Yes, fathers really can suffer from trauma of postnatal depression
ELIZABETH Crone was only eight months old when her father Tony was spotted walking along the tracks of a rural railway line. And were it not for the eagle eyes of an off-duty police officer that afternoon, Elizabeth would never have got to know him.
Tony, now 28, was about take his own life. Overwhelmed by feelings of depression after the birth of his first child, he had been driven to depths he had never imagined possible.
‘When I held Elizabeth, I felt no emotion at all, no warmth, little more than holding a sack of potatoes,’ he says.
‘I knew I should love and care about her but I just didn’t. It was a feeling that was so crushing, filling me with guilt and self-loathing.’
While it is well known that new mothers can develop postnatal depression, what is less recognised, even among the medical community, is that men can get it too. And this is what Tony was suffering from.
Indeed, it is claimed it is almost as common among men as women. Research published in 2015 by the Australian Institute of Family Studies found 10 per cent of new fathers are affected by postnatal depression, compared with about 15 per cent of mothers.
The triggers are thought to be a combination of physical factors – men may have an increase in stress hormones, for example – and emotional factors, as they struggle to cope with the demands and expectations of fatherhood. And it is thought to be becoming more common as men’s childcare roles evolve.
‘Times are changing,’ says Sarah McMullen, head of knowledge at the National Childbirth Trust (NCT). ‘At the same time as wanting to be involved in every aspect of their child’s life, from the pregnancy to the birth to night feeds, men also have to go back to work within a few weeks, handle the financial strains and support their partner – often without being given any support themselves.’
The symptoms for men or women are virtually the same: persistent sadness, difficulty bonding with the new baby and a lack of interest in life. They may also have extreme fatigue and changes in eating or sleep habits.
Men are less likely to be weepy, however, so the disorder may look different in males.
Men who feel stressed about their new role as fathers are most at risk, wrote University of Auckland researchers in the journal JAMA Psychiatry last year. They found that whereas women tend to develop symptoms four to six weeks after the birth, men often get them six to nine months later.
‘Maternal depression is linked to physiological changes such as hormone fluctuations, and expectant and new fathers also experience biological stresses... including changes to hormones that can increase their risk of depression,’ says research fellow Dr Lisa Underwood.
While new mothers may be monitored for signs of depression, this does not happen with men, says Dr Andrew Mayers, a psychologist specialising in perinatal health at Bournemouth University.
‘If a mother goes to her GP and says she feels depressed, there are a whole load of boxes that can be ticked to diagnose postnatal depression and start the referral process for specialist help,’ he explains.
‘At the very least, there is an acknowledgement that her condition is real and needs to be addressed.
‘With dads, that simply doesn’t exist. So not only is the GP very likely not to be aware of paternal postnatal depression, there’s also no process or funding in place to provide vital support when it’s needed.’
He said the majority of men who experience postnatal depression are misdiagnosed or do not seek help. Yet, even though the NHS acknowledges that postnatal depression can affect either parent, some within the medical profession are sceptical of the idea that men can have the condition.
‘In my opinion, new fathers don’t suffer from postnatal depression in the same way as a mother does,’ says Dr Natasha Bijlani, a consultant psychiatrist at the Priory Hospital, in Roehampton, southwest London.
SHE added: ‘Postnatal depression is due to the immense biological and hormonal changes in the female body, which the man does not experience.’ Dr Chirag Gorasia, a clinical psychologist at Great Ormond Street Hospital, believes new fathers may experience depression because they are expected to play more of a role in child rearing but may not have experience of what is required.
Tony, a care worker living in Norfolk, was told by health professionals that ‘men don’t suffer from PND’.
‘Before the birth of Elizabeth, I had no idea that men could get postnatal depression, or much about PND in general,’ he says. ‘In my teens, I’d been on mild antidepressants briefly after the death of my granddad, but nothing could have prepared me for what I went through as a new dad.’
Elizabeth was born happy and healthy but it was about a month after her birth, in June 2013, that Tony realised all was not right.
‘I felt flat when everyone asked if I was the happiest man alive,’ he recalls. ‘But I didn’t want to let on how I really felt because I knew how lucky we were to have a healthy baby.’
Tony admits he felt ‘a bit of a spare part’ while his wife, Mel, 24, was busy feeding and caring for Elizabeth, and sleep deprivation did not help either.
‘I threw myself into work, thinking that would help, but it didn’t,’ he says. In November that year, he went to see his GP. He said: ‘To his credit, my doctor took my depression seriously and I got admitted to the psychiatric ward at Great Yarmouth Hospital for four days.
‘But while I was there, I was labelled as having borderline personality disorder – a broad term for someone who can’t manage their emotions properly.
‘It was an easy box for them to tick and then discharge me with more medication.’
The antidepressants did not help and three months later, in February 2014, Tony felt he could not even hold Elizabeth.
‘I felt so guilty and suicidal,’ he says. ‘Then one day I found myself walking along that railway track.’
The off-duty officer who rescued Tony drove him straight to hospital. But despite cognitive behaviour therapy (CBT) being added alongside his medication, his symptoms did not improve.
It was only when Tony did some research online that he realised he had postnatal depression. ‘Everything made sense,’ he says.
The turning point came a few months later when, without prompting, a male health visitor specialising in mental health issues told Tony he had postnatal depression.
‘The sense of relief to hear I wasn’t making it up was unimaginable,’ he said.
Postnatal depression in men can be more serious than in women because men too often ‘bottle things up’, says Nick Summerton, a GP based in East Yorkshire. ‘I sometimes see new dads come in complaining of physical symptoms such as headaches, persistent exhaustion and weight loss, when in fact it’s PND.’
Dr Summerton added: ‘Many parts of the UK don’t have enough NHS services for mental health conditions, so you have to take steps yourself – maybe connect with online support groups, ask about local cognitive behavioural therapy or versions available online,’ he said.
THERE are also private initiatives such as Daddynatal – antenatal classes for men – and Fathers Reaching Out, a support group for husbands and partners of those with postnatal depression.
Tony got his depression under control after he began attending a weekly father and baby group to help him socialise with other dads, which taught techniques on how to bond with his daughter.
‘It felt unnatural and slightly forced at first,’ admits Tony. ‘But slowly I felt a change – that I loved this little girl living in my home. She needed me and I started to need her.
‘If anything, she became a bit of a daddy’s girl and I can’t imagine life without her now.’
When Mel gave birth to the couple’s son, Andrew, two years ago, Tony was worried his depression would return. But he coped thanks to the techniques he had learned.
He now aims to raise awareness of the condition. He said: ‘If my postnatal depression had been dealt with earlier, I doubt it would have escalated. I shudder to think about how I wanted to leave Mel a widow and Elizabeth fatherless when I was walking down that railway track.
‘I fear for the thousands of men out there still suffering in silence.’