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Alison Stewart: This is All Of It on WNYC. I'm Alison Stewart. A recent Psychology Today article revealed that 1 in 10 fathers experience postpartum depression. Yes, I said fathers. While mothers are warned about the possibility of PPD and sometimes screen for it, fathers and non-birthing parents are not, making the diagnosis hard to come by and the experience harder to navigate. As part of our Mental Health Monday series, we have NYU professor, Dr. Erin O'Connor, whose team performed the study. She is the Director of NYU's Early Childhood Education program, co-host of a parenting podcast, Parenting Understood, and the Chief of Education at Cooper, a platform designed to bring parents, researchers, and teachers around issues of child development. Dr. O'Connor, welcome to All Of It.

Dr. Erin O'Connor: Thank you so much for having me.

Alison Stewart: We want to open this up to listeners. Have you or someone you love experienced postpartum depression as a father or non-birthing partner? How did you navigate it? Or maybe you have a question for Dr. O'Connor about it. Give us a call at 212-433-9692, 212-433-WNYC. You can call that number, or text to us, or you can hit us up on socials @allofitwnyc. Our number again, 212-433-9692, 212-433-WNYC.

Dr. O'Connor, what inspired you to study postpartum depression in fathers?

Dr. Erin O'Connor: Well, I think the real impetus for me was looking originally at non-birthing parents. I am a mother through adoption, as well as through biology, and I myself suffered from what we call it now more PMADs, so perinatal mood and anxiety disorder, with both of my daughters. It started me really thinking about how we don't give a lot of credence to the experiences of those who don't. We don't give enough credence to anybody, but especially those who don't give birth. That made me sort of delve into the literature around non-birthing parents and fathers, and recognize how little there is out there about this, and yet, at the same time, we do know that it does impact fathers and non-birthing parents biologically, psychologically, as it does those who birth the children.

Alison Stewart: A lot of people would say they didn't even know that a father could get postpartum depression or perinatal depression. First of all, why is that?

Dr. Erin O'Connor: Several reasons. One is there's actually a biological reason. There are changes in the neurobiology of the brain that occurs in fathers as well as mothers. There's changes in hormonal levels that occur in fathers as well as mothers as well as this massive shift in identity that is occurring for both moms and dads.

Alison Stewart: You're a professor at NYU, and you also co-host a parenting podcast, Parenting Understood. Tell me a little bit about the work you do.

Dr. Erin O'Connor: Right now, we're starting-- My most recent work is with a colleague at NYU, and we are looking at the perinatal experiences of mothers, fathers, and non-birthing parents. Right now we're in sort of the middle of analyzing data on a thousand birthing parents and interviewing them.

The survey data is predominantly about the birthing mother, but we are also collecting secondhand data from the birthing parent around the non-birthing parents experience in the transition. I shouldn't always say just the transition to parenthood, because I think it's a little bit of a misconception that this can only occur after the birth of a first child. There are plenty of stories of the first sort of perinatal period being fine, and then going on and having a second or a third child, and experiencing some challenges around that birth as well. What we're really interested in looking at is this perinatal period for not exclusively first-time parents and not exclusively birthing parents.

Alison Stewart: For Mental Health Monday, we're discussing postpartum depression in fathers with NYU professor and Early Childhood Education Program director, Dr. Erin O'Connor.

Listener, have you experienced postpartum depression as a father or non-birthing partner? How did you navigate it? Or maybe you have a question for Dr. O'Connor about it. Our phone number is 212-433-9692, 212-433-WNYC. You can text that number, or you can call into that number as well. You can reach out to us on social media @allofitwnyc. Just so we're clear, we've talked about it a little bit, but I want to make it absolutely clear you use the term perinatal instead of postpartum. What's the difference?

Dr. Erin O'Connor: Perinatal encompasses the period of pregnancy through the first year, and as opposed to postpartum, which is referring to sort of that year after the baby arrives. That said, there is even being a push to consider the perinatal period to maybe being more than just that pregnancy and that first year, but into the second year. We're seeing more and more people diagnosed with PMADs actually in the second year following a child's arrival. For now, it's considered pregnancy in that first year of life.

Alison Stewart: There's a lot of focus placed on moms post-birth for obvious reasons, but you state that 18% of fathers develop some sort of anxiety disorder, what might that look like?

Dr. Erin O'Connor: That can look like fear, I think a great example. In our research study, our participants have agreed to let their stories be heard. This one woman was telling a story about how when she would have to travel for work, her husband was terrified to take a shower. He was terrified to put the baby in the pack and play, and go and do anything, because he was convinced that if he was not with the baby, something bad would happen to her. Things like that, things like another story was a woman was saying, you know, they had the bassinet next to their bed. Her husband kept waking up screaming at night, that he felt like he had rolled over the baby and killed the baby, even though the baby wasn't even in the bed with them. I don't want to call them irrational, but these extreme feelings of anxiety around keeping the child safe and really alive.

