with Dr. Pierre Azzam, Psychiatrist
WHAT YOU’LL LEARN
- Why Mental Healthcare for Dads Is So Important
- How Postpartum Anxiety Shows Up in Dads
- Intrusive Thoughts and Postpartum Anxiety for Dads
- Factors that Affect Paternal Mental Health
- What Dads Can Do If They Experience Postpartum Anxiety
Can dads get postpartum anxiety? The answer is yes! Just like moms, dads are at increased risk for anxiety in the postpartum period. Paternal mental health matters too.
Today, I’m joined by psychiatrist Dr. Pierre Azzam, founder of Braver Man, to discuss the signs and risk factors for postpartum anxiety in dads, and why caring for the mental health of the whole family matters.
Expanding the Mental Health Conversation to All Partners
I spend a lot of time talking about maternal mental health. As a mom therapist, a mom, and someone who has experienced postpartum depression myself, I know how much it matters.
But I also know that men can get postpartum anxiety and postpartum depression as well—and that their mental health is also important.
Whenever I write or speak about dads, I often receive pushback. People are concerned that focusing the narrative on paternal mental health somehow shifts the conversation away from moms.
But I don’t believe that’s true. I believe that mental health matters for the entire family. I believe that addressing the gender norms and pressures around all partners matters. I also believe that having more conversations and less stigma around mental health benefits us all.
And, while there aren’t enough resources available for moms, there are even fewer for dads. When I started searching for dad support, I found very few options out there.
So when I came across Dr. Pierre’s work, I was excited to have another voice for dads on the podcast. I couldn’t wait to dive in and hear his perspective on why dads are at risk for postpartum anxiety and what we can do to help.
Why Mental Healthcare for Dads Is So Important
Dr. Pierre pointed out that mental healthcare is often lacking for both moms and dads—especially when it comes to postpartum anxiety. But he also believes that expanding the conversation to include all partners is important.
He said that mental healthcare isn’t a zero sum game. Broadening the conversation shines a light on the fact that we need more resources for all partners.
Additionally, evidence supports the fact that the more we help one parent, the more we help the family unit. All parents are at increased risk for developing postpartum mental health concerns. But your chances are higher if your partner is suffering.
Instead of viewing paternal mental healthcare as taking away from moms, we need to view it as a collective concern—the more understanding and resources we can gain for everyone, the better.
Dr. Pierre pointed out that research on postpartum anxiety is limited—especially for dads. Because of that, it’s not easy to get a clear picture of the amount of dads that are struggling with it. But most research estimates the number to be around 1 in 10 dads.
Another factor that complicates the conversation about paternal postpartum anxiety is that the concept of anxiety is broad. With depression, the symptoms are often easier to identify. But the term anxiety often encompasses general anxiety, OCD, panic disorders, PTSD, and social anxiety. This means we don’t have a clear picture or a standardized experience for anxiety.
It also makes it harder for people to distinguish anxiety from their normal baseline experience—especially if they were already prone to worry. Because the postpartum period is a time of change and worry, it becomes even more difficult to identify postpartum anxiety both in moms and dads.
How Postpartum Anxiety Shows Up in Dads
While there are some similarities, postpartum depression and postpartum anxiety can show up differently in dads than in moms. In dads, depression tends to peak around 3-6 months postpartum, while anxiety often hits right around the time of delivery.
Postpartum depression often shows up in dads as withdrawal, avoidance, numbness or feeling depleted, attacks of anger and irritability, and an increased use of alcohol or other substances.
But the signs of postpartum anxiety aren’t as clear. For many of the dads Dr. Pierre works with, some of the signs are an overwhelming sense of dread, being stuck in their own heads, or worry that impacts their sleep. Other dads go through anxiety of being in public spaces.
Dads also often experience panicky, agitated, intrusive thoughts. This can be particularly difficult for dads who have been through traumatic experiences, especially if their partners went through birth trauma. Traumatic births often leave dads feeling terrified and out of control, having to make scary decisions and face intense fears.
Postpartum anxiety in dads often centers around a feeling of powerlessness or helplessness. Dads have often been socialized to be in control of their emotions, to appear stoic and strong. So when they start to feel out of control, it can become a breeding ground for intrusive thoughts and worries.
