A Qualitative Exploration of Awareness, Perceptions, and Help-Seeking Behaviors among Parents of Post-Partum Depression in Islamabad, Pakistan

Postpartum depression (PPD) profoundly impacts mothers' and fathers' mental health but remains underdiagnosed and stigmatized in the majority of low-resource settings. Cultural role expectations and gender roles further accentuate awareness and help-seeking in Pakistan. This research investigated parental awareness, perceptions, and help-seeking behavior towards PPD within Islamabad. Objectives: To investigate parental knowledge of PPD, determine barriers and facilitators to seeking help, evaluate the awareness and utilization of available resources and support systems for PPD. Methods: A two-stage qualitative design was employed, utilizing a non-probability purposive sampling technique. In Phase 1, EPDS was used to screen parents for symptoms of depression. During Phase 2, 12 mothers and 8 fathers who screened positive had in-depth interviews. Thematic analysis was applied to examine socio-cultural, emotional, and system factors that shape PPD experiences. Results: Findings identified a few parents with awareness of PPD, and strong stigma was present among both parents. Mothers outlined emotional exhaustion, pressure to be in control and happy, and insufficient time for seeking care. Fathers also reported emotional repression, cultural expectations, and concerns about being judged. Stigma, time, limited mental health service availability, and gender roles were identified as shared barriers. Spouses' and peers' casual support was a primary facilitator of seeking help. Conclusions: The study concluded that limited awareness, cultural stigma, and gendered expectations hinder help-seeking for postpartum depression among parents.