Ask the Doctors: Can husband have postpartum depression?

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Q: My husband has seemed really down since the birth of our son six months ago. We're both being run ragged, and very proud of our son, but my husband seems less happy than I had hoped he would be. Could he be suffering from postpartum depression? If so, how? I'm the one with the hormonal onslaught!

b "Running ragged" is a good description of parents in the first year of a child's life. Many have described it as going into a tunnel. Metaphorically, it can get mighty dark in there. Parents and their new child grope around to find some sense of normalcy, when every day brings a new change or a new obstacle. Adding to these challenges for women is the drop in the hormones estrogen, progesterone and oxytocin after pregnancy, which can trigger mood fluctuations and postpartum depression. Men don't have that same hormonal drop, but that doesn't mean they don't experience changes.

Studies in mammalian fathers, including humans, who take care of newborns have shown drops in their testosterone levels after birth and a rise in their levels of prolactin, a hormone typically linked to a female's ability to produce milk. Evolutionarily, it makes sense that men who are helping to take care of children should have a drop in testosterone. Testosterone is needed for procreation, which should be the last thing on a dad's mind when he's taking care of a child. In fact, studies in multiple societies have found that the more hours a father invests in childcare, the lower his testosterone level will be.

A recent study in the journal Hormones and Behavior attempted to evaluate levels of testosterone and postpartum male depression in 149 low-income males (30 percent had household incomes below the poverty line). Fathers and mothers were assessed for postpartum depression, parenting stress, relationship satisfaction and intimate partner aggression. These assessments were performed one to three months after birth, six to nine months after birth and 12 to 16 months after birth. Also, at nine months after birth, the fathers underwent salivary testosterone testing.

Lower testosterone in fathers at nine months after birth correlated with increased depressive symptoms at that time, but not when depression was tested again at 15 months. Men with depressive symptoms at nine months also reported increasing parenting stress six months later. Interestingly, though, lower testosterone in the father at nine months was associated with less postpartum depressive symptoms in the female partner at nine months and 15 months.

The men with higher testosterone levels had decreased depressive symptoms at one to three months after birth, but this did not hold true at the six-to-nine month and 12-to-16 month intervals. However, the female partners of the men with higher testosterone levels reported more depressive symptoms and more feelings of aggression from their partner at the six-to-nine and 12-to-16 month intervals. Also, men with higher testosterone levels had increased parenting stress at 15 months.

The findings are complex, but they show that hormone levels do indeed fluctuate in men, affecting their psyche, their outlook and their relationships. Specifically, higher and lower levels of testosterone are linked to psychological changes in both parents.

As you know, being a parent isn't easy. Aside from the hormonal changes, parents of both genders can face financial pressures, sleep deprivation and the realization that life has changed dramatically. Each person processes and adjusts differently. My advice: Keep communicating. Your son will benefit from it.



Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.
     Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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