Alison Stewart: Let's talk to Patrick, who is calling in from Fairfield, Connecticut. Hi, Patrick. Thanks for calling All Of It.

Patrick: Hi. Thank you so much for this segment.

Alison Stewart: Tell us your story.

Patrick: I'm an adoptive father in a same-sex relationship. Our son was born in the first month of lockdown. There were obviously a lot of emotions wrapped up in that, but I started to realize over time, for me, it was more than just lockdown anxiety. It was really related to the arrival of our child. I just remember feeling so isolated because I thought, there is not a word for this. In working with the therapist, even just hearing that confirmation that maybe that is what I was feeling and maybe more than women experienced that it was so helpful. I just want to say thank you for this segment and also to encourage people to check in on new dads and new parents of all stripes and genders, because there's not always somebody checking in on you when you are in a fathering role, especially medically in those early checkups.

Alison Stewart: Patrick, thank you so much for calling in. Yes, the question of isolation, how does isolation affect fathers?

Dr. Erin O'Connor: Affect fathers?

Alison Stewart: Yes. How do when you think about the isolation, that's what Patrick just said, really hit him hard?

Dr. Erin O'Connor: Well, I think there's such an isolation for both parents. To an extent, in that you don't have the same freedoms that you had before. You can't just leave the house. You have to always consider all these different factors. You often feel isolated from this life that you had before, but then if we look, there are support groups. I think we need to do a lot better, but there are support groups out there for mothers. If you google, there's a fair amount that comes up. It does not come up with fathers.

There was actually a piece-- I'm a huge fan of Emily Oster. In her newsletter, a father wrote in, Kevin McGuire, and he was talking about how he is in England, and he did a search in the National Health Service Directory for information on paternal postpartum depression. Literally what came up was, oh, you mean maternal postpartum depression.

I think there is a real sense of isolation for men and non-birthing partners in general because there aren't those groups out there really en masse, and there's not that awareness out there. It feels like, oh, my gosh, there must be something wrong with me, and I don't know where to go to find help because this isn't something that's widely discussed.

Alison Stewart: There were two things in the article about your study that I thought were interesting, attachment theory and one on cognitive behavior. First, how does attachment theory factor in?

Dr. Erin O'Connor: Well, I think, sort of in general, when we talk about parenting and we talk about attachment theory, we think about sort of these what we call internal working models, but these ideas of what parenthood looks like based on sort of how we were parented. If we have what we call a secure attachment to our primary caregiver in childhood, we're more likely to have that type of attachment with our own children.

I think what's interesting, too, especially when we're thinking about fathers is, and I'm not sure this really came out in the piece as much, but a lot of the emphasis has always been placed on sort of this mother-child attachment relationship, and so much research has been conducted on it. There are so many books about it and how to foster it. We, I think, as a community, have somewhat neglected that father-child attachment relationship, and looking at also just sort of role models and of how to do this, how to be a father and how to be a very engaged father with a secure relationship with their child.

I think that's something that also, we're just starting to really look at, especially the developmental psychology literature. The role that that father plays and being able to provide more information about that and what it looks like to be a dad who forms a secure relationship with his child.

Alison Stewart: Where does the cognitive behavior factor in?

Dr. Erin O'Connor: A lot of that, I think, sort of almost a fancy term for just sort of your own thoughts and how they get in the way.

Alison Stewart: Sure. Yes.

Dr. Erin O'Connor: Right. We've sort of had a lot of messaging that dad's roles are second in a way, I think. As a society, sort of, that's been a lot of what's gone on, and like mom does best, mom knows best, mom knows what to do. You get those messages playing in your head, and if you're not the mom, especially the biological mom, it can sort of play tricks on you. Like, oh, wait, maybe I don't know how to do this, and, of course, you do, but that's not necessarily the messaging that's been out there. Some of the cognitive behavioral therapy is thinking about how you change that message for yourself.

Alison Stewart: This is our Mental Health Monday, and we're discussing perinatal mood and anxiety disorders and postpartum depression in fathers. Dr. Erin O'Connor is our guest. We'll have more after a quick break. This is All Of It.

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You are listening to All Of It on WNYC. I'm Alison Stewart. For Mental Health Monday, today we're discussing postpartum depression and perinatal mood and anxiety disorders in fathers with NYU professor and Early Childhood Education director, Dr. Erin O'Connor. Listeners, have you experienced postpartum depression as a father or a non-birthing partner? How did you navigate it? Or maybe you have a question for Dr. Connor. Our number is 212-433-9692, 212-433-WNYC. Dr. O'Connor, we have Matthew from Sunnyside on line 2, calling in. Hi, Matthew. Thanks for calling All Of It.

Matthew: Hi. Good to be here.

Alison Stewart: Tell us your story.

