Postpartum Depression is Real for Fathers, Too

Traditionally, postpartum depression among women was thought to be primarily due to hormonal changes that occur during pregnancy and childbirth, but new studies suggest that it is not just mom who gets the “baby blues.” New fathers are also at risk for depression after childbirth.
Researchers performed an analysis of 43 studies that involved over 28,000 new fathers. About 10% of men whose partners who are pregnant or have recently given birth report symptoms of depression. This is about twice the usual rate of depression in men. The peak period for paternal postpartum depression is when the baby is 3 to 6 months old, according to the study published in the current issue of the Journal of the American Medical Association. About 25% of fathers reported depression during this time.
Read: Postpartum depression is Part of Mental Health Awareness
Further research suggests Dad's depression may express itself differently than Mom's. Men are more likely to be irritable, angry, or withdrawn instead of the sadness that is typically seen with female depression. Family members should look for these behaviors as "red flags," the authors write.
Research authors Gregory Simon, a psychiatrist with Group Health Research Institute in Seattle, and James Paulson of the Eastern Virginia Medical School say they still need more research to determine the cause. The most likely reason is the onset of stress that occurs with any major life change. Paulson says, “Going from being a single person to a parent is a real shock, and certainly both parents trying to cope with a big change in life can be stressful.”
Other factors that may play roles in the increase in depression symptoms include financial stress, relationship changes between partners, and sleep deprivation. Behavioral changes in the child also occur during this period, such as crying or being more demanding for attention. Paulson also speculates that the timing of the depression correlates with the ending of maternity leave, which is typically between 6 weeks and 3 months after childbirth.
While many fathers may try to ignore the signs of depression, the authors warn against it. Depression from either parent can have a “cascading effect “ throughout the entire family. "There's evidence growing that depression in fathers is negative for children, and increases the risk of emotional and behavioral problems," says Paulson. Women are also more likely to become depressed when the male shows symptoms.

How Culture May Affect Depression Diagnosis

A new study of depression from the Center for Addiction and Mental Health examines the widely held expectation that East-Asian people emphasize physical symptoms of depression, and offers clinicians valuable insight into cultural context when assessing a patient, leading to more accurate diagnosis.
New data may help doctors more accurately diagnose patients who may be suffering from depression.
The expectation that East-Asian people emphasize physical symptoms of depression (e.g. headaches, poor appetite or aches/pains in the body) is widely acknowledged, yet the few available empirical studies report mixed data on this issue. A new study from the Centre for Addiction and Mental Health (CAMH) debunks this cultural myth, and offers clinicians valuable insight to into cultural context when assessing a patient, leading to more accurate diagnosis.
Lead by CAMH Clinical Research Director Dr. R. Michael Bagby, in collaboration with Dr. Andrew Ryder, Concordia University, Steven Heine, University of British Columbia and a number of collaborators from Second Xiangya Hospital of Central South University, People’s Republic of China, this study recruited more than 200 participants, half from an outpatient clinic in China, and half from a clinical research department outpatient clinic at CAMH, and tested two central hypotheses: 1. East-Asian participants will emphasize somatic or physical symptoms of depression more than North American participants, and 2. North American participants would emphasize psychological symptoms of depression (e.g. report feeling sad, crying spells, or a loss of self-confidence) more than East-Asian participants. Dr. Bagby and his team also wanted to examine the role stigma and alexithymia (difficulty using words to describe emotions) play in how each culture presented and expressed depression symptoms.
This rigorous work is one of only a few studies to address these questions with a direct cross-cultural comparison of clinical patients. Also, it is the only study to use three assessment tools (spontaneous report of problems during unstructured discussion with doctor; clinician-rated symptoms in a structured clinical interview; and a symptom rating scale in questionnaire form) translated into both English and Chinese (Mandarin) and modified to address cross-cultural differences.
As Dr. Bagby explains, “the onset of depression triggers a biological response that takes place within a specific social context, resulting in a cascade of somatic and psychological experiences that are interpreted through a particular cultural lens. Careful translation and adaptation of our assessment tools helped us clarify if different approaches lead to different symptom profiles and conclusions about patients.”
Overall, the data demonstrate a consistently greater level of psychological symptom reporting in the North American sample, regardless of assessment tool. This suggests a tendency for Western cultures to emphasize psychological symptoms of depression (psychologization), rather than a tendency for those from East-Asian cultures to emphasize physical symptoms (somatization).
East-Asian participants did report a significantly higher level of somatic symptoms when reporting through the spontaneous interview and structured clinical interview. Also, these participants reported higher levels of stigma and alexithymia. A refined examination of this link revealed that the observed cross-cultural differences in somatic symptom scores relates, in part, to cultural differences in internally versus externally oriented thinking. This suggests that people who do not frequently focus on their internal emotional state are more likely to notice somatic symptoms.
While this data may help clinicians be more aware of how culture can impact how people talk about their illness, this data does not constitute a norm for depression worldwide. More work should be done to understand the interaction of biology, culture and individual differences in predicting variations in how people present symptoms of depression.

Red Clover May Relieve Depression in Older Women

Depression and anxiety are common among older women, and those who want to avoid drugs as treatment may want to consider red clover. A new study from Austria found that symptoms of depression were reduced by about 80 percent after older women took the supplement for 90 days.
The randomized, double-blind, placebo-controlled trial enrolled 109 post-menopausal women older than age 40 who received either a red clover supplement (80 mg of red clover isoflavones) or a placebo. The supplement used in the study contained isoflavones in their aglycone form, and specifically the compounds biochanin A, formononetin, genistein, and daidzein.
Among the women who took red clover, anxiety was reduced by 76 percent and depression by 78 to 80 percent. Women in the placebo group experienced a decrease in anxiety and depression of about 21 percent.
Whenever the topic of treatment with red clover is raised, some people voice concern about the possible risk of breast cancer, as red clover contains phytoestrogens. Based on data gathered during a recent (2009) European Food Safety Authority working group that investigated isoflavones, the experts concluded that red clover-derived isoflavones do not increase the risk of breast cancer and in fact provide real relief for post-menopausal women.
Red clover has been the subject of much scientific investigation. Some research has suggested that the herb may help protect against heart disease, with red clover isoflavones showing an ability to increase “good” high-density lipoprotein (HDL) cholesterol in pre- and post-menopausal women.
Other studies have suggested that red clover isoflavones may slow bone loss in pre- and post-menopausal women, but this has not been definitively determined. Red clover is also being investigated for its possible use in preventing cancer. Traditionally, red clover ointments have been used to treat eczema, psoriasis, and other skin problems.
Results of this new study may be good news for older women who suffer with depression and who want to avoid treatment with a prescription drug. Women who are interested in red clover to treat depression should talk to a knowledgeable professional. It is important to remember that extracts of red clover isoflavones are not the same as the whole herb. In fact, extracts of red clover isoflavones are only a small, highly concentrated part of the entire herb.