Many men struggle with mental health after becoming fathers. Photo / 123RF
Many men struggle with mental health after becoming fathers. But stigma and societal norms keep them from getting help.
When I was pregnant with my daughter, my husband and I took a parent prep class in which they talked at length about the signs of maternal postpartum depression. My husband took detailed notes. After all, I had a history of depression and occasionally fell down dark, deep rabbit holes from which only medication and therapy could pull me out.
My husband, on the other hand, is the epitome of stable. When his parents died in our first few years of knowing each other, I required more comforting than he did. If I had taken bets on who between us would suffer depression following the birth of our daughter, every single one of our loved ones would have bet on me. And I wouldn't have blamed them.
But it wasn't me.
I'd never thought about the possibility of men struggling with depression after the birth of a child. At the time I was focused on the well-being of our daughter, as well as my own physical and mental health. But men do struggle also.
As many as one in six men can experience high levels of anxiety in the postpartum period, and about 10 percent of new dads experience postpartum depression. In the 3- to 6-month postpartum period, that rate climbs to 25 per cent.
Perhaps the fact that my husband was low on my list of concerns contributed to the problem, a problem that dramatically affected the first three years of our family's life.
One weekday morning in 2019, while watching our then-21-month-old daughter sitting in her high chair, shovelling fistfuls of oatmeal into her face, my husband said:
"I hate this time of day."
"Why?" I asked. From where I stood, it was all rather pleasant.
"I just hate parenting," he said. "It's relentless."
I was not surprised to hear this. I had suspected a problem and had even started reading about postpartum depression online.
The Diagnostic and Statistical Manual of Mental Disorders defines depression "with peripartum onset" as a major depressive episode during pregnancy or within four weeks after birth. For men, this may develop more slowly over a full year.
Typically, symptoms of a major depressive episode may include feeling sad, crying, having recurrent thoughts of death and losing interest in activities. According to Sheehan D. Fisher, an assistant professor of psychiatry and behavioral sciences at Northwestern University, symptoms for men can differ.
"The actual DSM diagnosis of depression doesn't always fit how men experience depression," Dr. Fisher said. For men, symptoms may include frustration, agitation and irritability, an increase in dopamine-boosting activities (drinking, drugs, gambling) and isolation.
That was my husband — frustrated, irritable and detached. He went to bed before 7pm, claiming exhaustion, though I was the one getting up with our daughter every night. He snapped at the littlest things. He just wanted to be left alone.
I tried to help with pep talks: "She's a good kid! We're so lucky!" Then I remembered how, when I was depressed, such cheerleading only made me feel worse, as if I was letting others down with my inability to snap out of it.
So I whisked our daughter off to playgrounds, giving him time to lounge on the couch or obsessively clean, something he'd taken up as a hobby. I encouraged him to go surfing or grab a beer with a friend, but he shrugged off these suggestions.
I tried to initiate conversation, by asking how he felt. He just kept saying, "I'm fine," a lie familiar to me from my own depression days. Unlike women, men are often socialised to value independence, dominance, stoicism, strength, self-reliance and control over their emotions, and many see weakness as shameful.
"Men will do anything to avoid shame and vulnerability," said Dan Singley, a psychologist in San Diego who specialises in men's mental health issues. This, of course, is a challenge to getting help.
While maternal postpartum depression is widely discussed and recognised as a serious health issue, it's often hard for people to take seriously the idea of a man having similar problems. My husband, for one, found it "ridiculous."
One of the more glaring examples of this stigma, Dr. Singley said, was in the comments section of a video about paternal postpartum depression posted by ATTN: on Facebook in 2017. While most of the reactions were positive, many revealed a bias about depression among new fathers. One read: "These are just a bunch of old men who can't handle a baby, which makes me doubt their capability in anything else in life."
Overall, depression rates in men are about half those of women. Yet men exhibit significantly higher rates of substance use and account for three-quarters of suicides. There is some evidence that new fathers are especially at risk for the latter.
This discrepancy suggests that many men are experiencing depression, but not addressing it. In fact, men are half as likely to seek help for mental health concerns compared with women.
According to Dr. Fisher, "men tend to get treatment when their partner is distressed by their behavior," often long after symptoms begin. This was true in my case.
Around our daughter's first birthday, I told my husband that I thought he was depressed. It had taken me several months to acknowledge it because I didn't know irritability was a sign of depression in men (it hadn't been one of my symptoms). His response: "I'm not depressed."
For months, I broached the subject and he backed away from it. We fought. We went to couples therapy. I continued to urge him to seek help. According to Dr. Singley, that's all partners can do: Encourage self-care and suggest supportive resources like therapy and medication.
We finally got a diagnosis after my husband talked to his general practitioner. The doctor's wife was a psychiatrist, so he knew to keep prodding, which is something Dr. Fisher said is rare. "Clinicians need to dig deeper," he said.
By the end, my husband had a prescription for an antidepressant — the same one I take. Sometimes I wonder if my husband and I would have addressed his depression sooner if that parent prep class mentioned it or if there was a male-specific depression screener at my daughter's doctor visits, similar to the one I took.
"We all know about maternal mental health," Dr. Singley said. "It takes a real paradigm shift to include both parents when we talk about mental health."
For my husband, there are still bad days, but they are fewer and farther between. He's more patient, less grouchy. He laughs more. And he's developed a special bond with our daughter. He knows all of her baby dolls' names and helps change their diapers. They find bugs in the garden together and make pillow forts in the kitchen.
Parenting continues to be relentless, but now we're better able to support each other. Our marriage has been pushed to the brink and survived — there is confidence gained in that.
Where to get help:
• 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP) (available 24/7)
• https://www.lifeline.org.nz/services/suicide-crisis-helpline
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757 or TEXT 4202
• NATIONAL ANXIETY 24 HR HELPLINE: 0800 269 4389
If it is an emergency and you feel like you or someone else is at risk, call 111.
Written by: Kim Hooper
© 2021 THE NEW YORK TIMES
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