Researchers at the Colorado School of Public Health and the University of Colorado found that the rates of anxiety in new fathers are likely higher than what is reported by the World Health Organization (WHO). These findings, including more than 40,000 people over a 25-year period, suggest that “the transition into parenthood may place men at greater risk for anxiety,” the authors write. The meta-analysis was published in the Journal of Psychosomatic Obstetrics & Gynecology in late February.
Daniel Singley, PhD, a psychologist based in San Diego, who was not involved with the study, tells Verywell that the research underlines the need for a more comprehensive mental health approach among new parents. “I would really like to see a movement away from maternal and paternal mental health to parental,” he says. “Mental health that is gender inclusive and dignifies the fact that the transition to parenthood, or even the transition to somebody who’s grieving the loss of an infant, is not bounded by gender.”
Difference in Prevalence
The WHO estimates that anxiety disorders affect between 2.2 and 3.8% of men. Researchers wanted to see if that statistic held up when compared to other studies examining anxiety in men, but specifically related to the perinatal period.
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“The transition to parenthood is a major life event that’s often accompanied with new challenges related to financial, relationship, and work-life balance concerns,” Jenn Leiferman, PhD, professor at the Colorado School of Public Health and study author said in a press release. These changes happen for both men and women when awaiting a baby, she adds, but not much is known about related anxiety for men. “To our knowledge, our study is the first meta-analysis to explore the prevalence rates of anxiety among both fathers and mothers during the perinatal period.”
Leiferman and colleagues looked at studies from 1995-2020 that included more than 40,000 people. When they analyzed the rates of anxiety in men around the birth of a child, they noted that it was higher than the WHO’s estimate by as much as seven percentage points—from 9.9 to 11% of all men. In addition, men’s anxiety rates tended to be lower during a partner’s pregnancy, but rise more than two percentage points during the first year postpartum to 11.7%.
Drawing attention to this discrepancy between the WHO and anxiety studies data, the authors note, could encourage more conversation around the mental health and anxiety of new fathers, and assist them in getting care.
This study does not, however, mean to downplay the struggles of women during the perinatal period; researchers found that about 17.6% of women experience anxiety during this time. Rather, Leiferman adds, it raises awareness about the mental health struggles of both parents. “The prevalence of anxiety and depression among men is talked about less as a society, even though research shows men are more likely to commit suicide or abuse alcohol than women,” she said. “It’s important that we create more transparency around men’s mental health issues.”
New Dads in Therapy
Singley is happy to see a study point out the mental health struggles of men during the perinatal period. “It’s like the worst kept secret,” he says. “You see far more anxiety than you do depression.”
However, depression, Singley adds, tends to get more media attention because of its link to suicidal thoughts. “And so mortality and lethality tend to be what drive headlines and funding briefly,” Singley says.
In his therapeutic work, Singley finds that many men have a relationship with anxiety that isn’t well-represented or understood. “We’re directly socialized to believe that [experiencing anxiety] is a weakness,” he says. “So having anxiety means you’re weak and you feel vulnerable. And if you take the traditional guy box view of that, you can’t let anybody know that and you just got to power through it.”
This experience of anxiety in the perinatal period, Singley says, can play out in various ways. Within more than 15 years of working with clients, he’s worked with many fathers who present with acute stress disorder, a predecessor to post-traumatic stress disorder (PTSD), especially in the first six months postpartum.
Many men who go through this stress can cope, get therapy, and move on, but others don’t. This applies to all types of perinatal experiences—stillborn, maternal death, infant death, and medically uncomplicated procedures.
“It is very commonly the experience of, they know they have no control in the situation, they are completely terrified and overcome with fears about the baby, about their partner, about themselves, about their lives,” he says. “And they cannot leave the situation. In certain ways, like these are factors that come together.”
When people think of PTSD, they may not associate the condition with parenthood, but Singley says these perinatal experiences are enough to lead to an anxiety disorder for some men. He often sees dads who are self-medicating with alcohol and video games while isolating.
“They’re having nightmares. They are dissociating. They are highly avoidant of triggers,” Singley says. “And this is the thing that oftentimes gets these dads into my office: The baby serves as a trigger to their PTSD and they avoid the baby.”
The Importance of the Conversation
Experts hope this research can help draw media attention and research funding to male anxiety, ultimately lowering barriers such as stigma and false conceptions of masculinity.
“Say ‘masculinity’ to somebody, and maybe they’ve already filled in toxic,” Singley says. “That’s really unfortunate because there are now solid studies being done about healthy masculinity and positive masculinity.”
In order to achieve healthy masculinity, Singley says we need to start early. “If we, as a society, could make the changes necessary to socialize boys to be healthier, then we don’t have to fix broken men and fathers,” he says.
These socialization skills, Singley adds, involve teaching boys how to keep from shutting down emotionally, and how to navigate intimacy in platonic and romantic relationships. “Being able to say what they’re feeling—the good, the bad and the ugly, and not to teach them that it’s weak.”
It’s important to keep in mind too, he adds, that the current generation of new fathers is being held to a higher standard than any generation of fathers before—now, it’s not as socially acceptable to work and be emotionally absent. That second piece has to be there, too. “But we as a society haven’t really carved out a place for the respect that goes along with it,” Singley says, “So it still activates their insecurity about being feminine because we have feminized the role of parenting infants.”
The evolution of masculinity is happening slowly, Singley says. And the only way forward is by building a strong foundation, he adds, referencing a quote from Frederick Douglass: “It’s easier to build strong boys than to repair broken men.”
