Male postnatal depression: Symptoms and signs of depression in dads

Having a newborn baby is supposed to be a time of great joy. But for some, it can also trigger postnatal depression. And it's not just new mums who suffer. Even though it's not talked about as much, dads can experience male postnatal depression. 

Postnatal depression in women affects more than 1 in 10 mums in the UK. It is a relatively common response to the huge physical and emotional changes that occur after birth. While 'baby blues' are common in the first couple of weeks after childbirth – as hormones settle – PND lasts longer. Untreated, it can become a debilitating condition. Less well known is that some men suffer from depression after the birth of their children. Cases have risen in recent years, no doubt fuelled by the pandemic. One Swedish study reported that of 447 men interviewed, 27% of men had depressive symptoms above mild levels, yet fewer than 1 in 5 sought help.

In the UK, the guesstimate is about 1 in 10 new dads. "There is no official diagnosis of PND for men, but we do know that around 10% of fathers experience symptoms of what would be diagnosed as depression in the months after their child is born," says Dr Andrew Mayers, a psychologist at Bournemouth University and an expert in perinatal mental health.

What is male postnatal depression?

Pregnancy and giving birth can be exciting. It can also be, at times, worrying and even traumatic. Pregnant women and new mums have to deal with all sorts, from morning sickness, hot flushes and pre-eclampsia before the baby is born, to breastfeeding and lochia afterwards – as well as postnatal depression. "PND is essentially the same as any other depression, except that it occurs in the postnatal period," explains Dr Mayers.

But what about male postnatal depression? Men don't have to give birth, so why are they affected? The truth is that although male partners don't go through pregnancy and childbirth, they still have to adapt. "We all know that women have huge hormonal and physical changes to contend with but few of us realise that men do not escape as their testosterone, oestrogen, prolactin and cortisol levels can also change in response to becoming a dad," says baby and parenting expert Rachel Fitz-Desorgher.

Rachel continues: "Both men and women experience the enormous turmoil brought about by changes in income, a sometimes overwhelming and frightening sense of responsibility, and a feeling of loss of control. To cap it all there are the relentless disturbed nights. Needless to say, PND in either parent can cause immense strain to the relationship."

Annie Belasco, head of charity for PANDAS Foundation – which offers pre and postnatal depression advice and support – agrees. "Men can develop PND for many of the same reasons as a mother. This includes birth trauma, adaptation to life, sleep deprivation and other significant changes to their lives," she explains.

One of the main concerns about male postnatal depression is that men are less likely to admit to it. "Many men feel unable, through societal pressures, to tell anyone. So they bottle it up and put on a show of coping," says Rachel. She adds that they will also keep quiet to protect their exhausted partner. This may seem like an act of kindness, but it can cause serious problems later on.

Male postnatal depression symptoms

First and foremost, we know that PND is a form of depression. Typically, it can also include the following:

• Low mood and/or a lack of motivation
• Anxiety and/or panic attacks
• Feelings of low self-worth and/or guilt
• Poor concentration
• Changes in appetite
• Changes in activity (usually reduced, but can be agitation and restlessness)
• Withdrawal from people
• Poor sleep
• Loss of identity
• Hopelessness and crying
• Thoughts about death

The majority of these symptoms are the same ones that women with PND experience. And like women, men – says Rachel Fitz-Desorgher – will also find it hard to sleep even when they have the opportunity to, may feel indifferent towards their baby just as a struggling new mum might, and may notice changes to their appetite and libido. "In addition, men are more likely to turn to alcohol and drug use, and resort to physical violence within the relationship when suffering from PND," warns Rachel. This makes it all the more essential that dads with male postnatal depression seek support.

This short video is from the perspective of both mums and dads who have felt depressed.

https://vimeo.com/488062034?embedded=true&source=vimeo_logo&owner=30724562

How long does male postnatal depression last?

While it can be a terrifying prospect to reach out and ask for help, it's better than coping alone. As with so many conditions, the sooner male postnatal depression is treated the better – in terms of both longevity and intensity.

"Babies can bring joy but they can also rock the foundation of their parents’ lives and the sooner mums and dads seek help and support, the sooner they can start to feel emotionally stronger and start to enjoy life as a family," says Rachel Fitz-Desorgher.

Time is of the essence here. "How long PND lasts is down to how soon help is sought," says Rachel. "Left untreated, symptoms might drag on for years," she warns.

