A Letter to Fellow Fathers: You’re Not Alone in This Journey

Dear Fellow Dad,

I’m writing this letter as both a physician and a father who has walked the difficult path you might be on right now. My name is Dr. Garrett Sterling, and I’m an Emergency Medicine physician. When my first child was born, I experienced something I never expected: postpartum depression and anxiety. Even with my medical training, I was caught off guard. If you’re reading this and struggling with sleep deprivation, anxiety, or depression after your baby’s arrival, I want you to know that what you’re experiencing is real, it’s common, and most importantly—it’s treatable.

You Are Not Alone

First, let me share some facts that might surprise you: postpartum depression affects approximately 8-10% of new fathers, with the highest prevalence occurring within 3-6 months after birth. Unlike the common misconception that this only happens to birthing parents, paternal postpartum depression is a well-documented medical condition that can develop over the course of an entire year postpartum.

As fathers, we’re often expected to be the “rock” of the family—strong, supportive, and unshaken by the monumental changes happening around us. But the reality is that becoming a parent triggers profound biological, psychological, and social changes in men too. Recognizing this isn’t a sign of weakness; it’s a sign of awareness and strength.

The Science Behind What You’re Feeling

Let me explain some of the biological reasons why you might be struggling, because understanding the “why” can help reduce the shame and self-blame:

Hormonal Changes

Research shows that new fathers experience significant hormonal fluctuations. Your testosterone levels decrease during pregnancy and after birth, which has been directly linked to depressive symptoms in men. Simultaneously, your estrogen, prolactin, and cortisol levels increase. While these changes are designed to help you bond with your baby and become more nurturing, they can also predispose you to mood changes and depression.

Sleep Deprivation and Circadian Disruption

The chronic sleep deprivation that comes with having a newborn isn’t just exhausting—it’s medically significant. Sleep disruption directly correlates with increased rates of depression and anxiety. Your circadian rhythms, which regulate mood, hormone production, and cognitive function, become severely disrupted. This isn’t just being “tired”—it’s a physiological assault on your mental health.

Brain Changes

Neuroimaging studies have shown that new parents, including fathers, experience an increase in amygdala size—the brain region responsible for processing fear, anxiety, and threat detection. This biological change makes you more vigilant and protective of your child, but it can also manifest as heightened anxiety, hypervigilance, and even panic attacks. Your brain is literally rewiring itself to keep your baby safe, but this can feel overwhelming and frightening.

The Perfect Storm

When you combine hormonal fluctuations, severe sleep deprivation, increased responsibility, financial stress, relationship changes, and fundamental identity shifts, it creates what I call “the perfect storm” for mental health challenges. Add to this the societal pressure to be the strong, silent provider, and you have a recipe for emotional struggle.

What Paternal Postpartum Depression & Anxiety Look Like

Your symptoms might not look like the stereotypical image of depression. In men, postpartum depression often presents as:

• Irritability and anger outbursts
• Emotional numbness or feeling disconnected
• Difficulty concentrating at work
• Loss of interest in activities you used to enjoy
• Increased use of alcohol or other substances
• Physical symptoms like headaches or digestive issues
• Feeling inadequate as a father
• Anxiety about your baby’s safety or your ability to provide
• Sleep disturbances beyond normal newborn-related disruption

My Personal Experience

When my first child was born, I expected to feel joy and fulfillment. Instead, I felt anxious and sometimes resentful of how much my life had changed. I questioned my ability to be a good father. I felt disconnected from my partner and overwhelmed by the responsibility. The sleep deprivation made everything worse—my judgment was impaired, my emotional regulation was shot, and I felt like I just wanted to go back to “normal”.

As a physician, I was embarrassed. I “should have known better.” I “should have been stronger.” These thoughts only made things worse. It wasn’t until I recognized that my symptoms met the criteria for postpartum depression and anxiety that I could begin to address them properly.

Breaking the Stigma

Men are conditioned to suffer in silence, to “power through” difficulties, and to prioritize everyone else’s needs above our own mental health. But here’s the truth: taking care of your mental health isn’t selfish—it’s essential for your family’s wellbeing too.

Research shows that paternal depression adversely affects children’s emotional and behavioral development. Children of depressed fathers have higher rates of behavioral problems and developmental delays. By getting help, you’re not just helping yourself—you’re helping your child and your family.

When to Seek Help

Please consider reaching out for professional help if you’re experiencing:

• Persistent feelings of sadness, emptiness, or hopelessness
• Significant irritability or anger
• Loss of interest in your baby, partner, or activities
• Difficulty bonding with your child
• Thoughts of harming yourself or others
• Substance use to cope
• Inability to function at work or home
• Persistent anxiety about your baby’s safety beyond normal parental concern

Treatment Options That Work

The good news is that paternal postpartum depression and anxiety are highly treatable. Options include:

Therapy: Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have proven effective. 

Medication: If appropriate, selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) have been extensively studied and can be very effective. 

Lifestyle Interventions: Prioritizing sleep (when possible), regular exercise, maintaining social connections, and practicing stress management techniques.

Support Systems: Connecting with other fathers, joining new parent groups, or working with a postpartum doula who understands paternal mental health.

Practical Steps You Can Take Today

1. Acknowledge your feelings without judgment
2. Talk to someone—your partner, a friend, or a family member
3. Call/Make an appointment with your doctor– primary care physicians are able to initiate treatment for anxiety and/or depression. This is a great place to start as primary care doctors can also refer you to therapy.
4. Prioritize sleep whenever possible—take shifts with your partner, accept help from family
5. Maintain some routine that gives you a sense of control and normalcy
6. Connect with other fathers who understand what you’re going through
7. Be patient with yourself—adjustment to parenthood takes time

A Message of Hope

What I want you to know most of all is that this difficult period is temporary. With proper support and treatment, you will feel like yourself again. You will bond with your child. You will find joy in parenthood. The fog will lift.

Your struggles don’t make you weak or unfit to be a father. They make you human. Some of the best fathers I know have walked this path. Seeking help demonstrates wisdom, courage, and love for your family.

Your mental health and wellbeing matter and that is why I agreed to write this letter when my wife, the other Dr. Sterling, asked. The fact that mental health support for the entire family unit is becoming more recognized and available gives me hope that other fathers won’t have to struggle in silence the way many of us have.

You Are Enough

Remember: You are not broken. You are not failing. You are adjusting to one of life’s most significant transitions while dealing with real biological and psychological changes. Your feelings are valid, your struggles are real, and help is available.

Being a father is one of the most challenging and rewarding experiences of your life. You don’t have to navigate this journey alone, and you don’t have to suffer in silence. Reach out. Get help. You deserve support, and your family deserves the best version of you.

With understanding,

Dr. Garrett Sterling
Emergency Medicine Physician & Father