Abstract Postpartum depression (PPD) has been identified as a mental health condition that impacts women, men, and families. PPD has been shown to be prevalent in both women and men following the birth of a child; it has been associated with marital conflict, insecure attachment, and poor infant-child outcomes. While PPD has been studied extensively in women, paternal PPD often goes understudied, undetected, and untreated. The purpose of the present research was to explore the lived experiences of men who have experienced PPD through the lens of self-perception theory using a qualitative phenomenological study. Six men who have experienced PPD shared their lived experiences with PPD, including how they recognized they had a problem and what alerted them to get help. Data were analyzed using coding and the development of themes; the findings for this study showed that men's lived experiences with PPD included feelings of sadness, anger, fear, confusion, and being in denial. The men tended to not seek help for their experiences of PPD, and they were not previously informed about the disorder of paternal PPD. The present study provides a better understanding of PPD for fathers, information for healthcare providers who deal with expectant fathers, and significant others such as mothers of the child, and other family members and coworkers regarding how to respond to paternal PPD. Better understanding of PPD will provide fathers with more of the support they need to successfully make the journey through PPD.

Sammanfattning Syftet med den föreliggande litteraturstudien var dels att beskriva hur faderlig postpartumdepression påverkade familjens livssituation samt att beskriva vilka tecken och riskfaktorer som fanns för faderlig postpartumdepression. Empiriska vetenskapliga artiklar söktes i databasen Medline (PubMed) och fjorton artiklar valdes ut. Artiklarna kvalitetsgranskades avseende urval och bortfall och tabeller över studiernas metod- och resultatbeskrivning sammanställdes. I den föreliggande studiens resultat framkom att en ökad risk för ”parsjuklighet” fanns och även barnen påverkades, då barn till deprimerade fäder i högre grad riskerade att drabbas av temperamentsproblem. Deprimerade fäder upplevde det svårare att hantera sitt barns temperament. Fäderna blev mer irriterade och hade mindre tålamod för barnet vilket gav färre positiva föräldra-barn interaktioner, vilket i sin tur påverkade barnens vokabulära utveckling negativt. I den föreliggande studiens resultat framkom även att fadern kan uppvisa känslomässiga yttringar i form av exempelvis irritation och ilska som tecken på postpartumdepression samt att prenatal depression var en riskfaktor för fadern att drabbas av postpartumdepression. Ingen av de granskade studierna bedömdes ha låg kvalitet och endast två studier bedömdes ha medelkvalitet efter utförd granskning. Författarna till föreliggande studie anser att depression hos fadern bör identifieras och uppmärksammas eftersom tillståndet inte bara kan få konsekvenser för partnern utan även för barnets välbefinnande och utveckling.   Nyckelord: Faderlig postpartumdepression, Familj, Livssituation, Riskfaktorer, Förebygga. / Abstract The purpose of this literature study was partly to describe how paternal postpartum depression effects the life situation of the family and to decribe which signs and risk factors that exist for paternal postpartum depression. Empirical articles were searched in Medline database (PubMed) and fourteen articles were selected. The articles were reviewed for quality regards the selection and dropping. Tables of the articles method and result description was compiled. Result of the present study revealed that an increased risk of "couple morbidity" existed and even the children were affected. Children of depressed fathers were more likely to have temperament problems. Depressed fathers felt difficulties in dealing with their childs temperament. The fathers became more irritable and had less patience for the child which resulted in fewer positive parent-child interactions, which in turn affected the children's vocabulary development negatively. The results of the present study also revealed that the father may display emotional expressions in the form of irritation as well as anger as a sign of postpartumdepression and that prenatal depression was a risk factor for the father to suffer from depression. After performed review none of the selected studies were judged to have low quality and only two studies were judged to have medium quality. The authors of the present study consider that depression in the father should be identified and addressed, since depression not only can have consequences for the partner but also on the child's welfare and development. Keywords: Paternal postpartum depression, Family, Life situation, Risk factors, Prevention.

