Are mental health problems in new mothers being missed?
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Can men experience postnatal depression?
Postnatal depression is a mood disorder that can affect fathers as well as mothers. Yet, there is much less awareness surrounding postnatal depression in men. It's important to break the taboo around men's mental health so that fathers and their partners can recognise the warning signs of male postnatal depression and seek the help they need.
What is postnatal depression?
If you are a parent, you will probably agree that having a baby is both physically and mentally challenging, no matter how much happiness it brings. Unfortunately, the expectation on both mothers and fathers to feel this joy can often mean that they don't feel comfortable asking for support for postnatal depression (PND).
Also called postpartum depression, this mood disorder is believed to affect around 1 in 10 parents. If you are a new parent and find yourself struggling with feeling low, teary, anxious, or with a persistent stream of negative thoughts, then you may have postnatal depression.
Of course, the stress and sleep deprivation that comes with childbirth and caring for your newborn can cause low moments for every parent. This is the challenge of parenthood, and it doesn't necessarily mean that you have postnatal depression.
Many experience the "baby blues" around days 3-10 after birth. While this tends to go away on its own, PND typically develops in the first four weeks, lasts for much longer, and can seriously affect a person's long-term well-being.
Can men get postnatal depression?
Fortunately, postnatal depression in mothers is now a much more widely accepted and understood condition than it has been historically. However, postnatal depression in men (or postpartum depression) is still largely undiscussed and relatively under-researched.
According to Annie Belasco, head of charity at the PANDAS Foundation, male postnatal depression is thought to affect 1 in 10 fathers within the first year of having a baby. This means that postnatal depression in men is as common as it is in women.
This makes sense, considering that a baby brings about a dramatic change in both parents' lives. "The triggers can be the same ones that present with women, including birth trauma, adaptation to life, sleep deprivation, and other significant changes," says Belasco.
What are the signs of postnatal depression in men?
"Men can experience symptoms such as low mood, anxiety, loss of identity, intrusive thoughts, and persistent feelings of sadness," says Belasco.
The most common signs of postnatal depression in men include:
- A loss of interest and lack of enjoyment in your baby or the wider world.
- Difficulty bonding with your baby.
- Feeling persistently tearful, irritable, indecisive, or guilty.
- Feeling helpless, confused, or fearful about the future.
- Lacking in energy and motivation.
- Overeating or undereating for comfort.
- Having trouble sleeping at night.
- Experiencing frightening or unwelcome thoughts.
- Withdrawing from other people and social situations.
These symptoms may also be accompanied by physical symptoms such as indigestion, constipation, diarrhoea, changes in weight, headaches, and nausea. Everyone is different, and you may experience one or several of these symptoms. If they have lasted for longer than two weeks, it could be time to seek support.
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How common is postnatal depression in men?
Male postnatal depression affects around 10% of dads. "It is also reported that if the maternal mother has PND, the father is then between 50%-75% more likely to become unwell with perinatal mental illness," adds Belasco.
Research by the Fatherhood Institute further shows that:
- Men in their first year after becoming a dad are twice as likely to get depression as the general population.
- First-time dads are particularly vulnerable.
- One in ten dads-to-be will also become depressed during their partner's pregnancy.
- Three to six months after birth is the peak time for postnatal depression in men.
Other risk factors
Mothers and fathers both have a greater chance of developing postnatal depression if they have:
- A history of depression or other mental health problems.
- Relationship problems with their partner.
- No support network of close family or friends.
- Experienced a recent traumatic or stressful event.
According to the NCT, postnatal depression in men is also more likely in fathers who:
- Are under 25 years of age.
- Have money worries.
- Are not in a relationship with the child's mother (married fathers have the lowest rate of depression).
- Feel unsupported by their partners.
- Have a baby with sleeping or crying issues.
- Have a problem with drug misuse/dependence.
While research has found a correlation between these factors and male postnatal depression, it's unclear whether these may directly cause PND.
Do hormonal changes also affect men?
