Postnatal depression in men is real
It is commonly known that women can experience depression or anxiety during pregnancy and early parenthood. What is less well known (and less discussed) is that men are also at risk
At least 1 in 10 new dads experience depression or anxiety related to the arrival of a new baby. So, there is a good chance you or someone you know could be affected.
The purpose of this article is to raise awareness of postnatal depression in men and to give you some tools and resources to recognise the symptoms and seek help if needed.
Terminology explained
Firstly, let’s clear up some terminology, because it can be confusing.
For both mothers and fathers, the signs of depression and anxiety sometimes occur before the baby arrives i.e. during pregnancy. In this case, it is referred to as Prenatal or Antenatal Depression.
However, it’s more common for symptoms to appear during the first year following the birth, in which case, it’s known as Postnatal or Postpartum Depression.
But just to confuse things further, you may also come across the term Perinatal Depression.
‘Perinatal’ refers to the period immediately before and after the birth of a baby, however, the exact definition is up for debate. Typically, it starts around the fifth or sixth month of pregnancy and ends about one to four weeks after the baby arrives. But the experts can’t even agree on that, so it’s no wonder the rest of us are confused.
Anyway, for the purpose of this article, it’s not actually important. And most of the studies I’ve read group all these forms of depression and anxiety together under the one umbrella.
But wait – there’s more. We all love an acronym, right? So you’ll also see these terms shortened to PPD or PND. And in the case of fathers, you can stick another P in front of it to signify ‘Paternal’.
So let’s not split hairs. What we are talking about is parental depression related to the arrival of a new baby – which may occur before, during or after the baby is born.
So there you have it…… Paternal Postpartum Depression (PPPD) or Paternal Postnatal Depression (PPND). Take your pick!
I decided to let google choose. And it turns out that the most commonly searched phrase is Postnatal Depression, so I’m going to run with that one. Postnatal Depression in men, also known as PPND.
What are the stats?
Just as there are many names for the condition, there are also many studies on the topic of postnatal depression in men.
In fact, there were at least 43 studies conducted around the world between 1980 and 2009.
Comparing and cross-referencing all these results sounds like a tedious task. But that’s exactly what Dr James F. Paulson decided to do as part of his 2010 paper published in the Journal of the American Medical Association.
By conducting what’s known as a meta-analysis, he was able to combine the results of 43 separate scientific studies covering over 28,000 participants. So, I think we can consider that pretty comprehensive right?
Anyway, after all that analysis the three key conclusions were:
- 1 in 10 men experience pre or postpartum depression
- It most commonly occurs in the period 3-6 months after the birth
- There is a positive correlation with maternal depression (i.e. it’s more likely to occur in dads if the mother is also experiencing depression)
What are the risk factors
Statistically, the biggest risk factor for paternal postnatal depression is when the mother is also experiencing depression. Research indicates this can double the likelihood of the dad becoming depressed.
According to Beyond Blue, some of the other risk factors that can contribute to PPND include:
- A history of anxiety or depression
- Current or past issues with drugs or alcohol
- A lack of practical, emotional and social support
- Supporting a partner through a difficult birth
- If the baby is premature or unwell
- Relationship difficulties or other major life changes
- Finding the reality of parenting different from expectations
- Having trouble bonding with the baby
- Attitudes to fatherhood and masculinity – thinking you can’t talk about how you’re feeling or ask for support, or a fear that you’ll be seen as a ‘failure’ if you’re not coping
- Changes in relationship with partner, which can lead to feelings of resentment and exclusion
- Worries about extra responsibilities, financial burdens and managing the stress of work.
What are the signs that you or someone you know may be suffering from PPND?
Men and women can experience depression in different ways. So the signs to look out for in men can be different from women.
According to the Pacific Post Partum Support Society, some of the common signs of postnatal depression and anxiety in men include:
- Increased anger and conflict with others
- Increased use of alcohol or prescription/street drugs
- Frustration or irritability
- Violent behaviour
- Significant weight gain or loss
- Isolation from family and friends
- Being easily stressed
- Impulsiveness or risk-taking (this kind of behaviour can include reckless driving or extramarital affairs)
- Feeling discouraged; cynicism
- Increase in complaints about physical problems, like headaches, digestion problems or pain
- Problems with concentration or motivation
- Loss of interest in work, hobbies and/or sex
- Working constantly
- Concerns about productivity and functioning at work or school
- Fatigue
- Feeling sad or crying for no reason
- Conflict between how you feel you should be as a man and how you are
- Thoughts of suicide or death
How to know if it’s PPND and not just normal tiredeness?
Whilst some of the symptoms of PPND could be easily confused with the general tiredness and chaos that comes with having a new baby, you will probably know if something is not quite right.
When testing for PND, the most common method used is the Edinburgh Postnatal Depression Scale, which was developed in 1987 by Scottish Health Centres. It is still used all around the world and is the basis for most of the studies into PND.
You can take the Edinburgh Postnatal Depression test here
However, the problem with this test is that it was developed for testing PND in women. So whilst it can also help detect the condition in men and is commonly used for that purpose, it’s probably not the best test for men to be using.
Another option is the ‘Dad Stress Test’ which has been developed by the BeyondBlue organisation and is specifically designed for new dads.
You can take the dad stress test here.
What to do if you think you are experiencing PPND
Firstly, and this is very important to make clear:
If you think your partner or baby would be better off without you, or you are having thoughts of suicide or thoughts of harming your baby, seek emergency assistance. Don’t wait any longer. Call someone immediately and get some help.
For everyone else, if you identify with some of the symptoms on the list or you have reason to believe you (or someone you know) may be experiencing postnatal depression, the best thing to do is seek advice from a medical professional i.e. go and see a doctor!
There is also a lot of information and support available online. Here are a few examples from around the world.
- postpartummen.com – a blog by Dr Will Courtenay, offering information and support for men with PPND
- postpartum.net – provides international support covering most countries
- postpartum.org – PND support organisation in the USA
- Beyond Blue – Australian mental health organisation
- Mind.org.uk – British mental health organisation
Don’t be afraid to talk about it
For a long time, men have been afraid to talk about mental health issues. Whilst this is starting to change, we still have a long way to go.
Depression is not something that you can simply ‘get over’. It’s a medical condition and needs to be treated like one. It’s no different from a heart condition, a prostate problem or a broken bone. If you have the symptoms, go and see a medical professional. Pretty simple really. There’s no need to be ashamed about it.
And if you have a friend who you think may be depressed, speak to them about it. Ask them if they are okay. Encourage them to get some help. It’s no different to if you noticed them looking sick with the flu or limping around with a sore leg.
If you are a manager in the workplace, then start to think of mental illness like any other form of illness. If you believe a staff member is suffering, encourage them to take some time off and get help. If someone requests a day off for mental illness, don’t assume they are slacking off. Treat it seriously, like any other illness.
Together, we all have a part to play in changing the culture on mental illness. So, let’s break the stigma and start treating depression like any other health condition.
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