Like many fathers, Adam Elmaghraby enjoys spending time outdoors with his daughter. On weekends, he takes the 3-year-old to a farmers market, sharing his love of food with her and teaching her about fruits and vegetables.
Elmaghraby especially appreciates this time with his daughter, because his entry into fatherhood was difficult. A few months after her birth, he struggled with bouts of paralyzing anxiety and depression.
"Shortly after my daughter was born, I started feeling anxious. My mind would swirl, and I felt out of control. I didn't have enough time for myself, parenting and my professional life," he said.
Like many new parents, Elmaghraby struggled to adjust to the child-care responsibilities and sleep deprivation that a baby brings. As his mood worsened, he started to blame parenthood. But it took him nearly a year to reach out for help.
Once he saw a doctor, he was diagnosed with anxiety and depression, the two most commonly diagnosed mental illnesses. However, Elmaghraby believes he was actually suffering from the same mental health concern that affects up to 15 percent of women each year: postpartum depression.
Although PPD mostly affects new mothers, recent studies have found that men might also suffer from the illness. And, according to one research study, hormonal changes could be partly to blame.
The study, published in the journal Hormones and Behavior, found a correlation between testosterone levels and symptoms of paternal postpartum depression. Using a saliva sample, the researchers measured each father's testosterone levels. They discovered that those with dipping levels of the hormone were more likely to feel depressed.
"Our findings suggest a potential biological and hormonal correlate of depression during the postpartum period," the study's author, Darby Saxbe, an assistant professor of psychology at the University of Southern California, said in an interview.
Symptoms of postpartum depression can include feelings of irritability and sadness, anxiety, insomnia and, in extreme cases, thoughts of self-harm. For women, postpartum depression is the No. 1 complication of childbirth, affecting 10 to 15 percent of new mothers each year.
"Postpartum depression in men is not so easy to spot," says Will Courtenay, a psychotherapist in Oakland, California, who diagnoses and treats dads suffering from PPD.
According to Courtenay, depression can look different in dads. Instead of crying, they may become irritable, work constantly, or turn to gambling or drinking to cope with their emotions. Citing a meta-analysis in the Journal of the American Medical Association, he says that during the postpartum period, "especially during the three- to six-month period after the baby's birth, one in four dads suffers from postnatal depression."
Elmaghraby was never officially diagnosed with PPD, even after seeing a psychotherapist. "My therapist never addressed the possibility of postpartum depression with me. Luckily, a few friends mentioned that the illness could also affect men," he said. Just learning that fathers could suffer from PPD made Elmaghraby feel less alone and more willing to talk about his experience openly.
Although studies show that untreated maternal depression can affect mother-and-baby bonding, paternal depression can also influence a child's development.
"We know depression can impact the father-child relationship, as well as children's future behavior," said Sheehan Fisher, a clinical psychologist and researcher at Northwestern University.
According to Fisher, kids who grow up with depressed dads may have a harder time coping with negative emotions such as anger, anxiety and sadness. He said these children may be more likely to "act out" their feelings by misbehaving and becoming aggressive.
While biology and hormonal shifts may affect the mental health of new parents, social pressures can as well. Many of today's dads are stepping into new parenting territory, becoming more active parents than fathers of previous generations. And because of this, many feel unprepared.