Postpartum Depression: What about the Dad?

There are several different forms of depression (i.e. major depressive disorder, bipolar disorder, seasonal affective disorder), but one that is not talked about as often is postpartum depression (PPD). PPD is diagnosed when there is an onset of major or minor depression during pregnancy or within the first 12 months after giving birth, and affects 1 in 7 new moms (14.5%). There is not a clear cause of PPD, but it is believed to be caused by physiological changes, a previous history of depression, poor sleep, or the burden of childcare.

No matter the cause, it is a disorder with extreme consequences. Beyond the depression in the mother and marital conflict, it also impairs family functioning and child development. For instance, a mother with PPD may not attend to the child’s needs as much, impairing child health and growth. It may also influence the child’s psychopathology later in life, increasing their risk for anxiety, depression, or emotion disorders.

A large portion of the current research has focused on PPD in mothers, but it is missing something important: the father. Men can also suffer from PPD, and it affects approximately 10% of new dads. This compares to a depression incidence of 5% in men in the general population (not new dads), revealing just how serious of an issue this is.

What causes PPD in men? This is a very new area of study, and one can only formulate educated guesses as to why men also suffer from PPD. According to Family Systems Theory, a family member’s emotions influence the emotions of those in their household, so it is possible that men develop PPD if their wife also has PPD. In fact, PPD in men and PPD in women are positively correlated, such that the father is at higher risk for PPD if the mother also develops it. An explanation for this relationship has to do with social support. A male’s strongest source of support is his wife, and if she has PPD she may not be as emotionally available to help him with the stress of being a new father.

While not yet shown with any empirical data, I would hypothesize that poor sleep also influences PPD in men. Following birth, sleep schedules in both parents are drastically changed and impaired sleep is a risk factor for the onset of depression. Further, more dads now than ever are stay at home dads, thus embodying the role of the infant’s primary care taker.

We know that research on PPD is important because it influences the physical and mental health of both the infant and the parents. Dads may be a particularly important group to learn more about in relation to PPD. A 1998 study found that a non-depressed father may buffer the negative effects of the relationship between a mom with PPD and child development. In other words, the dad may compensate for the mother’s PPD and take a larger role in caring for the infant. Overall, PPD research in both new mothers and fathers is extremely important, and future investigations need to learn more about PPD etiology, prevention, and treatment.

 

Goodman, J. H. (2004). Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of Advance Nursing, 45 (1), 26-35.

Grace, S. L., Evindar, A., & Stewart, D. E. (2003). The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Archives of Women’s Mental Health, 6 (4), 263-274.

Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA, 303 (19), 1961-1969.

Your Friends’ Friends’ Friends Can Make You Happy

Over the summer, I read a book titled Connected: How Your Friends’ Friends’ Friends Affect Everything You Feel, Think, and Do. Ever since I read it, I have been thinking of social networks in a whole new light. So this week, I wanted to write about one of the chapters in the book.

First, let’s quickly go over what a “social network” is in this context. I am not talking about Facebook or Twitter. A social network is your group of friends, and their friends, and their friends’ friends, and so on. How distant in your social network someone is from you is considered his or her “degrees of separation.” Your friends are considered one degree of separation from you. Your friend’s friend (someone that you do not know) is two degrees of separation from you. Your friends’ friends’ friends are three degrees of separation from you. This can continue out all the way out to six degrees of separation. Some of you might be thinking, I once heard that everyone in the world is connected within six degrees of separation from each other. This theory was cultivated from a clever study done some time ago, but this is not the focus of this post. *

What I am talking about today is what Christakis & Fowler (2009) call three degrees of influence. In other words, our friends’ friends’ friends can have an effect on how we think, behave, and feel. It is well established people can “catch emotions” from those around them. When college freshmen are randomly assigned to live with a mildly depressed roommate, they also become increasingly depressed throughout the first semester. If your waiter smiles during your dining experience, you are more likely to leave feeling satisfied, and also give a bigger tip. But can someone you have never met effect how you feel?

Amazingly, they can. In studies of large social networks, a person is 15% more likely to be happy if someone one degree of separation apart is happy, 10% more likely two degrees of separation away, and 6% more likely for three degrees of separation. Further, for each happy friend someone has, this increases their likelihood of being happy by about 9%. These effects are not significant after four degrees of separation.

Location within a social network has also been shown to predict happiness. When people are central in a social network, this means that they have more friends, and their friends also have more friends. When someone is peripheral, they do not have a large number of friends, and neither do their friends. When looking at the picture to the right, the dots in the connected picturemiddle of the cluster are considered central, and those on the outside are peripheral. In their analyses, they found that individuals who are centrally located in a social network have higher levels of happiness. So, the happier your friends are, and the more happy friends your friends have, the happier you are.

