PTSD can affect dads, too
Two months after the birth of his twins, Ben Orrah was driving to work when he found himself sobbing uncontrollably. He and his wife, Paula, were thrilled to have become parents, and their babies, Polly and Logan — born two months early — were home and doing well after six weeks in special care.
“I should have been so happy,” he says. In addition to continuing bouts of unexpected tearfulness, Orrah, a biomedical scientist, began to experience frightening nightmares and vivid flashbacks to moments in the special care unit.
“They were so real. I could be at work, looking down my microscope and suddenly I was back there. My heart was racing,” he says. He now knows he was ill, with post-traumatic stress disorder (PTSD), severe depression and anxiety, triggered by the difficult circumstances of the twins’ early weeks.
Awareness of perinatal mental health problems — including PTSD, depression and anxiety — and of the ways they can affect both parents, is growing.
In the U.K. National Childbirth Trust (NCT), research found about one in three new fathers admitted concern about their mental health, with one in 10 receiving a diagnosis. (The equivalent figure for mothers is one in five.) The number of fathers affected by PTSD is not yet known and it is an area of growing research interest.
“This is a particularly vulnerable time for men and their mental health,” says Sarah McMullen, head of knowledge at the NCT. “And we need to know more about PTSD generally. We know it is happening in men, too.”
Changes in relationships, lifestyle, financial worries and the pressure of feeling unable to support a partner — a kind of provider/ protector anxiety — are all factors. “The experience of witnessing a traumatic birth or illness in mother or baby can be key,” McMullen adds. Men are also not only less exposed to health-care services that might identify problems, she adds, but also often more reluctant to ask for help.
For many men, agrees Orrah — “convinced that, as fathers, they have to be strong, always able to cope” — this is very difficult.
“We need to be honest about our feelings,” he continues. “I have now discovered many other dads who have struggled after the birth of children, even when on the outside everything has seemed fine.
“I saw myself as a failure and I wrongly assumed everyone else would as well,” he says of the silence that resulted in a damaging spiral of self-reproach and distress.
He felt not only that his feelings were unjustifiable — “other people had it much worse” — but also that to share them with his wife would be selfish.
“I didn’t want to burden her,” he says. “She had so much to do already, looking after two premature babies. I didn’t want to be a responsibility for her or to distract attention from the babies, and I thought that if I was feeling so terrible it might be worse for her. I was supposed to protect her.”
In addition to anxiety over Polly and Logan’s uncertain prognoses, Orrah found the situation of other families on the unit extremely upsetting. “We were always hearing about babies that had died,” he says. One incident — in which the baby in the incubator next to Polly’s heart stopped — affected him so deeply that it became the focus of distressing flashbacks.
“I kept reliving it again and again,” he says. “It was absolutely awful. I could see the expression on the parents’ faces. Everything.”
Although Orrah was increasingly aware that his experiences were not typical, he tried to carry on as normal.
“The routine was exhausting. We were up early to drive to the hospital so I could spend time with them before work,” he says. “There was no time to take stock of how we felt. I was trying to be professional at work and I was worried about Paula and how she was coping. I just swallowed all my feelings.”
While the twins were in hospital, Orrah began to worry about how his wife was coping, and then with the stresses of caring for them at home. “I had concerns about her developing depression — because of how I felt, really — but she was fine. When we got the twins home, she was actually the happiest I had ever seen her,” he says.
Having previously experienced bouts of mild depression, Orrah researched his symptoms online. “I knew I wasn’t coping and I knew it was 10 times worse than anything I had felt before,” he says.
He came across information about PTSD after birth. “It described how I felt exactly but every single thing was about mothers. There was nothing about fathers, and that made me feel even worse,” he says.
When, a few weeks later, his wife found Orrah crying by Polly’s cot, the relief at telling her how he felt was huge. “I just came out with it all. It changed everything,” he says.
Orrah received counselling — which focused a lot on his sense of guilt and lack of self-compassion — and learned to use mindfulness and meditation techniques.
He doesn’t know, he admits, what might have happened if he hadn’t sought help. “After the first therapy session, I was having thoughts about harming myself. That was terrifying. Luckily, I wasn’t yet sick enough to go further.”