While Paternal Postnatal Depression may not be widely known, it can affect many new dads, including Geraldine Walsh’s husband
Growing up, my dad was always the pillar of our home. He was the warrior, the leader and nothing could ever touch him or knock him down. Perhaps this is a typical vision from a child’s perspective that dads don’t suffer. But they do.
My husband, Barry, faced a distressed anguish and sadness after he became a father. The strong, silent type was obscured and masked by an anxiety and low mood which we initially put down to exhaustion and the dramatic life changes a newborn brings. Why did this new dad seem so unhappy? Paternal Postnatal Depression.
Ursula Nagle, CMM2, Perinatal Mental Health, Rotunda Hospital, outlines how men are not always recognised to have this condition but it is a very real concern for dads.
“There are no Irish statistics on the prevalence of Paternal Postnatal Depression (PPND), however a systematic review in 2016 estimated prevalence at 8.4%. While the woman’s transition to motherhood has been widely documented, men’s transition to fatherhood is only beginning to be explored.”
After the birth of our first daughter in 2013, Barry showed signs of shutting himself in. He developed a kind of siege mentality, disconnecting himself from the world in order to protect himself and our little family.
It wasn’t until our second baby was born and I myself was diagnosed with postnatal depression and anxiety that we realised what he was going through. His symptoms almost mirrored mine in some ways.
Ursula Nagle says: “Symptoms of PPND, while similar to maternal postnatal depression, can appear different. This is largely due to the difference in male expression of depressive symptoms which may be displayed as cognitive and behavioural symptoms rather than affective. Symptoms can include feeling persistently low, irritable, angry, loss of interest. PPND impacts on physical health and can lead to fatigue through lack of sleep and emotional exhaustion. Some men may drink excessively as a coping mechanism.”
Considering postnatal depression was often considered to only affect the mother, is it possible new dads are not recognising what they are feeling or going through?
Ursula says that: “Research among men in the perinatal period suggests that there is an association with the increased demands of fatherhood which can precipitate with PPND.
“If a father has experienced symptoms of depression or anxiety before, he may have some insight into PPND. However life changes associated with fatherhood including feeling tired, irritable and being overwhelmed might seem like normal feelings after the birth of a new baby. Some men may be slow to talk about their feelings and may not seek help. It may be a partner or loved one who recognises that a father is struggling.”
Despite finding it very difficult to accept that he was suffering PPND and avoiding seeking medical help, Barry eventually opened up to only two people, myself and his brother.
He says: “I just figured it was all tiredness. I didn’t tell anyone for a long time. I tried to put up a front for others around me but I accepted we have only one life so why make it harder or live in your own mental prison? Talk and just vent, even if you say the same things over and over. Sometimes it felt like I was trying to take a bowl of spaghetti and make straight lines but eventually I was able to communicate how I felt a little clearer. I only recently spoke to my brother about it all. He has been very supportive.”
Considering Barry suffered in silence and only recently opened up, I asked him if he felt a stigma surrounding fathers and postnatal depression. He said: “I think men are more reluctant to talk about feelings. I, for one, bottled it up for years. It might be because in childhood we are used to being told to “man up” with macho comments. Thankfully men, and the world in general, seems to be changing and the days of the strong, silent but suffering alpha male might be less of a thing next generation.”
Russell Phillips says that he had no idea why he was suffering after the birth of his child and “couldn’t ever imagine being truly happy again.” The lack of understanding and knowledge about PPND naturally made him reluctant to seek help and hide his feelings from those closest to him.
“I didn’t really manage it, to be honest. Mostly I tried to ignore it and carry on. I just kind of accepted that this was how my life was now.
“My wife had an extreme stress reaction to the birth of our eldest, so she couldn’t at first understand. She was very supportive later, but I wasn’t very receptive and found it difficult to talk about. I didn’t tell any of my friends until after I was cured. I couldn’t bring myself to tell people that I didn’t really love my kids and didn’t want them.”
Having fought against depression for a number of years, Russell eventually sought help. “I was diagnosed a few years later with depression, and took anti-depressants, which helped. When my son was nine, my wife
persuaded me to get counselling, and that’s what finally cured me.”
Today, Russell says that he is, “much happier. I can honestly say that I love my kids, which wasn’t true for a long time. I really wish I’d sought counselling sooner, but I’m very glad that I did eventually.
“There’s a lack of understanding. I think a lot of people don’t even realise that men can get postnatal depression.”
It is quite common for a new dad not to recognise that what he is suffering with is more than the upheaval of bringing a newborn home. As the months progress and symptoms linger or worsen, it’s important for fathers and partners to recognise the challenge they are facing.
As Ursula says: “The first issue is to raise awareness. Supporting men with PPND begins with firstly recognising that the father is struggling. Opening the conversation by talking to a partner, friend, loved one, or a healthcare professional is often the first step in asking for help.
“The support of a partner has been established as a protective factor against PPND (Philpott & Corcoran, 2018). If their partner is also struggling, then both parties i.e. the family, need help and support.
“Currently there is no specific referral pathway for PPND, but men should attend their GP primarily to discuss their symptoms and have a clinical assessment.”
What can fathers do to get through this difficult period in their lives?
Ursula says early intervention is key. “Treatment depends on the severity of symptoms, but can include practical social support from loved ones/family as well as psychological support such as a one-to-one talk or group therapy.
“Some couples may benefit from couples counselling. Medication may also be required in some instances as directed by the GP or treating healthcare professional.
“Early intervention is key, if fathers or partners recognise they have symptom, it’s important to ask for help.”