One Year After the Birth of their Child, Fathers are at Increased Risk of Depression

Fathers in Sweden are less likely to receive a psychiatric diagnosis during their partner’s pregnancy and in the months immediately following the birth of their child. However, this pattern reverses over time. A new study published in JAMA Network Open reports that diagnoses of depression and stress-related disorders increase about a year after the birth. The research was led by scientists at the Karolinska Institute in Sweden and Sichuan University in China.

Depression and Stress Diagnoses Increase After One Year

“The transition to fatherhood often brings both positive experiences and a range of new stresses,” explained Jing Zhou, a doctoral student at the Department of Environmental Medicine at the Karolinska Institute and co-first author of the study. “Many cherish the intimate moments with their child, while at the same time the relationship with their partner may be strained and sleep quality may deteriorate, which can contribute to an increased risk of mental health disorders.” The researchers analyzed data from more than one million fathers whose children were born in Sweden between 2003 and 2021. Using linked national registries, they tracked when new psychiatric diagnoses were made among the men, starting one year before pregnancy through the child’s first year of life.

The results show that psychiatric diagnoses during pregnancy and in the first months after birth became less common compared to the year before pregnancy. One year after birth, diagnoses related to anxiety and substance use had returned to the levels observed before pregnancy. In contrast, there was a significant increase in depression and stress-related disorders. These diagnoses rose by more than 30 percent compared to pre-pregnancy rates. “The delayed rise in depression was unexpected and underscores the need to watch for warning signs of mental illness in fathers even long after the birth of their child,” says Donghao Lu, lecturer and associate professor at the Department of Environmental Medicine at the Karolinska Institute and corresponding author of the study.

Why Fathers May Develop Depression

There are several reasons why mental health issues in fathers often don’t increase until months after the birth. Immediately after the birth, many men are still in a sort of “state of emergency”: the joy of having a child, social expectations, and the immediate need to organize daily life can initially have a stabilizing effect. Over time, these effects subside, while the long-term stresses become more noticeable. These include, above all, chronic sleep deprivation, increasing pressure from responsibilities, potential financial worries, and changes in the relationship. Attention is also often strongly focused on the mother and child, so that fathers tend to put their own stresses aside or receive less support. These factors can gradually add up and ultimately lead to conditions such as depression or stress-related disorders.

In fathers, such problems often manifest somewhat differently than classically expected. In addition to typical signs such as low mood, listlessness, or a sense of emptiness, many men exhibit more indirect symptoms. These include increased irritability, anger, or withdrawal from family life. Some throw themselves excessively into work or develop unhealthy coping strategies, such as increased alcohol or substance use. Physical complaints such as sleep disturbances, exhaustion, concentration problems, or diffuse pain may also occur. Fathers often find it difficult to talk about their feelings, which can lead to problems going unnoticed for a long time or becoming more severe.

Timely Support for Fathers’ Mental Health

The researchers point out that their findings are based on clinical diagnoses, meaning that men who did not seek medical help may not have been included. Nevertheless, the study highlights when fathers may be particularly at risk during early parenthood. “By identifying phases of increased risk, healthcare providers and other stakeholders can more easily offer support,” said Jing Zhou. “Postnatal depression is often discussed in relation to young mothers, but fathers’ well-being is equally important, both for themselves and for the entire family.”

For fathers, this means above all that help should be actively offered not only immediately after birth, but also months later. This includes low-threshold counseling services, such as consultations with a family doctor or at family counseling centers, as well as programs specifically tailored to fathers, such as support groups or online resources. It is also important that fathers are more actively involved in postnatal care, for example through targeted questions about their well-being during routine checkups for the child. Practical relief in everyday life—such as flexible work hours, parental leave models, or household support—can also help reduce stress. Additionally, education and awareness-raising can help ensure that mental health issues like depression are recognized early and taken seriously, so that affected fathers receive appropriate help more quickly.

The study was conducted in collaboration with Sichuan University in China and Uppsala University in Sweden. It was funded by the Strategic Research Area for Epidemiology and Biostatistics at the Karolinska Institutet, the Swedish Research Council, and the European Research Council. The researchers report no conflicts of interest.