Paternal postnatal depression: dads can suffer too

Adele’s recent revelation about postnatal depression was a comfort to women the world over, as it showed that successful, talented, rich women can suffer too. But less talked about is paternal postnatal depression, affecting one in ten dads…

The heartache of postnatal depression hit the headlines again in the past week. Adele’s comments that she only has one son because she’s too scared of feeling like that again hit a nerve with the hundreds of women around the world who feel the same.

“I didn’t talk to anyone about it,” she told Vanity Fair. “One day I said to a friend, ‘I fuckin’ hate this’ and she just burst into tears and said, ‘I fuckin’ hate this too.’”

According to the Royal College of Psychiatrists, an estimated 10-15% of women will experience postnatal depression (PND) and years of campaigning has meant that general awareness of the condition in mothers is high. But less well known is that fathers can be affected too.

A 2010 analysis published in the Journal of the American Medical Association, covering 28,000 participants, found that one in 10 fathers worldwide will experience some form of depression after their child is born (known as paternal postnatal depression, or PPND). The incidence rises to 50% of fathers whose partners are suffering from PND.

I didn’t want to kill myself, but I just wanted something to hit me to take my mind off it

Mark Williams, from Cardiff, says he was thrilled when his wife Michelle fell pregnant with son Ethan, 11 years ago. But after 22 hours of labour, she was rushed to surgery for an emergency c-section and Mark had his first panic attack.

“I thought my wife and baby were going to die,” he says. “I didn’t know what was going on.”

Michelle was diagnosed with severe PND three days after the birth and Mark left his job as a sales training manager to look after her. Over time, he says he noticed his own mental health declining.

“I’d had no experience with mental health issues before. We were reaching crisis point. I couldn’t tell my best friends. I didn’t want to tell my wife how I was feeling because I didn’t want her to think it was her fault.”

The cause is up for debate. Beyond the strong correlation with the mental health of the baby’s mother, there’s research that points to the likelihood of pre-existing mental health issues, such as OCD or anxiety, the effects of lack of sleep, financial concerns and age – those fathers in their 20s are at an increased risk of suffering from PPND. There is some evidence men also experience hormonal changes when a baby is born. And if there has been a traumatic birth, as in Mark’s case, this can also contribute to the onset of PPND.

While many men are reluctant to share their feelings, the repercussions of not seeking help can be long-lasting for all of the family. A 2012 Australian study found that 30% of fathers who have problems in the first 12 months after having a child will continue to report ongoing mental health issues.

It was around four to five months after Ethan was born – that Mark started having suicidal thoughts. This is in line with medical research that three to six months after the birth of a baby has been found to be the most common time for fathers to experience PPND. In comparison, women are typically diagnosed four to six weeks after birth.

“I was walking into Cardiff and I saw a bus,” Mark says. “I didn’t want to kill myself, but I just wanted something to hit me to take my mind off it.

“My coping skill was drinking [and] my personality was starting to change. I used to go out and pick fights. Not to hurt [anybody else], but I just wanted someone to hit me so I could stop these agonising feelings. I now know it’s a form of self harm.”

Dr Jane Hanley, a mental health nurse and academic with 30 years of experience, says the way men deal with depression is different to women and can often go undetected. “Men tend to self medicate more so than women [and] the stigma is still there, so people find it difficult to admit they’re feeling down or depressed.

“It’s something we need to keep on reinforcing all the time so every midwife, GP and health visitor thinks, have I assessed that father’s mental health and how did I assess it?”

Hanley adds that thankfully, interest and awareness in male mental health around birth is growing. She and Mark now run awareness courses together and at this year’s UK Ireland Marcé Society conference, which focuses on perinatal mental health, a number of medical professionals spoke about their research and interest in the subject.

60% of the fathers I dealt with had relationships that were breaking down; families were splitting up. These guys are turning to drink

Dr Florence Bristow, a clinical psychologist, ran a small study last year, exploring 10 fathers’ experiences of traumatic labour and childbirth. She points to evidence that up to 12% of fathers will develop symptoms consistent with post-traumatic stress disorder after witnessing childbirth.

“What appeared unique to fathers’ experience was the responsibility they perceived to support and protect their partner and baby,” Dr Bristow says. “Fathers often desperately wanted a role of some control over what was happening but … were left feeling powerless and helpless.

“Many fathers felt a desire to tell their story to process the experience but were prevented from doing so because of shame, feeling like they needed to protect other people from the traumatic story, stereotypes that men don’t talk about their feelings and feeling excluded because the focus in society and services is mainly on the mother and her story.”

After his experience Mark set up the support charity Fathers Reaching Out and speaks at events all over the world to raise the profile of men’s mental health issues. He is also campaigning to change the NICE guidelines around antenatal and postnatal health to include fathers, and set up International Father’s Mental Health Day (the day after Father’s Day) last year.

“I’ve spoken to close to 1,000 fathers over the past five or six years,” he says. “I think 60% of the fathers I dealt with had relationships that were breaking down; families were splitting up. These guys are turning to drink, they’re having flashbacks and nightmares … there’s a lot of trauma.”

There are so many other fathers going through this as well. I always say to people the quicker you get help, the quicker the recovery

Dr Sukhbinder Noopuri, a doctor with 16 years’ experience and co-founder of the i-GP platform, says while men may not have structured appointments with the health profession after the baby is born, it’s important that men seek help if they find they’re struggling.

“Your doctor will be able to give you lots of advice and support. It could be counselling services, or advice such as making time for yourself, getting more family involved, doing things to help you relax such as exercise, can often help,” he says.

“It’s about making sure there’s a network of support and really monitoring to see how things go over time – not something you need to [necessarily] jump straight on prescribing medication for.”

Setting up the network, Mark adds, has made it clear to him just how many men are suffering in silence. He believes the one in 10 figure is a grave underestimation. “There are so many other fathers going through this as well. I always say to people the quicker you get help, the quicker the recovery. If you don’t treat it straight away, it will just manifest [and] it will get you in the end.”

If you, or someone you know, is suffering with paternal postnatal depression, here are some organisations that may be useful…

NCT‘s helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700

MIND, a leading mental health charity, has information on postnatal depression, and provides a contact number you can call if you need further help: 0300 123 3393

The Fatherhood Institute, a think-tank specialising in fatherhood, posts its latest research summary on fathers and postnatal depression