Matthew: Yes, well, I'm father of a three-year-old. He was born right in the middle of the pandemic, but it was kind of a traumatic couple of days following his birth. He was in the ICU for about 48 hours, and my wife also endured a hematoma during the birth and was in an extraordinary amount of pain and didn't know what it was a few hours following. She had to have emergency that evening. Yes, I didn't see her or my son for about 24 hours following her birth, and I just got my head down and tried to navigate that as best as I could. Yes, in the months that followed, I never felt more depressed in my entire life to the point where I was kind of experiencing suicidal ideation, and, yes, it was this extreme dissonance of what, you know, ostensibly should have been a really happy and joyful moment, albeit in the middle of the pandemic, but then just not feeling like there was any way out of this deep, deep depression I was in.

It wasn't until a friend of ours related her own experience of postpartum depression, and mentioned that what I was going through seemed very similar to her. That gave me the impetus to actually get some help because I hadn't even considered that the non-birthing parent could actually have this response to becoming a parent. It was just such a relief to actually know that I wasn't the only father going through this necessarily, and that this is a thing. Yes, I found a therapist who deals mainly with parents, and it just felt so gradually began to feel much better afterwards and, really came to terms with what was happening in my life and kind of really helped me contextualize my own experience in relationship.

Alison Stewart: Thank you so much for calling in. We really appreciate it. Dr. O'Connor, did you want to respond to anything you heard?

Dr. Erin O'Connor: No. Thank you so much for sharing. I think that's also sort of an important step forward is men coming forward and talking about their experiences. We're supposed to not all, it doesn't always happen, but all birthing parents are supposed to be screened for postpartum depression at least twice, both when they are at the hospital or birthing center, as well as at their six-week follow-up and ideally pediatricians as well. What we have found in our sample of a thousand parents is that only one parent reported that their husband had been screened. I think it's just so important bringing that awareness up so that more dads like yourself are able to seek the help that will support them and their families.

Alison Stewart: How would someone who's experiencing PMADs or PPD, how would that affect the relationship with the child?

Dr. Erin O'Connor: That's a good question. Sort of going back to attachment theory, we always say, you know, sort of the two most important factors that within the parent-child relationship in those first, well, all along, but in those first three to six months really is how sensitive and responsive you're able to be. Sort of figuring out the baby's cues, the hungry cry, the tired cry, those sorts of things, and being able to attend to them in that manner.

As we know, if we're experiencing our own mental health concerns, it's harder to gauge someone else's needs and someone else's, you know, signals that they're giving off. When you have a newborn baby where it's very hard to know what they need, and then when you yourself are unable to sort of attuned to your own emotions, it's very difficult to be able to be. I'm not saying you can't, but it's much more difficult to be that sensitive and responsive parent that we know is so important for the parent-child attachment relationship.

Alison Stewart: We have two differing texts that we've gotten. We got one that says, thank you for this gender equity discussion, and then this on Twitter, it's truly an insult for those of us who go through an almost incomparable embodied experience. We can support fathers and non-birthing parents, and raise awareness without trying to make a fighting a competitive battle around postpartum depression. I'm curious what you think of the two responses.

Dr. Erin O'Connor: I think that's a valid point. I think the idea is that we're all in this together, not that it's one versus the other, right? That acknowledging that perinatal mood and anxiety disorder is more prevalent among birthing mothers. It's an incredibly traumatic experience, but we're also seeing that it is also evident among fathers and non-birthing parents, and that, I think working together to raise awareness across the board is where we're going to move forward and make sure that parental mental health gets the supports that it needs.

Alison Stewart: What do you wish more people knew about this issue?

Dr. Erin O'Connor: Well, I think, (a) that they knew how prevalent it was, and (b) that they also knew more about the symptoms. I think we talk a lot about postpartum depression, which, of course, is very important to talk about, but there's also postpartum anxiety, there's OCD, there's suicidal ideation. There are a lot of other mental health concerns that go along with PMADs, and I think being aware of those so that people are willing to or able to hopefully find the supports that they need. I think something that's come up a lot in the interviews that we've done is a lot of the women have reported high levels of anxiety, but not necessarily feeling depressed, but just very, very anxious, and not really recognizing that it was PMADs. It was just anxiety. It wasn't depression manifesting itself.

Alison Stewart: If someone is listening to this, and they're thinking this might be me, I think this might respond to me, what should they do? Where should they go?

Dr. Erin O'Connor: Well, in an ideal world, your obstetrician should be able to provide resources for you, as well as pediatricians. Pediatricians have a lot of, not necessarily resources available unless you ask, but if you ask, they can be great sources of support for parents, as well as their children. I hate to send folks blindly to the web, but there is a lot of great information online, and I am blanking out of the name right now. I will send it.

Alison Stewart: We'll make sure we get it. We'll make sure we put it online. You should also tell people the Crisis Lifeline. If you're listening, and you need support, you can call or text 988 for Mental Health Crisis Services and counselors that are available 24/7.

Dr. Erin O'Connor from NYU, thank you so much for all the information.

Dr. Erin O'Connor: Oh, thank you so much for joining me, and for raising this really important matter. Before I go, it's the Postpartum Support International is where I would send folks.

Alison Stewart: There you go. Thanks so much.

Dr. Erin O'Connor: Thank you.

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