What Postpartum Depression Looks Like in Men (And Building the Tool I Wish I'd Had)
A postpartum depression test for fathers—and the essay that started everything
January marked half a decade of writing this newsletter to you all. But this week is the real anniversary, because Tuesday was five years since I pressed publish on my essay about paternal postpartum depression. My experience after my son was born drove me to start writing, in the hope that others out there might find the help I once sought so desperately. That essay—originally titled “When Fatherhood Doesn’t Go to Plan”—was the beginning of it all: the newsletter, the book, the therapy fund, all the work I now do; those branches trace back to that single trunk.
Many of you found your way here after Emily Oster shared this story in her ParentData newsletter. And a fresh version of this story will be among the first things dads read in my book when it comes out in May. This story has grown, been reshaped and expanded through conversations with dads across the world, but the core of it remains the same. I’m running it again today with a very deliberate, on-the-nose headline—because I remember Googling “new dad depression” and “new dad sad” in vain, on long dark nights when things were falling apart. The entire reason I started this newsletter was the hope that other dads might find help in their time of need.
And now, if one of those dads arrives on these shores, I want him to find something I didn’t have: a tool. I’ve built a paternal postpartum depression assessment, developed using the latest peer-reviewed research and with input from three therapists and counsellors—Alan P. Bader, Maria Lee, and Gareth Clark Jones—who all work with dads via The New Fatherhood Therapy Fund. (Also, shout out to Claude Code, who played a huge part too.) If you’re a dad reading this and things don’t feel right, take the assessment here. And if you’d like to speak to a counsellor, wherever you are in the world, you can apply to our direct access fund here.
One last thing. For the last few days of February and the entire month of March, 100% of paid subscriptions that come through this newsletter will go directly into the Therapy Fund to help dads who need it most. If you’d like to donate without Substack taking a cut, you can do so here.
After my son was born, at around 8 p.m. each day, once the kids were tucked up in bed, I’d take the dog for a walk—just the two of us. The smell of the balmy Mediterranean evening, a warm glow slowly setting on the horizon. I’d walk to a park—far enough from home to prevent bumping into someone I knew, but close enough not to arouse suspicion—to sit on a bench. And cry.
I spent most of the summer of 2019 wondering what was wrong with me, and why I didn’t love my son. He was born three months earlier: happy, healthy, and everything we could have asked for. After settling into the unique cadence new parents face—moving abruptly between adorable vignettes and constant sleep deprivation—I started to sense something wasn’t right. The thought didn’t arrive fully formed; a dull background static, initially attributed to exhaustion. But when it remained, after even the occasional eight hours of sleep, I started to question what I was feeling. A darkness had crept upon me since his birth. I was getting angry all the time, over the smallest things. I didn’t want to be close to my wife. Didn’t want to play with my daughter. Didn’t want to talk to friends. Getting through each day was a struggle, like wading through mud with a 50-kilo weight strapped to my back. And, most painfully of all, I didn’t want to be near my son.
Hearing him cry was like nails scraping down a chalkboard. And he cried—a lot. At least I thought he did, though I now realise my mind was playing tricks on me, blowing this small thing out of proportion, like it was treating everything else: molehills transformed into mountains, trapping me within. I avoided any attempt to solve the problem he had, because my mind told me he’d only start crying again soon after. What would even be the point?
So I shrunk away. From being a husband. From being a father. I went to a dark place.
While sitting on that bench crying, my eternally sad basset hound watching tears run down my face, I tried to get a handle on what was happening. With hindsight, I’m lucky this was my second child and I had some kind of benchmark to compare it against. I knew that what I was feeling wasn’t “normal,” so I started searching online about why I might be feeling this way. Whilst googling things like new dad sad and why am I crying new dad, I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief: ongoing feelings of anger towards your partner and child, feeling numb and empty, increased irritability, increased use of alcohol, significant weight gain or loss, loss of interest in work or hobbies, feeling sad and crying for no reason.
Paternal postpartum depression. PPPD. I had no idea it existed.
I was aware of postpartum depression. All dads-to-be are. We’re warned about it, advised on the signs to look out for when your wife, or other women in your life, have a baby. But there were slim pickings when trying to learn more about a father’s mental health after a newborn comes into their life. On the World Health Organization’s website, searching for paternal mental health returned the non-helpful “Did you mean: maternal mental health?” Paternal postnatal depression still returns zero results on the UK National Health Service’s website, and back in 2019 I’d read that some mental health charities wouldn’t allow male writers to use the term paternal postnatal depression when talking about the problem—they were only allowed to refer to it as “depression for dads.”
PPPD is not as widely acknowledged or well-researched as postpartum depression in mothers, so the papers we rely on are spread across decades, not years. A 2003 paper said it could affect as many as 25% of new fathers (or 50% for those whose partners already show signs of postpartum depression), a 2015 paper from Japan pegged the number at a very precise 13.6%, whilst a meta-analysis from 2010 suggested the figure as somewhere between 8% and 13%. But it’s impossible to know the true number, because men are less likely to seek help, to reveal negative thoughts to partners, friends, or health-care professionals, or to be routinely screened in the way new mothers are.
