It should have been the happiest time of his life, but after his son was born in 2016, Gary (who did not want to use his real name to protect his family’s privacy) felt depressed. On a few occasions, he even considered taking his own life. His days felt overwhelmingly difficult, but Gary thought it was normal. “I didn’t pay attention to how I was feeling because I assumed it was par for the course after having a baby,” says Gary, who was 36 at the time. “It was only when my friends pointed out a change in my mood that I realised something was wrong.” Gary’s wife was difficult to talk to after their baby arrived, which exacerbated the situation. Gary says that she was stressed out herself and unaware of how he was feeling. Her refusal to work and her demand for a live-in domestic helper only added to their marital strife, not to mention the fact that they were both severely sleep-deprived. Even though he had time off work, Gary still had to deal with problems that cropped up at the office. He felt stretched to his limit and could see no way out. Besides having suicidal thoughts, he also contemplated divorce. Gary eventually sought help from a psychologist, who told him that he had all the symptoms of postpartum depression (also called postnatal depression), PPD for short. “My marriage and family life are far from perfect, but generally I’m coping better,” Gary says. “Therapy helped – I learned how to break my problems down into smaller, more manageable parts and get to the root of those problems and come up with solutions. Talking to friends, doing things for myself that I enjoy, and staying active also made things easier. It definitely helps to know that I have support to get through this.” Dr Sanveen Kang, principal clinical psychologist at Psych Connect in Singapore, says PPD can affect not just women, but their male partners, too. “PPD is a mood disorder associated with childbirth,” she points out. “There’s growing evidence that men can experience very similar symptoms to maternal PPD.” One study, published in the Journal of Advanced Nursing in 2003, found that about 50 per cent of dads experienced PPD when their wife was going through it as well. Another study, published in 2010 in the Journal of the American Medical Association (JAMA), revealed that 10.4 per cent of fathers suffered from depression at some point between the first trimester of their partner’s pregnancy and their child’s first birthday. Another study, from Indiana University in the United States, found that new dads may suffer from depression almost as much as new mothers. The research, published in JAMA Paediatrics in 2018, found that 4.4 per cent of new dads tested positive for depression in clinic visits, compared with around 5 per cent of mothers. PPD has a number of symptoms, says Dr Adrian Low Eng-ken, a Hong Kong-based psychologist. “These include fear, confusion, a sense of helplessness and uncertainty about the future, withdrawal from family life, work and social situations, indecisiveness, anger, and marital conflict,” he says. “Some of the symptoms may reflect hormonal changes – for instance, levels of testosterone, oestrogen, cortisol, vasopressin and prolactin may change in men after their babies arrive.” The peak time for PPD in men is three to six months after their child’s birth. Low says that one in 10 dads-to-be also experiences depression while their partner is pregnant but, like PPD in mothers, often goes undiagnosed. Being a new dad also requires adaptation and emotional management skills. If you feel like you can’t cope, don’t wait to get help Dr Adrian Low The causes of PPD in men are wide-ranging and tend to be the same as in women. These may include a shift in the marital relationship, feelings about becoming a parent, and an inability to cope with being a parent. “It’s a huge life change for both partners,” says Low. “On top of this, dads might feel guilty about what their partner has to go through, such as breastfeeding at 3am and healing physically from giving birth.” There are several risk factors associated with PPD. For example, if you find it hard to develop an attachment to your baby, have insufficient support from family and friends, feel that parenting is not rewarding, or feel stressed at work or financially, then you may be at a higher risk of experiencing PPD, Kang says. Some men also develop PPD because they’re jealous that their wife prefers to bond with their baby more than with them, or because their relationship with their wife has changed in that it now lacks intimacy. If your wife is depressed, your risk of PPD is higher, too. Besides ruining the experience of new parenthood, paternal PPD can strain a man’s relationship with his partner and baby. He may also not look after his baby, or himself, as well as he would if he was well. PPD can affect the child’s development and behaviour long after the depression has ended. “Depressed dads are more likely to use physical forms of discipline on their children than those without depression. They’re also less likely to interact with their kids in positive ways, such as singing songs or reading to them,” says Kang. “This depression may also transfer to the man’s marriage, increasing conflicts with his wife and making his wife more vulnerable to depression. Interestingly, if a child has a mother who’s depressed, having an involved and nurturing father can protect that child from some of the negative effects of the mother’s depression.” Men with depression are also at a higher risk of suicide, Low says. It’s normal to feel overwhelmed after having a baby, but, like maternal PPD, paternal PPD must be taken more seriously. “While women are the primary carers, we shouldn’t ignore the role men play during and after pregnancy,” says Low. The forgotten Hong Kong women left behind by crushing depression “Being a new dad also requires adaptation and emotional management skills. If you feel like you can’t cope, don’t wait to get help. Consult your general practitioner, confide in a friend, look up counselling services or join a support group. “Don’t forget to take care of yourself, too – eat well, exercise, get enough rest, and don’t neglect your hobbies. To feel closer to your baby, I suggest doing things like changing his diaper, bathing him or playing with him.” Gary admits that his battle with PPD has been tough; it affected his outlook on life and caused problems in his job. But because he loves his son and wants the boy to grow up with both his parents, he decided not to divorce his wife and to get professional therapy instead. His situation is improving.