Support for male postnatal depression

Fortunately, says Annie, more men are becoming aware and educated around perinatal mental health. As a result, they are seeking answers and support for male postnatal depression. "They're not risking their symptoms being brushed off or undermined," she says, which is good news.

And there's a lot of support out there. The charities Tommy's and PANDAS provide a wealth of advice and resources, and Dr Mayers information on fathers' mental health is very useful. Dr Mayers is also working with the NHS to help men with PND.

"With our campaigning work and research evidence, we persuaded NHS England to include methods to screen new fathers for mental health, where their partner has been referred to support services," he says. The NHS recognises male postnatal depression so dads don't need to feel embarrassed or afraid to discuss their worries with a health professional.

"First port of call should be the GP who can get the ball rolling fast, keep support in place, and also monitor how well treatment is working," confirms Rachel Fitz-Desorgher. "And the role of support groups should not be underestimated – just knowing that you are not alone and that other dads have experienced PND can be hugely helpful," she says. For example, PANDAS offers PANDAS Dads. "It's an online community for just men who are fathers or carers who may be suffering with pre or postnatal depression or anxiety," explains Anne. "This is a safe, moderated place for fathers to share their experiences with other dads."

While some men may wonder if treatment differs from female PND, the medical response remains largely the same, although breastfeeding mothers may be less inclined to take medication. "While many medications are probably safe in breastfeeding, many mothers feel that it is not safe," says Dr Mayers. As a result, some women will feel they have to choose between drug treatment and breastfeeding – a dilemma men won't have to face.

But, as a general rule, male postnatal depression gets the same clinical treatment as female PND. Help includes talking cures and lifestyle changes to improve mood. "Treatment is the same for men and women and can reduce symptoms within a few months," confirms Rachel. "So, a mixture of self-help, talking therapies, cognitive behavioural therapy (CBT) and, where appropriate, medication."

Can you reduce the risk of male postnatal depression?

For most new parents, there are ways to lower the risk of developing postnatal depression or to prevent it from spiralling out of control. These include leaning on friends, family or health professionals, spending time outdoors and exercising, eating well, and getting as much rest or sleep as possible.

Reducing expectations can also be hugely beneficial. "Not putting unrealistic pressure on yourself is a great place to start," says Rachel Fitz-Desorgher. "Just by acknowledging that babies cannot be made to sleep or wait for cuddles, or to learn night from day before they are developmentally ready, can help both parents to stop feeling like they have failed when their baby behaves erratically," she advises.

Some women will be more prone to PND because they have a history of depression or substance abuse. Or they had a traumatic life event or illness during pregnancy, a difficult birth, or their baby had – or has – health problems. These circumstances can also apply to fathers who develop male postnatal depression, plus there's the challenge of getting men to talk about their feelings in the first place – something women usually find easier to do.

"One of the key factors in PND with fathers is encouraging men to speak about emotions and mental health and seek help," says Dr Mayers. "Men can be typically reticent when doing either of those things, for physical and mental health. We need to make it easier for men to speak up. Increasingly, we are seeing male role models speak up, especially in sports such as professional football. This helps legitimise it," he says.

A traumatic birth can also trigger male postnatal depression, adds Dr Mayers. Witnessing a partner in danger or pain can be very distressing for men. Then there are life challenges such as financial worries and separation. Another aspect to take into consideration is society's tendency to dismiss the load fathers carry. Raising a family is still regarded as women's work. While this is essential for new mothers – who, more often than not, carry the burden – it's also important that we don't ignore the male experience. "It's crucial that we treat men equally in the parenting journey from conception through to birth and beyond," says Annie. "This can reduce anxiety and the unknown path ahead as a father."

This is particularly true of first-time dads, she says, or men who have a pre-existing mental illness. Age counts, too, adds Rachel – studies show that like younger women, younger men more likely to be affected by male postnatal depression than older dads.

Caring for a new mum with PND can be exhausting, so it's perhaps not surprising that a woman's fragile state of mind can have a knock-on affect on their nearest and dearest. "It is more likely for men to become unwell with PND if their maternal partner has symptoms or a diagnosis," says Annie. So, if you know a mum who's suffering it could help enormously to ask her partner how he's doing, too. If he's struggling and you can offer advice, he's in a much better position to support mum and baby.

(Rachel Fitz-Desorgher will be speaking at The Baby Show at London’s Excel from 4-6 March)