David Walsh: Postnatal depression in men is more common than you think

'˜Do you feel like a failure? Do you wake up every morning feeling exhausted? Have you been anxious or worried for no good reason?'

New mothers are checked for symptoms of postnatal depression but similar symptoms in new fathers go unrecognised. Picture: Stock image

Our health visitors posed these questions to my wife at least twice in the weeks after our daughter was born over a year ago. Despite having my history of depression in their notes, I was never asked.

If I had been, it would have been an exception rather than the rule. Fathers are rarely screened using the Edinburgh Postnatal Depression Scale (EPDS). The predominant opinion that men are not affected by postnatal depression seems a stubborn one to correct, despite compelling empirical evidence to the contrary.

Sadly, just the mention of “paternal postnatal depression” is enough to light the touch paper on a corrosive battle for ownership of a condition primarily recognised and treated as a psychosis in new mothers.

Men obviously don’t know what it is to carry a child to term nor do they go through the physical trauma of labour or deal with the after-effects on the body; from the constant spike and dip of hormone levels post-labour and cracked nipples, to “mummy tummies” and scarring.

While this in itself is admittedly a one-dimensional reading into the causes of PND in women, a similarly glib line of argument has been persistently applied to men with the result being further alienating fathers who see no option but to resign themselves to struggle in silence.

For instance, Observer columnist Barbara Ellen once noted that male PND was a fallacy that could be distilled down to merely being: “Pissed off, knackered and yearning to be carefree again.”

While this was written in 2012, hers continues to be the prevailing opinion.

The failure to recognise PND in fathers is further compounded by esteemed health organisations, including the World Health Organisation (WHO) which prescribes screening for women only, while here in the UK, the National Institute for Health and Care Excellence (Nice), explicitly frames PND in maternal terms.

While I count myself fortunate that my child’s arrival didn’t destabilise my mercurial mental state, for a growing number of young men, PND is a way of life far too often left unchecked to the endangerment of many of their lives.

“After a year, we started to bond and things started to become easier. I no longer considered driving the work van into the harbour.” Gerard*, a 31-year-old father of two, told me as I prepared to fill these column inches.“I’d even gone as far as to plan it in my head,” he added.

“The thought of leaving my girls fatherless was always enough to pull me back. It was a constant tug of war between the two for a year.”

While elated by the birth of his second child, Gerard couldn’t shake a sense of foreboding that he had not experienced when his eldest daughter was born.

“I hadn’t managed to build a bond with my daughter and she screamed every time I picked her up. It was a shock after the ease with which my first daughter and I had formed a lifelong bond,” he admits.

So entrenched by a crippling anxiety, Gerard often feared going home, to the detriment of his familial relationships.

“I was scared of the rejection from my own daughter. I wanted to help my wife but as harsh as it sounds, I didn’t like my daughter. I resented her. My wife would always say: ‘she’s young, she loves you and you her.’ At the time, I can honestly say I didn’t.”

Gerard’s story is just one of thousands that have fallen by the wayside when it comes to postnatal care. It is believed that one in ten fathers in the UK begin experiencing PND in the days, weeks or months after the birth of a child, roughly equivalent to the number of mothers affected by it.

It would be wrong to try to equate the male experience to that of the female when it comes to cases of PND. Raising awareness of paternal depression should never trivialise what can be a serious, long-term condition for new mothers, but as is the case in so many case histories of depression, one person’s experience can be vastly different to another, irrespective of sex.

But while men do not by virtue of physiology endure the act of childbirth, the lasting effects of a traumatic labour, sleep deprivation, anxiety about financial stability or the strain on relationships in the aftermath of a baby’s arrival can act as triggers in both parents.

And as with the causes, the consequences are often the same, that is to say feeling estrangement from your baby, sometimes even revulsion at touching them for fear of hurting them or being rejected.

According to the most recent research carried by Lund University in Sweden, male PND may even be more prolific than first thought.

Admittedly, the sample size of 447 men is small but the results are still persuasive.

A surprisingly high 28 per cent of fathers in the study had registered some symptoms while four per cent had moderate depression. Only one in five surveyed had sought professional help, despite a third of those having considered harming themselves.

Wider acknowledgement and a sea change in mental health policy is unlikely to happen overnight. Nevertheless, there is a glimmer of hope on the horizon for new dads.

Groups like Fathers Reaching Out are working relentlessly to put fathers’ mental health in the spotlight with notable successes including their #howareyoudad campaign.

While the importance of men talking and seeking help for mental health issues is mercifully now starting to gain traction, one of the underlying concerns here should always be for the child and that it has two functioning, healthy parents to raise it.

While the transition to parenthood is arguably a disparate path for both mothers and fathers, the mental wellbeing of both parents should surely be of paramount importance, if not for their own health but for the welfare and development of their newborn baby.

*Name changed to safeguard privacy