This will be my first Mother’s Day in 21 years without any children at home. When my youngest left for college in August, my friends and family predicted that I would suffer from what is commonly known as the “Empty Nest Syndrome” – the sadness and loss of purpose that sometimes hits parents when their children leave home. They suggested books that might help me cope; they offered their shoulders to cry on.
But rather than feeling depressed or lost, I found a new sense of freedom when my chicks left the coop. Does it make me sound like a bad mother when I admit that I am reveling in my new-found independence? I like not having to share my car. It is satisfying to cook something for dinner and not hear any complaints. Suddenly, my husband and I can go out whenever we like. We can go to sleep without listening to a movie blaring from the family room upstairs or without wondering if everyone will make it home before their curfews.
Despite all of that, I do miss the kids sometimes. I miss the crazy pace and the constant activity that comes with teenagers. I miss hearing the details of their days, their friendships, their challenges.
With the kids gone, I worry less. Not because there is less to worry about, but because I am less involved. Now, when worry comes, it comes like a missile – out of the blue – and hits without giving me time to brace myself. I can be running errands or on the tennis court. It may be a beautiful sunny day, or a peaceful evening. It is during these placid moments, when everything seems to be going right, that I will get a phone call.
“Mom,” a frail voice says, “I am really sick.” These phone calls generally come from my oldest child, who, at 21, still needs mothering sometimes. He will go on to explain that he has been violently ill and feverish for many hours and, in fact, has been so sick that he was unable to call sooner, unable crawl to a neighbor’s apartment for help. For me, this is the worst part of being any empty-nester. It is excruciating to know that your child needs you and that you are too far away to help.
One morning, I turned on my cell phone and saw that I had a new voicemail message from my son. He had left the message in the middle of the night, not wanting to wake us up by calling on the house phone. “Um,” his message begins in a very shaky way, “I just swerved to miss hitting a deer in the road and my car is in the ditch and I think I’m okay, and the deer is okay, but I am not sure about my car.” He sounds anything but okay. He goes on to explain that he is going to try to get his car out of the ditch and may call again.
That was the first of three messages. In the second call, his voice sounds a little stronger and he tells me that his car is out of the ditch and appears to be undamaged and that he is going to try to drive the rest of the way home. In his third message, he sounds relieved and exhausted as he tells me that he has finally, safely, arrived at his apartment. I can hardly dial the phone fast enough. Even after hearing that last message, I must speak to him immediately. I must know that he is really safe. More than anything, I want to hug him…but I can’t.
Now I understand why my father, at 78, still worries. He gives advice about which cars I should buy; expresses concern if I am in the house alone at night. You never grow out of being a parent. There are no children living in my house right now – but that doesn’t mean that I have stopped being a mother.

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When we think about the stresses associated with pregnancy and giving birth, we usually focus our attention on the mother-to-be. We forget there is also a father-to-be.

Men can suffer from depression during pregnancy and, as surprising as it may seem, about 3 percent of fathers suffer from postnatal depression.

When it comes to pregnancy, men frequently feel left out. It is impossible to understand how it feels to carry a life inside oneself for nine months. Men can try to sympathize with their partners as the women experience the hormonal and physical changes that come with pregnancy, but they can never really experience the same thing. Men want to help, to make it better for their partner, but they don't know how.

Thoughts of impending fatherhood create stress during pregnancy. Research studies show that more than 60 percent of fathers feel some form of depression within the first four months after a baby's birth. While the birth of a baby is exciting and exhilarating, it brings about many changes all at once. These changes impact the entire family, not just the mother.

Roles change and responsibilities increase. Feelings of freedom may be in the past. Experiencing fear of the unknown during pregnancy is common for both women and men. Men and women differ, however, in the issues that occupy their thoughts before and after the baby is born.

For men, who are protectors by nature, the ability to support the expanding family financially and keep the family safe are frequent worries. Additional fears have to do with thoughts about harming the baby by accident; the health of the baby and wife; the unexpected loss of the wife and having to raise the child alone, and dying unexpectedly, leaving the wife and child alone. A new father may question what kind of dad he is going to be ? especially if he had a poor relationship with his own dad. This fear starts with the pregnancy and may continue through the early years of the child's life.

Once the baby is born, the reality of the situation finally sets in. There is a new person to consider. All of the nagging fears and doubts at the back of the mind during the pregnancy may come rushing to the forefront.

Men may minimize the importance of these thoughts and feelings, unfortunately. Discussions about male depression are still somewhat taboo. Many men think it is not "manly" to experience or express feelings of doubt and fear about being a father. Keeping these feelings inside and pretending they don't exist leads to increased stress, however, and puts additional strain on the family.

Understanding the various symptoms associated with postnatal depression will enable expectant and new fathers to recognize when a potential problem may exist. Symptoms include mood swings, anxiety, irritability, feelings of hopelessness and insomnia. It is also common to lose motivation, interest in activities and experience a loss of appetite. In severe cases, there may even be thoughts of suicide.

Unfortunately, these symptoms do not occur in a vacuum, and can affect those around the men affected ? including the newborn child. Studies have proven that maternal postnatal depression affects a child's development. New research indicates that boys whose fathers experience postnatal depression are twice as likely to have behavioral and emotional problems during their pre-school years.

While some level of mood change is to be expected after a birth, it is important to pay attention to the severity and frequency of depression symptoms. For men who have been experiencing any of the symptoms for 14 days or longer, the advice of a mental health professional is strongly advised. Early treatment can greatly minimize the longer-term consequences of male postnatal depression on the father, mother and child.

Spending time alone with the newborn, bonding with the child and caring for his or her needs can be valuable in creating a role for the father in the newly expanded family. Feeling left out is not unusual when the care of the child falls primarily to the mother. Both mothers and fathers are learning about parenting and baby care at the same time. It is important for a father to create an open dialogue with his spouse and share his concerns. The couple may find that each is experiencing the same fears.

For more information about postnatal or male depression, call Princeton House Behavioral Health, a unit of Princeton HealthCare System, at (800) 242-2550. To locate a University Medical Center at Princeton physician near you, call (888) 742-7496.

Jeffrey T. Apter, M.D., is board-certified in psychiatry and conducts clinical research for patients with depression. He is a senior attending physician at University Medical Center at Princeton.