Presentation Title

Postpartum Depression in Men: Evidence That Calls for Refining a Paradigm

Abstract

Science proceeds through disconfirmation. Theories appear that seem to explain the data and, once these theories crystalize into a paradigm, disconfirming evidence tends to be discarded until sufficient disconfirming evidence accumulates to produce a sort of tipping point. We are at such a precipice now in our knowledge of postpartum depression. Much has been written about women’s experience of pregnancy and postpartum, most of it exploring negative reactions ranging from clinical depression to postpartum psychosis and infanticide and most of it attributing negative reactions to the unique physiological changes that women experience during pregnancy and parturition. But the incidence rates of depression among birth mothers and adoptive mothers is the same, and the incidence rates between mothers and fathers is not statistically significant. Postpartum depression in adoptive parents and in fathers provide the evidence necessary to tip our "hormones only" paradigm to something broader, more nuanced, intricate and multidimensional.

Partners preparing to welcome a baby share the experience and influence one another at many different levels ranging from internal and hormonal to the external and social. Studies repeatedly show that “close contact with a pregnant partner can induce hormonal changes that enhance and accelerate the onset of paternal responsiveness in some men, as has been found in nonhuman animal studies”[6]. These hormones seem to prepare men for fatherhood and encourage responsiveness to an infant as males who have never reproduced ignore, avoid, or aggress toward infants of the species. But this only happens in cultures where the marriage partnership is intimate and emotional. Similarly, men also experience birth with a wide range of emotions and biological changes and these vary across cultures. Thus, postpartum depression can no longer be seen as primarily a pathological variant of female reproductive processes. Our existing paradigm is too small, it must be modified.