Think only mothers experience postpartum depression? Think again. Fathers feel it, too.

Women are most often associated with postpartum depression because of hormonal changes during and after pregnancy, but that’s just a part of the picture, according to a recent presentation at the American Psychological Association. A timely reminder on International Men’s Day on Nov. 19: Some men get postpartum depression too.

New dads likely experience depression or anxiety because of a lack of sleep, attending to the child and possibly a disruption in their work routine, according to Sara Rosenquist, a clinical health psychologist, and Dan Singley, a psychologist at the Center for Men’s Excellence. Symptoms include irritability, significant weight loss or gain, working nonstop and problems concentrating.

“ New dads likely experience depression or anxiety because of a lack of sleep, attending to the child and possibly a disruption in their work routine. ”

They may not know how to embrace fatherhood or could be worried they’re not doing a good job at it. Other factors may include feeling a disconnect with their partners or babies and the aftermath of a stressful birth for the parents and child, according to Pacific Post Partum Support Society, a Canadian support group for women and their families.

About 10% of new dads experience postpartum depression and anxiety — about the same percentage of adoptive mothers — and up to 18% suffer from an anxiety disorder, according to research originally published in the American Journal of Men’s Health in 2016. Postpartum depression and anxiety “have a negative impact on family relationships, as well as the health of mothers and children,” the researchers said.

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Men may be more likely to show signs of depression specifically if they were stressed during the pregnancy, another report published in JAMA Pyschiatry found. About 2.3% of the 3,500 expecting fathers from New Zealand studied showed signed of depression before the baby was born, and nine months after the child arrived, postpartum depression affected 4.3% of fathers.

“ As more companies offer new fathers paid time off, many men say they are still reluctant to take paternity leave. ”

Men increasingly face the challenge of balancing their roles as both a new father and provider, according to the Seleni Institute, a global nonprofit organization dedicated to perinatal mental health. That’s one reason why they may work harder after birth, which could lead to burnout.

In fact, as more companies offer new fathers paid time off, many men say they are still reluctant to take paternity leave.

Men sometimes mirror their partners’ symptoms and feelings throughout the pregnancy, the latest research found. New fathers may have nausea, heartburn, bloating or appetite changes during pregnancy, and when they’re constantly close to their pregnant partners, may experience hormonal changes. In some cases, men might see a temporary decrease in testosterone after the child is born, or see higher levels of prolactin, the hormone that allows women to produce milk.