The Edinburgh Postnatal Depression Scale (EPDS) has become the go-to method of screening postpartum depression in new mothers, and many countries will routinely administer it, passing cases forward if the score indicates the potential of PND. But fathers are not asked the same questions, even though research suggests that the same questionnaire, with a lower cut-off point, would uncover many cases.
How many cases might that be? Let’s take a look at the UK, where I’m from and where the EPDS originated. Assuming the 2019 ONS figures of 640,370 new babies born in the UK (and removing 12.8% of lone-parent mother households), there are around 558,000 new fathers in the UK each year. Even assuming a fairly conservative estimate of 10% of new fathers experiencing PPPD, that means as many as 55,000 men, each and every year, with the vast majority suffering in silence.
Research shows the knock-on effects of undiagnosed cases can harm generations to come—for example, with children of depressed fathers twice as likely to develop a psychiatric disorder by age 7, and 2.8 times as likely to use mental health services when they become adults.
The changes happening in fatherhood are altering the very landscape of parenting. A problem previously thought of as only happening to mums now needs to be considered for dads, too. As men take more active roles in the upbringing of their children—with many attempting to equally co-parent, or the increasing number choosing to become stay-at-home dads—we’re shouldering the burden of sleep deprivation, the pressure to be both a perfect parent and productive employee, and the many things that have contributed to postpartum depression in women over the years.
When I look back on photos from that time, I don’t recognise the man in the picture. Of course, there are photos of me holding my son and smiling; I knew well enough to put on a happy face for those. But there are other photos—ones where I don’t know I’m in the background, walking in the park, or sitting on the sofa. And that man looks broken. Truly defeated. Empty. Shattered, in every meaning of the word. I look at him and realise what my wife must have felt, seeing the man she loves so far removed from the person she fell in love with. I needed help. I’m thankful that she was there to give it.
We figured it out together. Worked on a routine to get things back on track. I started therapy, a daily meditation practice, and exercised regularly. Worked hard to get a good routine back into my daily life. Cut out bad habits that were putting me in a negative headspace. And purposefully spent time with my son, on our own, building the belief that I could do this.
One thing that helped was opening up to other dads in my life. I started talking to friends about my problems, and realised that I wasn’t alone in these feelings. When I started to feel better, I began reaching out to friends who had recently become dads, making sure they were doing okay (and telling them it was fine to talk if they weren’t). I started writing about my experience in the hope it might help others—these essays became the start of The New Fatherhood, a weekly newsletter I’ve continued writing about the highs and lows of being a modern dad. Since first sharing my PPPD story, I’ve had dozens of emails from people thanking me for opening up, helping them identify the same symptoms, encouraged to seek help. I’ve continued writing about the importance of mental health since. Since 2022, I’ve used the revenue from my newsletter to create a direct-action therapy fund that helps dads access therapeutic support, no matter where they are. The dads (and curious mums) reading contributed enough to help almost a dozen dads.
Paternal postpartum depression tears families apart. It makes men resent their children—at one of the most pivotal, wonderful times of their lives, and maybe forever—because they don’t get the help they need. There are thousands of undiagnosed dads, silently suffering, unsure of why they feel this way. Taking it out on themselves. Their partners. Their family and friends. And, worst of all, on their children. It’s only through bringing these issues into the open—be it a newsletter about fatherhood, or a moment of vulnerability between two friends—that we can hope to change things for the better.
Let’s Hear From Other Dads
In the five years since publishing this essay, I’ve heard from dozens of dads. I’m sharing a few of their emails and comments, with permission, here, to let you know that if you are feeling this way, you are not alone.
My 2nd born were identical twins and everyone kept telling me what a gift I received. About 3 months in I remember telling my wife that they took everything from us and I wish they were never born. Playing FIFA until 4am, sleeping forever and still being tired. Calling myself a wimp and a loser because I can’t process this on my own. We just celebrated their 3rd birthday last weekend. I woke up crying and hugged my wife. Everything has been clicking for about 8 months now after I got help. I don’t know if I could have done it without your essay. Nick
Today was the first time when I had the courage to research what the hell happened to me in the last two years. I cried reading your article and it was somehow relieving. Maybe I will find the courage to also share my story and seek help because I am in a really dark place now. I really thought I was alone in this. Charles
My daughter is now 13 months and I have recently had to take some leave from work, as my depression and anxiety became unbearable. I carry immense guilt to not be the partner and parent that I had thought I would be right now. Thank you for sharing. Thank you for helping me not feel alone and so ashamed. Nate
When my daughter was born, I was struggling with what I didn’t realize at the time was postpartum depression, a phenomenon I associated with new mothers but didn’t know could affect fathers, too. It was largely through Kevin’s writing that I was able to put a name to the intense shame I felt about my early relationship to both my daughter and parenthood. Daniel
I was diagnosed with paternal postnatal depression about 6 months after my son was born. Up until reading this I have struggled to find anyone dealing with the same thing. All the Dads I met through NCT seemed fine and loving fatherhood. It just pulls you further and further into the hole. It’s so good to know that others go through the same thing as it’s so easy to fall into the mindset that there is something fundamentally wrong with me. Alex
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It was this essay that got me to start writing to my son. A million thank yous ❤️
Thanks for sharing this