Intrusive Thoughts and Postpartum Anxiety for Dads
Intrusive thoughts are our brain’s way of reminding us to be on guard for the safety of our children. But they often become distressing or scary—as if the volume on our internal alarm gets turned up too loud.
Dr. Pierre pointed out that while the research shows that 80% of fathers experience intrusive thoughts, the number is likely higher. He believes it is an almost universal experience.
Intrusive thoughts in dads are commonly associated with the safety of the baby—thoughts of the baby being harmed or even thoughts of intentionally harming the baby. This can cause immense amounts of stress.
When a dad has been conditioned to view protecting as his ultimate role, and experiences thoughts of harming a baby, it also becomes a big source of deep shame. Dads might wonder if there is something wrong with them when they have these thoughts. They often feel as though these thoughts clash with their core beliefs and their identity as dads.
They might be hesitant to talk about these thoughts or admit their struggles, even to their partners. Sometimes they begin to withdraw and avoid contact with the baby out of fear that they might hurt them.
Dr. Pierre pointed out that intrusive thoughts are not indicators of desired actions or latent intentions. They are natural experiences that come from a protective place. Understanding what intrusive thoughts are, and practicing awareness about them, can help. It’s also important to understand that there are many dads and moms experiencing these thoughts—you are not alone. The more we normalize them, the less we will hold onto the shame that they often bring.
Factors that Affect Paternal Mental Health
There are many factors at play when it comes to postpartum anxiety for dads. Some of those factors are physical, such as sleep deprivation and hormonal changes.
Research has shown that dads go through similar hormonal shifts as moms. Biologically, this prepares them to be nurturers and bond with the baby. However, those dips in hormones also put dads at risk for mental health struggles.
Gender norms and social pressure also play a role. Many dads have been told that they must be strong. If they struggle, it can feel like they are failing.
It’s important to remember that anxiety happens in our brains—it’s not our fault. If we can shift our mindset from viewing it as a flaw, we can develop a growth mindset and see that there are skills we can learn to control it and keep it from tormenting us.
Dr. Pierre said that a big part of working with dads is recognizing the stories we tell ourselves about what it means to be a good father. Dads can work toward that goal, and embrace the vulnerabilities that come along the way—they aren’t mutually exclusive.
Recognizing and naming our vulnerabilities, and even embracing and sharing them, allows dads to cultivate the growth they need to become the fathers they want to be.
These narratives might include being a good protector, being a provider, being present with the family, or even being the type of father they didn’t have growing up.
Dr. Pierre said that it often relates back to the fallacy of trying to show up as the perfect parent. Just like the perfect mother myth, dads often have an unattainable bullseye of perfection they try to reach. Mistakes can feel like missteps, leaving dads wondering if they are cut out for the role.
What Dads Can Do If They Experience Postpartum Anxiety
Dr. Pierre pointed out that one of the hardest parts of a dad experiencing postpartum anxiety is the sense of loneliness and isolation.
Sometimes dads don’t want to vocalize their struggles, whether that’s because of the stigma, social pressures, or simply not wanting to burden their partners if they are going through a tough time.
Dads can often cling to self-sufficiency, trying to just muddle through their mental health concerns.
But in reality, the loneliness can prolong the anxiety. Dr. Pierre recommends dads seek father support groups, locally or virtually. It can help to hear what other dads are going through.
Dr. Pierre is also an advocate of programs that partners work through together. He pointed out that research has also shown that moms and dads who work on mental healthcare together do better than those who work independently of each other. It can create a sense of teamwork, cooperation, and emotional intimacy to come together and support each other.
If you find yourself struggling, remember that seeking help isn’t selfish. It isn’t weak. It isn’t a burden. Your mental health matters—both on an individual scale, and to the entire family unit.
Are you struggling and unsure where to turn? Our Wellness Center can partner you with a virtual therapist in your area who specializes in the adjustment to parenthood. Book a FREE 15 minute consult today!
Dr. Pierre Azzam is a psychiatrist turned professional coach who specializes in working with men at times of major life transition, including early fatherhood. He’s worked alongside several professional organizations, including the American Psychological Association, Postpartum Support International, and Marcé Society to raise awareness related to mental health for mothers and fathers, alike. Pierre serves as contributing editor for the “Handbook on the Psychology of Fatherhood,” a textbook which is due to be released in October, and runs Braver Man, a platform for men’s professional coaching and mental health awareness.