If you're man is experiencing postpartum depression learn why and 4 ways you can help.
Postpartum Depression (PPD) doesn't just affect women, it can also affect our partners. Men, particularly may demonstrate early symptoms of PPD that we just aren't aware of. This month we've focused on teaching women (and men) more about how common it is for men experience this slump when baby is born. Today, I met with Core System Specialist and Father of 4 (including twins), Jim Harrison, DPT to chat about his experiences. Jim had fantastic advice on how he and his wife worked together to overcome challenges and depression, in early parenting years.
Watch the interview here.
Understanding the physiology behind depression - particularly in men, can help put these symptoms into perspective - and perhaps find a solution. Here's the basics on why many men experience baby blues. Then, I'll share my and Jim's four best strategies that can help your man feel like himself again.
To start, let's clarify what depression is. From the DSMV IV: Depression is usually a group of symptoms that include either depressed mood, or loss of interest or pleasure, and some of the following: irritable mood, weight gain or loss, changes in appetite, difficulty sleeping or sleeping too much, fatigue/tiredness every day, feelings of worthlessness or excessive guilt, restlessness or feeling slowed down, inability to concentrate or indecisiveness. What distinguishes depression from the baby blues (dysthymia) is thoughts of death or suicide, like "the x would be better without me," type of thinking. Everyone experiences most of these symptoms sometimes, but in PPD these symptoms are interfering with daily life, and last longer than 2 weeks or longer than 2 months with an influencing event such as the death of a loved one (or birth of one?).
What is helpful to remember is: depression is a symptom - a sign that something is out of balance in the body. Any of these symptoms persisting is a way that your body is trying to tell you it needs something. Because each man is an individual, your partner may express this imbalance this differently. Each person also learns to cope with these symptoms in their own way. What helps in the long run, is to start listening - recognizing that symptoms of depression mean something, and figuring out what these symptoms mean your body is trying to communicate to you.
Why does he feel this way?
The source of these feelings can often be related back to stress. But, stress comes in many ways. For example, think of how you feel when you're sick. You feel tired, you want to sleep more, you are irritable, you can't concentrate or think clearly, you may even feel hopeless like you are never going to get better, or have other irrational thoughts. Why do you feel this way? Because your immune system is fired up fighting off pathogenic intruders! This is stressful to the body. During illness your stress hormones like Cortisol rise.
Another type of stress is mental stress. Worry about work, family, relationships, money, and fatherhood can all raise cortisol levels, but unlike when you're sick and you feel better after a week, this type of stress can be ongoing. Chronic or unmanaged stress allows Cortisol and other hormones to remain elevated which begins to affect sleep, appetite, weight, sex drive, concentration, mood, and so much more. The longer cortisol stays high, the greater effects it has on the entire body. Additionally, in men, when cortisol is high, testosterone drops. This drop in testosterone is what drives many of the symptoms we identify with baby blues in men, showing up as symptoms of tiredness, irritability, loss of muscle mass, sleep disruption, depressed mood and sexual dysfunction.
Other stressors on the body may include illness, injury, nutritional deficiencies, hormone imbalances, blood sugar dysregulation, poor diet, substance abuse, sedentary lifestyle, physical or emotional abuse.
Another type of stress is often beneficial, we see it most clearly with exercise but it can be found with mentally challenging tasks as well. Physical exercise also increases cortisol, but when the workout is over, over the next 3-4 hours cortisol drops back down to normal levels. This type of stress actually increases testosterone to repair and build muscle. Exercise improves sleep, reduces blood pressure and blood sugar, controls weight and can calm a person down. Be aware that exercise without proper recovery can become chronic stress and just as damaging as persistent mental stress. But with adequate recovery exercise, particularly strengthening exercises, can boost testosterone and feel-good hormones.
So what is it about the postpartum period that promotes blues?
Some of the more obvious ideas include:
1. Worry - the mental stress that frequently comes with becoming a father may include feeling inadequate about being able to care for a baby financially, physically, emotionally. This new role may also bring up memories good and bad from past experiences, that can affect how confident a man is in entering this new life stage.