Postpartum depression (PPD) is a medicalized condition that exists on a continuum of postpartum mood disorders. PPD is reported to be experienced by 10-15% of mothers and 10% of fathers during pregnancy or after the birth of a baby. PPD, as experienced by either parent, is considered a serious condition because of its potential short- and long-term negative impacts on the developing child. In this thesis I explore how motherhood and fatherhood are constructed in the context of articles on maternal and paternal PPD in Canadian and American newspapers. Specifically, I focus on how references to the opposite partner were used to position each parent, and how each parent was positioned with respect to the new baby. In the articles on maternal PPD, husbands were either inconsequential to the story, positioned as being absent, or constructed as supporting the mother through instrumental and action-oriented behaviours. In addition, mothers were constructed as lonely and isolated because of self-imposed limitations (e.g., feeling ashamed for not being happy). In the articles on paternal PPD, the mother-father relationship was based on differences and competition. Fathers were constructed as isolated, lonely and misunderstood, most often through mother-blaming, such as by positioning the mother as responsible for the father’s well-being (e.g., causing his PPD), and by labelling PPD “a woman’s domain.” Fathers’ loneliness was presented as being due to imposed limitations of others (e.g., others did not properly prepare fathers for fatherhood). Mothering was constructed as being instinctually skilled, tolerant, and self-sacrificing, with the inherent capability to manage multiple roles and changes. The mother-baby relationship was constructed as naturally joyful, all-important and –consuming. Fathers were not expected to be as skilled or instinctively prepared and tolerant, to engage in chores/childcare, or to be explicitly overjoyed with the baby. Mothers were blamed for their distress in the role, while others were blamed for fathers’ distresses. Gendered stereotypes in the parenting role were perpetuated in these newspaper articles. Parenthood was not constructed as a collaboration, but rather motherhood and fatherhood stood in isolation from each other, with motherhood positioned as the primary role. These constructions continue to maintain fathers in the background of parenthood as an “other,” and to position mothers as responsible for the well-being of her partner, child(ren) and herself.

While major depression is a well-defined mental health condition, it's presentation can be vastly different across individuals and groups, and many factors impact one's vulnerability. A critical period of vulnerability to depression is the postpartum period. Despite the frequent assumption that postpartum conditions solely affect women, prevalence estimates of paternal postpartum depression (PPPD) are comparable with those of women. Similar to mothers, men experience significant biological and psychosocial changes following the birth of a child that contribute to the onset of postpartum depression. A growing body of research has identified many potential variables related to PPPD, yet there is no clear consensus as to which variables are the most impactful. Following PRISMA guidelines, we conducted a meta-analysis to aggregate the known findings and quantitatively determine the most salient predictors of PPPD. We hypothesized that the psychosocial factors of relationship satisfaction, social support, partner depression and history of depression would yield the strongest aggregate effect sizes. By searching databases using logical operations, as well as conducting backward and forward searches, we identified 129 articles that met inclusion/exclusion criteria with a total sample size of 114,712 participants (79,743 fathers). Trained independent coders extracted data directly from identified studies, including sample characteristics for descriptives and moderators, and demographic correlates. Correlates of primary interest include but are not limited to maternal depression, history of depression, relationship satisfaction, and social support. Effect sizes represented as Pearson correlations (or transformed to r using standard procedures) were calculated and compared using a random-effects model. In partial support of our hypothesis, fathers' reported history of depression had one of the largest effect sizes (r = .469, unbiased r = .368). The other primary psychosocial factors had relatively moderate effect sizes: social support, r = -.359 (unbiased r = -.398); relationship satisfaction, r = -.300 (unbiased r = -.266); and partner depression, r = .294 (unbiased r = .471). The correlates of PPPD with the strongest effect sizes were all factors associated with personal distress and stressful pregnancies. Demographic correlates (i.e., younger age, non-White ethnicity, lower education, unemployment, lower SES) generally had small though statistically significant effect sizes. This study helps provide a clearer picture of what predicts PPPD to more accurately screen for men at greatest risk and inform the development of diagnostic measures and treatments. It also lays the groundwork for future work in a more unified and productive direction. By researching and sharing better information, we can provide better access and better outcomes for postpartum couples.

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