You may be aware that a woman's hormones change during and after pregnancy, but did you know that a man's hormones change too? These hormone patterns are thought to encourage child-rearing qualities.
Although there is little research on hormone changes and postnatal depression in men, it's possible that these could be biological risk factors in male PND:
- Lower testosterone levels - a decrease in the male sex hormone is linked to more involved parenting and stronger attachment with the child but may also be connected with depression.
- Lower oestrogen levels (often described as a 'female sex hormone', it is also made naturally in men) cortisol levels (stress hormone) vasopressin levels, and prolactin levels - normally these increase in men when their child is born to encourage child-rearing behaviour.
Some scientists theorise that certain men who produce lower-than-average levels during this period are more prone to parent-child bonding difficulties. This in turn could make PND more likely.
Breaking the taboo about postnatal depression
"Although there is recognition for postnatal depression in fathers as a diagnosis, PND is much less talked about for men," says Belasco. "But more men are becoming aware and educated around perinatal mental health and are seeking support and answers for their signs of depression."
Despite this progress, male postnatal depression often goes undiagnosed. Sadly, a big part of the issue is that the male PND experience remains something of a taboo - it is a topic that carries a stigma relating to old-fashioned toxic masculine stereotypes.
This means that postnatal depression in men is less likely to be talked about, and this greatly affects whether fathers seek help. One recent study on male PND identified several help-seeking barriers. The study was small but may still provide a useful snapshot of the kinds of issues many fathers face.
Recognition and perception of depressive symptoms
Men may not recognise the signs of postnatal depression. Sometimes the symptoms can look a lot like the normal stresses of caring for a newborn baby.
Knowledge and beliefs about PND
Many men haven't heard of male PND and believe that the condition can only affect women. Another misconception is that postnatal depression means that a parent doesn't love their child - this is particularly dangerous as it promotes judgement against parents who are struggling with a mental illness, who have done nothing wrong, and are good at caring for their child.
Taboo, stigma, and conforming to masculine norms
Harmful masculine norms (stereotypes) - for example, the belief that all men should be "proud, cynical, protective, and strong" - can make fathers feel like they can't admit to having PND.
The father's partner
If a partner notices the signs of PND in their male partner and speaks up, this is likely to encourage the father to ask for help - either from their partner or from other support networks or healthcare professionals.
Screening and perinatal healthcare services
Getting checked (screened) for postnatal depression by a health visitor, GP, or psychologist is an important part of help-seeking. It's possible that this will be the first time a father has heard of male postnatal depression.
Postnatal depression in men has a massive impact on the father's well-being and can also damage relationships with their partners and children. As a society, we need to break the taboo and talk more openly about male PND. This will help men and their partners to recognise the warning signs and feel more comfortable in asking for help.
Finding support for postnatal depression
If you believe that postnatal depression may be affecting your mental well-being, speak to your healthcare provider or GP. They will be able to diagnose the problem and recommend treatment that can get you on the road to recovery.
The main forms of support are:
- Talking therapies - such as cognitive behavioural therapy (CBT).
- Medication - usually antidepressants.
- Self-help and support from friends and family.
- Other support services - such as charities and online communities.
Talking to your loved ones can be extremely therapeutic. Postnatal depression can often make you feel guilty but it's important to remember that having this illness does not make you a bad parent. Opening up to others about how you feel can help you to understand that you have done nothing wrong.
There are also several support groups and charities that offer confidential support services, helpful information, and communities through which you can learn of others' experiences and feel that you're not alone. For example:
"The PANDAS Foundation is a safe, moderated place for fathers to be heard and share their experiences with other dads who have similar challenges," says Belasco.
Other postnatal depression support networks:
- Dads Matter - a free service that provides support for dads worried about or suffering from depression, anxiety, or post-traumatic stress disorder (PTSD).
- Make Birth Better - a network dedicated to improving the prevention, diagnosis, and treatment of birth trauma.
- Mind - offers advice and support for mental health problems.