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June 23, 2005
"We found a doubling of risk of behavioral problems in children
of fathers who had been depressed eight weeks after the birth," Ramchandani
tells WebMD. "The thing that is striking is there is the same
effect for fathers as has been established for mothers."
The
researchers analyzed data collected as part of the Avon Longitudinal
Study of Parents and Children. The study, based on questionnaires
and psychological tests, included 8,431 fathers, 11,833 mothers,
and 10,024 children. Data were collected eight weeks after
the birth of a child, 21 months after the birth, and when the
child was 3 years old.
The effect of a father's postpartum
depression is not quite the same as that of a mother's depression.
"The
mothers' depression effect is slightly higher than in fathers," Ramchandani
says. "Depression in mothers seems linked to a range of later
problems in both boys and girls. The father effect seems confined
to boys and to behavior problems -- but this is not definitive."
Postpartum
Depression: A Family Problem
The findings don't surprise Shari
I. Lusskin, MD, director of reproductive psychiatry at NYU
School of Medicine. Postpartum depression, Lusskin says, isn't
a mother's problem; it's a family problem.
"For a change, this
study turns the spotlight away from women onto the rest of
the family constellation," Lusskin says. "That is very important.
Women get saddled with all the blame, which further stigmatizes
postpartum depression and leads to women not getting diagnosed
or treated. So now we are spreading the blame."
Nobody is really
to blame, Lusskin is quick to point out. Mothers and fathers
don't get depressed because they are bad parents.
Treatment
for Mom and Dad
"Depression is a medical condition, not a moral
condition," Lusskin says. "If you feel that your mood is not
what it should be after the birth of a child, or if you feel
your partner's mood is abnormal, seek help and seek help early.
The sooner you get treated, the better -- and the fewer consequences
for the mother, the father, and the child."
Ramchandani, too,
argues that the focus should be on the family.
"This study
flags one thing: There is an effect of fathers' depression," he
says. "At the time of childbirth we focus on mothers. But actually
we should be paying attention to the wider family. The birth
of a child is a fantastic thing, but it is also a time of intense
change, and that impacts the whole family."
Treatment, Lusskin
says, should involve both partners -- not just the one who
seems to be depressed.
"If you seek help, advise your doctor
to meet your partner whenever possible, to assess the partner's
emotional well-being and involve the partner in your recovery," she
says. "A woman may be depressed but if her partner is even
more depressed and nonfunctional, she has to take care not
only of herself but her partner -- and can't rely on the partner
to help with her own depression."
Even if a person's partner
is not depressed, involving your significant other in postpartum-depression
treatment minimizes mixed messages and unintentional interference
with treatment.
"For example, if you going to give a woman
antidepressant medications during breastfeeding, it is good
to explain to her partner why you are making this risk/benefit
choice, so the partner does not misunderstand and sabotage
treatment," Lusskin says.
SOURCES: Ramchandani, P. The Lancet, June 25, 2005;
vol 365: pp 2201-2205. Paul Ramchandani, MD, consultant,
child and adolescent
psychiatry, University of Oxford, U.K. Shari I. Lusskin, MD,
director of reproductive psychiatry; and clinical assistant
professor of psychiatry and obstetrics/gynecology, NYU School
of Medicine.
© Associated
Press.
© 2005 ComStock,
Inc.
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Postnatal period and breastfeeding 