The level of scepticism associated with Male Post Natal Depression is undoubtedly attributed to its moniker, however a recent study highlighted in The Journal of the American Medical Association on the effects of Prenatal and Postpartum Depression in fathers referenced ‘Paternal Depression’ as being a poorly misunderstood condition receiving little attention from researchers or clinicians.
The birth of a new baby is a major landmark event in any couples life; however the reality of the situation can be somewhat different for new dads.
The change in lifestyle, the feeling of exclusion after the baby is born, the general apprehension of fatherhood, and of course the obvious demands and upheaval a newborn can bring can cause a great deal of stress on new fathers. Adopting the role more of the passenger than the driver, many expectant dads, though having the entire nine months to familiarise themselves with the notion of fatherhood, feel that the situation is not ‘actually’ real until they are holding their baby in their arms for the first time.
In many cases new fathers find that working during the day and coping with the ‘disruptive’ nights, particularly in the first few months, is an overwhelming and exhausting experience – one they did not sufficiently prepare themselves for. Whilst fathers in other EU countries benefit from a period of Paternity Leave, Ireland is still one of the few countries not to offer its fathers any form of Statutory Paternity Leave, thereby inhibiting them from any sort of re-adjustment to new family life which is of paramount importance in the early stages of fatherhood.
“I had no idea you could be as tired as this, for most of my working day I was in a zombie-like state unable to function normally. I am grateful to my boss for his support, the fact that he was a relatively new dad himself did help my situation, I suppose I was more of a spectator throughout the pregnancy so when the day finally arrived I was very much taken off guard” says Gary, dad of Chloe, 5 months.
While postnatal depression in mothers first came to light in the 1950s, it was not until very recently that medical professionals started applying the same diagnosis to fathers. But if post natal depression is very much a ‘hormonal’ and psychological condition, what is it exactly that man can claim to possess? One leading expert in Men’s Health, Dr. Tony Foley, explains:
“I feel paternal depression is increasingly well recognised as a distinct entity. Though not hormonal, it may be a subset of reactive depression, that is to say a depression directly attributable to an event such as the changing family dynamic, the stress, the lack of sleep, and the financial worries”.
Over-tiredness is a common foe of any new parent which can easily be written off as a result of sleepless nights, however if this is accompanied by a change in eating pattern, insomnia or unexplainable irritation, Paternal Depression could be setting in.
Other common symptoms include loss of libido, feelings of being overwhelmed, isolation and disconnection, the use of drugs or alcohol and submerging oneself in work as a part of the withdrawal. These symptoms are most prevalent in the first six months after a baby’s birth.
A dad whose partner is suffering from PND is said to be at greater risk of developing depression in the postnatal period with many female sufferers citing that their partners were showing similar symptoms as their own.
“I'd say it's probably one of the most common modes of presentation of paternal depression” Foley adds. “Furthermore, as healthcare professionals, the increasing awareness of paternal depression should prompt us to enquire both routinely (during checkups with female patients) and opportunistically, regarding paternal, as well as maternal depression”.
Men have historically been reluctant to talk about this type of depression, and statistics regarding paternal depression have only recently highlighted the problem.
The Eastern Virginia Medical School found that many new fathers experience post-natal depression, yet most cases go undetected and untreated according to the team behind the research. The findings have been based on 43 studies involving 28,004 parents from 16 different countries including the UK and the US and found that new fathers were generally happiest in the early weeks after the birth of their baby, with depression kicking in after three to six months and that at least 10% and up to 25% had post-natal depression.
They called for doctors to watch out for symptoms of post-natal depression in men as much as in women and even suggested that new parents could be offered treatment as a couple. Other studies have suggested that the figure may be as high as one in three men experiencing depression during the antenatal and postnatal period.
A similar study led by Professor Irwin Nazareth, Director of the Medical Research Council general practice research framework, studied 86,957 families who received medical care between 1993 and 2007. They identified depression among fathers by analysing diagnoses of the condition and antidepressant prescriptions.
The researchers believed that the stresses of having a child triggered the depression – such as too little sleep, changed responsibilities and extra pressures being placed on the parents' relationship. 3% of fathers suffered depression in the first year of their child's life, rising to 10% by the time their offspring was four, 16% by the age of eight and 21% by 12.
The influence of fathers during early childhood has probably been underestimated in the past. However these findings indicate that paternal depression in fathers has a 'specific and persisting impact' on children's early behavioural and emotional development. The babies of depressed men are twice as likely to suffer from behavioural problems, including hyperactivity, as they grew older as opposed to those whose fathers are not depressed.
“I can recall my wife telling her sister that I was a bit down for a while after our baby was born, shortly afterwards her sister rang me in work to berate me out of it saying that didn’t my wife have enough to worry about without looking after me as well. I have to say that I felt very ashamed, is it no wonder that men remain mute when it comes to this subject”, Gary adds.
Today’s society still dictates that men hide their emotions, quite often bottling things up in the hope that they will go away in time. The main reason that this condition is lesser known is that men often find it difficult to talk about it with some not realising that they are actually suffering from the condition.
“Unfortunately depression is wrongly regarded as a sign of weakness by some men with many being embarrassed to admit their sense of struggle. They may lack the motivation and courage to share these inner thoughts. Secondly many men aren’t regular GP attendees and don't have a real relationship with their GP. Ladies on the other hand tend to attend more frequently for their pregnancy care and subsequently with their babies for vaccinations and childhood illnesses - and so get to know their GP rather well”, Foley says.
We manage best in any new situation by being well prepared in advance of it. A new baby can be very tiring on new parents so it is very important to ensure ‘both’ parties receive sufficient rest, this is also essential in the final few weeks of the last trimester. Alternating who takes care of baby on a particular night will also allow for a better night’s sleep. Family and close friends are always at hand so don’t be reluctant to take up on the offer of a break. Consider talking to other dads who have survived the trials of early fatherhood, a little reassurance from other men will give you peace of mind that the early stages especially can be difficult and will help you feel less isolated.
Fathers should take solace in the fact that paternal depression is a common infliction, one that is perfectly normal and that you should feel no shame in being overwhelmed in the first six months of baby’s arrival.
If you are a new dad bleary-eyed from sleep deprivation and you are harbouring any of the symptoms mentioned above then it is vital that you talk to your partner. Parenthood is all about negotiation and coming up with solutions as a couple.
“I would strongly advise new dads to try to communicate with their loved ones. I'd ask them to be open to the fact that depression can affect anyone and that there should be no embarrassment or shame involved. I'd also urge them that if concerned to contact their GPs for a chat” adds Foley.