2. Lack of sleep - the early life of a newborn, waking every couple hours can get Dad off to a rough start. Especially when Dad is trying to juggle helping with baby in the nighttime with working full-time, he misses out on daytime nap opportunities that we encourage new mothers to take - "sleep when your baby sleeps." The Journal of Medicine published this article in 2011, showing significant reduction of testosterone levels in men after just one night reducing sleep from 8-10 hours to 5 hours of sleep. Tetosterone continued to drop the longer the sleep restriction occurred. The symptoms of sleep deprivation included reduced muscle mass, reduced strength, sexual dysfunction, increased fat, decreased vigor and decreased well-being - sound familiar?
3. Change in lifestyle - Along with a new baby comes a new way of life. For many men this often means changes in activity levels as time is spent elsewhere resulting in less exercise. For many men, the parenting years are a transition to greater demands on time with full-time work, very often with less physical demand than sports or activities in high school or college. Just as important as it is for women to find the space and time to exercise regularly, the same goes for men, balancing work, family and self-care into the mix.
4. Isolation - Back to the cold analogy, do you feel like going out and socializing when you're sick? No, you just want to curl up in bed and stay there. Similarly, men having difficulty adjusting to a new role can begin to withdraw. Sometimes this isn't a physical isolation but more often an emotional/social isolation. Have you noticed your man being with people but not connecting with them? For many first-time parents, this isolation can even happen in the home, as all Mom's energy is focused on a new little one, commonly, Dad can feel left out, or not needed. Many men find it difficult to express their concerns openly with a spouse or a friend. This pattern exacerbates these feelings of isolation and can further worsen depression.
Our 4 best tips to help your man avoid the blues.
Listening to Jim's experience helped me recognize some important points about how new parents can support one another. I recommend hearing this advice straight from our interview by watching it here. From Jim's advice here and my own from working with many men, I suggest the following four tips to help.
1. Give Dad one-on-one time with baby without you. For 9 months he's been prepping for the big day he becomes a Father. I hear from many men how once baby arrives, in the early years he feels disadvantaged because the baby always "needs" mom. Yes you have the milk, and the skills (but you developed those skills by spending time with your baby and figuring it out). Offer your man the chance to become a great father, by giving him the time to do it and showing your support for how he does. One important rule I had to learn was to accept the fact that it's okay if Dad doesn't do things exactly like I would - and in fact I found many of his ideas worked better (don't tell). Give him the chance to test out his baby skills by having regular one-on-one opportunities from the very start for Dad to improve his fathering skills.
2. Make your relationship a priority. Yes that baby is the center of attention but when he/she is grown, you still want to have each other. Relationships can't go backwards so wishing things were like when you met doesn't work. Your relationship is evolving. Scheduling time to be together, to talk, do something you enjoy together. Make it baby-free when possible, but even if it's those couple of hours that baby's sleeping, share it together, get to know the new people you are becoming.
3. Support each others needs. You know now you both need good sleep, exercise, time for relationships (and I'll throw in healthy foods too). Be willing to adjust your schedule to help him slip in a nap if he needs it. Take turns going to the gym or start a home exercise challenge. Work together to create good daily habits that support a healthy lifestyle. This may also include encouraging your man to talk to a doctor. Other problems that commonly pop up during the parenting years can look like depression such as thyroid disease, or substance abuse. Seeking advice from a professional can help identify these or other underlying issues.
4. Talk, and listen. Shut down those invisible conversations in your head that draw all the wrong conclusions by being the first to speak up, "Are you feeling okay?" And be eager to listen when he says he's "had a hard day." Learning to listen openly, non-judgmentally will bring him in, create a safe space for both of you to express what you're feeling, and open the doors to understanding.
Men and women entering into parenthood have a lot of adjusting to do. Entering into this period with a supportive partner, recognizing this is a chance to learn new skills, and focusing on the daily things in your lifestyle to better managing stress - will help build healthy habits for the entire family. These four tips are the basics that can keep baby blues away. Nevertheless, if either of you feel burdened by depression that's not improving with the basics, seek out a medical provider to help identify underlying stressors that may be holding you back from feeling your best.