But wait, does being happy just mean that you attract more friends? When performing a very complicated set of analyses, they found that this was not the case. Over time, happy people’s networks did not expand (they did not become more central). Instead, they found that happiness spread throughout the network. When an individual became happy, so did people one, two, and three degrees away from them.

This is pretty fascinating, but why is it important? First, these effects are not found just for happiness. Throughout the book, the authors detail the same effects for depression, loneliness, obesity, health behaviors, voting, political beliefs, and more. Further, this is a potentially exciting avenue for public health interventions. Let’s say we want to improve health behaviors in a community. What would be an efficacious strategy to provide interventions to a small amount of people (which is cost effective), while also having effects throughout the community? You guessed it, target individuals who are central in the social networks.

One last thing to remember that I think is really important. While the focus of this post is that others can effect how we feel, we can also have a profound effect on others. So the next time you come across a stranger, give them a smile. You never know what that smile can do, not just for them, but others too!

*If you would like to learn more about this, please feel free to message us.

Christakis, N. A., & Fowler, J. H. (2009). Connected: How your friends’ friends’ friends affect everything you feel, think, and do. New York, NY: Back Bay Books.

Love, Depression, and Insomnia

Emotions are an important part of being human. Recent studies on emotions have shown that along with shaping how we behave throughout the day, they also have a drastic effect on how we sleep. So this week, I thought examining the relationships between emotions and sleep would be good topic to cover.

Before I delve into the literature, there are two things I would like to briefly talk about. First, in psychology we love to talk about these things called “bidirectional relationships.” What this means is that two variables each have an effect on each other. In other words, emotions can affect sleep and sleep can also affect emotions.

Second, insomnia is a tricky topic. There is a lot of debate in the field whether it is a disorder on its own, or a symptom of another disorder. According to the International Classification of Sleep Disorders, you receive an official diagnosis if you have difficulty falling asleep and/or maintaining sleep throughout the night, there is no other presenting clinical disorder, and you also experience symptoms of daytime fatigue, decreased cognitive functioning, memory, attention, motivation, and irritability for at least four weeks. However, insomnia is also considered a symptom of several psychiatric disorders, such as depression. This perspective is well researched and it has been found that if you treat insomnia symptoms in individuals with major depression it not only improves their sleep, but also their other depressive symptoms.

Now, let’s take a look at the bidirectional relationships between emotions and sleep. Individuals who have insomnia symptoms for at least two weeks are at higher risk for developing depression in the following three years. Additionally, longitudinal studies have complimented the idea that poor sleep is a risk factor for the development of major depression.

Sleep deprivation studies have also shown that insufficient sleep time leads to poor mood regulation. In these studies, participants are brought into the lab overnight and are only allowed to sleep for four hours. Upon awakening, they are shown a series of different pictures that evoke emotions of anger, sadness, fear, and disgust. When compared to participants who were allowed to sleep an adequate amount of time, they reported higher ratings of anger, sadness, and fear. Other studies have even found differences in physiological responses. Measuring pupil dilation is a well-established test of emotional stimulation; the more emotionally stimulating, the larger the pupil dilates. In these studies, sleep deprived individuals had larger dilations when presented with negative stimuli than did the control group.

Looking at the other side of the relationship, different mood states can affect sleep. Loneliness is one of the more negative emotions that one can experience, and can be defined as the difference between one’s desired and actual relationships. The larger the discrepancy, the lonelier one may feel. One particular study examined how loneliness may affect sleep. Participants answered several questionnaires and were then divided into three groups: lonely, middling, or non-lonely. It was found that those in the “lonely” group had more restless sleep, and also spent more time awake throughout the night. Further research has added to this study, showing that sleep disturbances are positively associated with higher levels of self-reported loneliness. While these studies claim that loneliness may be causing poor sleep, there is something important to consider. Poor sleep leads to daytime fatigue, which can cause social withdrawal, which can then lead to loneliness. Much more research is needed in this area to establish this relationship.

Now let’s talk about romantic love. A recent study recruited participants and divided them into three groups: adolescents who reported recently falling in love, reported being in a long-term relationship, or reported being single and not in love. Those who were in “intense love” reported less daytime sleepiness, higher daily concentration, more physical activity, and better mood. However, they also reported significantly shorter sleep time. These participants were comparable to someone in a hypo-manic state! The researchers explained these findings in a fascinating way. While intense love may lead to a shorter quantity of sleep due to increases in arousal, it may actually improve the quality of your sleep. Much more research is needed, but these positive emotions may lead to more time spent in the deep stages of sleep.

So why is all of this important? Mood and sleep have a complex, yet important relationship. Depression and other negative mood states can have a detrimental effect on your quality of life, and decreasing your risk for these might be something as simple as making sure you attain adequate sleep every night.

Baglioni, C., Spiegelhalder, K., Lombardo, C., & Riemann, D. (2010). Sleep and emotions: A focus on insomnia. SleepMedicine Reviews, 14, 227-238.