. If you find you are still holding on to snippets where your husband let you down, try adding a sprinkling of compassion for his journey, and if that doesn’t help, consider bringing him along to counseling or Parent Coaching. The latest research on parent-child relationships repeatedly states that the ability to mentalize, to imagine how another is feeling, is the key to connectedness. Parent coaching at its core is about helping parents mentalize their children regardless of age. Nature helped us out by rebooting our brains when our babies were born, but most of us could benefit from updating the “default mode network” or ability to mentalize when it comes to our children as they are today.
The joyous event of a new baby also has its difficult side. We are all challenged and changed by becoming parents, and those endearing differences between our partners and us suddenly seem like serious character flaws - in the other! For most of us, our children are our most significant legacy. Having an irritable and withdrawn parent increases household stress and has been linked to a myriad of negative outcomes for children, such as behavioral issues and delayed milestones. Podcasts and support groups can be great, but if you have the privilege of being able to access therapy and parent coaching, it can be in your family’s best interest to use all the resources at hand to give your children the optimum environment to thrive.
At Everyday Parenting, we believe in empowering families to create meaningful connections and navigate challenges with compassion and confidence. Whether you're seeking strategies to address specific behaviors or simply want to strengthen your family bond, we’re here to support you every step of the way. Contact us today to learn how our evidence-based approaches can help your family thrive.