When Robert Estrada returned from home after serving eight years the Marine Corps, he didn’t initially experience any symptoms of post-traumatic stress disorder. Crowds didn’t terrify him until two years later, when his daughter was born. By the time she was old enough to notice that her father couldn’t just enjoy strolling in the zoo or seeing a movie in a theater, Estrada had begun to accept the fact that something was wrong.
“I knew I was disappointing her,” he says.
PTSD affects 8 million adults each year and about four percent of men throughout their lifetimes, according to the U.S. Department of Veterans Affairs. While it is unclear how many fathers struggle with PTSD, about half of all American men are fathers so it isn’t farfetched to assume that roughly four million dads may be dealing with violent flashbacks, intrusive memories, debilitating panic attacks, and other PTSD symptoms. And since a growing body of evidence suggests that fathers are disproportionately affected by PTSD, eight million might actually be an underestimate. Without significant interventions, these fathers, including Estrada, will pass down suffering to millions and millions of kids.
Estrada’s PTSD symptoms remained dormant until he became a father and studies suggest that’s not unusual. There’s a strong link between fatherhood and PTSD. One study that looked at the records of more than 100,000 veterans found that those with dependent children were 40 percent more likely to be diagnosed with PTSD in their year returning home than non-parent. Numbers for formerly incarcerated fathers are harder to come by, but likely extremely significant given the outsized population of American dads in jails. Additional data from a smaller sample showed that, when children lived with their fathers at home, that alone increased the likelihood of the father experiencing more severe symptoms. Yet another study comparing more than 300 single and partnered veteran parents found that single parents faced the most dire symptoms.
One explanation for this may be that men don’t worry as much about threats—whether real or imagined and amplified by past trauma—until they have children and families to protect. Some experts add that the stress of being separated from loved ones and then returning home to them may intensify these symptoms, which could explain why family men face harsher symptoms.
But Suzannah Creech, a clinical psychologist and associate professor of Psychiatry at the University of Texas at Austin, tells Fatherly that there may be a more simple explanation—being a parent is stressful, and a combination of everyday parenting stressors could bring latent PTSD symptoms to the fore. She adds that family-oriented people are more motivated to seek treatment for medical issues. So the data may skew toward dads because dads (and married men, in general) are more likely to visit the doctor when their symptoms spiral out of control.
Estrada believes he was part of the latter group. “I didn’t want my daughter to see me that way.”
And with good reason. There is some evidence of that PTSD can be “contagious”, and that fathers who suffer from untreated mental health issues could have negative impacts on their children. It’s not that fathers can somehow pass along their nightmares or flashbacks to their children, Creech explains. Rather, specific PTSD symptoms can alter specific parenting behaviors which can, in turn, shape a child’s behavior. In a recent review of 20 studies on the topic published in Frontiers of Psychology, Creech divided flashbacks, nightmares, paranoia, avoidance, and other PTSD symptoms into three domains—behavioral avoidance and accommodation, cognitive processes and thematic content, and emotional disturbances.
Estrada was most likely experiencing “behavioral avoidance and accommodation” when he was unable to go to the zoo with his daughter or when he had to leave his family alone during a Sesame street concert. “It was a very close atmosphere with everyone sitting around each other,” he recalls. “I had to leave my daughter with my wife and go out to the car.” For many people with PTSD, avoidance is seen as a means of managing symptoms by removing themselves from stressful situations. Still, to clinicians like Creech the impulse to do that is a symptom in itself, rather than a long-term solution for coping.
Fortunately, the symptoms of avoidance are relatively benign. Symptoms of related to “cognitive processes and thematic content,” on the other hand, can really begin to damage children. This domain includes confusion—individuals with PTSD often view power, trust, control, and intimacy in a warped fashion, leading to violent conflict with romantic partners and family members, and can cause a father to misinterpret a child’s harmless behaviors as imminent threats. “When kids are active they can misbehave, and it can cause difficulties in how parents interpret that behavior as if it’s on purpose, when really it’s just kids being kids,” Creech says.
These negative behaviors peek when they involve “emotional disturbances”. Sometimes that manifests as neglect—fathers with PTSD may have trouble responding a child’s positive or negative emotions and fail to develop healthy attachment to their children. Other times, this manifests as feelings of anger and shame, which can, tragically, lead to child abuse. But Creech cautions that this is no reason to assume a father with PTSD will necessarily raise a hand to his family members. “There are plenty of parents with PTSD who are not violent,” she says.
Estrada says that he never felt violent as a result of his PTSD, but certainly experienced blunted emotional responses. He recalls struggling to share in his daughter’s excitement, even when she was ecstatic. “It was more social anxiety and isolation,” he says. “Nothing made me snap.”
Today, Estrada has three children ages 4, 6, and 7, and works to manage his PTSD symptoms with a combination of therapy and medical marijuana, which he claims have helped him manage both his social anxiety and sleep issues (though he still has nightmares almost every night). Estrada says he has also found that CrossFit and Jiu-Jitsu help clear his mind and keep him fit. In 2015, he founded the organization Endurance for Veterans, which works to set up group fitness programs for individuals suffering from PTSD and he has commissioned a study to determine whether exercise therapy is an effective treatment for veterans suffering from trauma.
Clinicians like Creech applaud fathers for working to strike a healthy balance and manage their symptoms, but she stresses that there is no cure for PTSD beyond Cognitive Processing Therapy and Prolonged Exposure. As more research continues to confirm that having children intensifies the experience of PTSD, Creech believes that fathers may even need specialized cognitive therapy that does not yet exist. One of her recent studies found that, when parents reported higher levels of parenting satisfaction, their symptoms of PTSD were less severe. This suggests that the ultimate cure may lie within interventions that facilitate more positive parent-child interactions—interventions that are likely to help kids, too.
“We’ve really got to think about how we can help mitigate the impact on the child’s behavioral health,” Creech says. “But also, are there ways we can strengthen the parent-child relationship that improves the parents’ mental health?”