Postnatal depression and anxiety in dads

Symptoms

• Tiredness, headaches and pain
• Irritability, anxiety and anger
• Loss of libido
• Changes in appetite
• Feelings of being overwhelmed, out of control and unable to cope
• Engaging in risk taking behaviour
• Feelings of isolation and disconnection from partner, friends or family
• Withdrawal from intimate relationships and from family, friends and community life
• Increased hours of work as a part of the withdrawal from family
• Increased use of drugs or alcohol instead of seeking treatment for depression

Risk factors

Some men may not be able to identify any of the risk factors in their lives yet still develop postnatal depression. Paternal postnatal depression can affect men of all ages, personality types and economic status. Some of the known risk factors associated with paternal postnatal depression include:

Partner experiencing postnatal depression
• Previous history of depression
• Relationship problems and conflict
• Low self-esteem
• Feelings of incompetence in parenting role
• First time father
• Infant irritability

Contributing factors

The factors that affect men can be very similar to those affecting women, such as:

• Lack of social and emotional support
• Personality characteristics (perfectionist or controlling)
• Stress and changes in relationships (particularly the couple relationship)
• Lack of sleep
• Unresolved issues of grief and loss
• Difficulty adjusting to the changes of parenthood
• Unmet expectations of fatherhood and himself
• Negative or traumatic birth experience - the way in which men experience childbirth may have some influence on their subsequent emotional well-being

Biopsychosocial factors

As with all forms of depression there are a range of biopsychosocial factors that contribute to the development of paternal postnatal depression: some physical, some emotional and some social. Some factors are the same as those that contribute to women experiencing antenatal and postnatal depression and others are related to the man’s experience of pregnancy and new fatherhood.

Factors that generally seem to relate to the man’s experience:

• The impact of changing social roles for fathers in the family
• Norms and attitudes toward fatherhood and masculinity – men are less likely to talk about how they feel and maintaining that they are coping is very important
• Change in family dynamics so that some men may feel excluded from the parenting role or from the relationship with their partner. This may result in resentment towards the baby.
• Worries about extra responsibilities, financial burdens and managing the stresses of work.
• Unmet expectations for the resumption of the sexual relationship in the early postnatal period
• Pregnancy, particularly early on, appears to be the most stressful period for men in the transition to fatherhood. This may be due to changes to his partner’s body, how supported and included he feels, concern about the pending changes to his life and feeling unsure about his role in caring for his partner.
• Partner experiencing postnatal depression. Studies have shown that maternal and paternal depression are highly correlated (Ramchandani et al, 2005; Meighan et al, 1999). The extra pressures of managing a new baby, an unwell partner, additional household duties and work demands can contribute to fathers developing postnatal depression themselves.

Seeking help

Seeking help early leads to a faster recovery. Men who have experienced symptoms of depression for two weeks or more should be encouraged to seek help. Strategies and treatment options available for fathers who may be experiencing postnatal depression include;

Contact PANDA for support, information and referral to services for men experiencing postnatal depression;
• Visit your doctor for a full medical and mental health assessment, to clearly establish what is going on;
• Your doctor may suggest antidepressant medication to help reduce some of the symptoms. These are effective for many people, especially in conjunction with counselling and are preferable to the use of alcohol or illicit drugs. Your doctor, pharmacist or a drug information helpline will be able to provide more information.
• Ask your doctor for a referral to a psychologist or psychiatrist who specialises in postnatal depression. You may be eligible for Medicare rebates.
• Seek extra support. Go along to your baby’s next maternal and child health nurse appointment and discuss your situation with the nurse. She may be aware of other local services.
• Support groups. It is very common for women experiencing postnatal depression to attend support groups. These groups can be immensely beneficial but there are very few groups established for men. It might be worth alerting your community health centre to this gap or talk to PANDA about setting one up in your area.
• Seek emotional and practical support from your partner, your family and friends, your work colleagues, anyone who is willing to help. The nature of depression will probably mean you feel isolated and alone. Asking for help, talking things through, even just spending more time with the people you love can help you to re-connect with your positive feelings again.
• Lastly, be kind to yourself and remember there is a way out and you are not alone. There is help available and with the appropriate treatment, you can begin to feel better and enjoy being a new father.

References

Deloitte Access Economics (2012) The Cost of Perinatal Depression in Australia.
Davey, SJ., Dziurawiec,S, Brien-Malone, AO. (2006). Men’s voices: Postnatal depression from the perspective of male partners. Qualitative health research.
Meighan et al, (1999). Living with postpartum depression. The father’ s experience. American Journal of Maternal Child Nursing. 2494): 202-208.
Bielawska-Batorowicz, E, Kossakowska-Petrycka, K. (2006). Depressive mood in men after the birth of their offspring in relation to a partner’s depression. Journal of Reproductive and Infant Psychology.24(1). 22-29.
Condon, JT, Boyce, P. Corkindale, C. (2004). The first time father’s study: a prospective study of the mental health and wellbeing of men during the transition to parenthood. Australian and New Zealand Journal of Psychiatry, 38(1-2), 56-64.