Daddy blues - why we need to talk about postnatal depression in men

A global survey shows as many as 26 per cent of new fathers struggle with depression in the three to six months after their baby is born

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Men who fail to bond with their babies or feel worthless during or after their partners' pregnancies could be suffering from peri or postnatal depression (PND).

In the past, it was thought that only women could suffer from the illness, but now doctors believe new fathers also struggle with depression.

A report in the Journal of the American Medical Association found that 10 per cent of men across the world showed signs of depression from the first trimester of their wife's pregnancy until six months after birth.

The number increased to 26 per cent in the three to six months after the baby was born.

The report assessed 43 studies of more than 28,000 fathers worldwide and the results were published last year.

The attitude when I spoke to people was 'get on with it, men don't get post-natal depression'
Barrie Palfry

This figure is more than twice the rate of depression normally seen in men, and higher than the number of women who suffer PND, which is widely accepted to be between 10 and 20 per cent.

Barrie Palfry, 43, suffered from PND after the birth of his daughter when he was in his twenties. She was his third child.

"I didn't have any problems with my two boys, but when she was born, I just couldn't connect with her. I went through all the motions of changing nappies, but I just thought of her as a thing," said Mr Palfry who is from Manchester in the UK.

"I knew something was wrong, but I couldn't put my finger on it. I was beating myself up, but it didn't make any difference.

"I could feel myself going downhill and felt useless, I couldn’t function. I even felt suicidal at one point."

It took 11 months for the depression to lift, but during that time his illness was never diagnosed.

"I tried to speak to people, but I'm from a town in northern England, and the attitude when I spoke to people was 'get on with it, men don't get postnatal depression," said Mr Palfry.

"My partner just told me to stop being soft. There's a stigma around all mental illness, but in particular for men."

It was only many years after his illness, when he was reading up around the subject, that he realised his symptoms exactly matched those of paternal PND.

Dr Ioannis Delipalas, a Swedish psychiatrist who works in Dubai, said this was very typical in the past.

"Often men are expected to be strong and to be the provider, and they are not allowed to be depressed or to have feelings of inferiority or anything like that," said Dr Delipalas, who is medical director at Thrive Wellbeing Centre.

Now the stigma surrounding mental illness has started to dissipate. More men are coming forward and talking about their feelings, and recent studies have revealed a widespread problem of depression in fathers with young children.

Feeling like a 'third wheel'

Dr Ioannis Delipalas, DHA licensed consultant psychiatrist and the medical director at Thrive Wellbeing Centre, has treated several fathers who were struggling with their mental health after the birth of their babies. Pawan Singh / The National

While only 10 per cent of men feel depressed over the period covering their partner's first trimester up until six months after their baby was born, more than 86 per cent feel depressed at some stage during the first five years of their child's life.

Post-natal depression in mothers is often caused by hormonal changes. Dr Delipalas said the cause can be the same for fathers.

"There are many studies that actually show we can have fluctuations in men's hormones as well. So testosterone can drop, and oestrogen and prolactin - which are typically female hormones can rise. Also cortisol, the stress hormone can rise," said Dr Delipalas.

"There are also social or psychological explanations. For example, expecting a baby can put a lot of pressure on the man because they need to provide - so this can add and fuel depression."

Men with a history of mental illness in adolescence or early adulthood, are also more likely to suffer from paternal PND.

Relationship stresses, such as men feeling neglected or abandoned by their partner because of the baby, can add to feelings of worthlessness.

"Men can start to feel like a third wheel," said Dr Delipalas, who has treated several fathers in Dubai.

"I have met a few patients that were borderline for developing post natal depression, but we were able to monitor them and with early intervention such as therapy, and in some cases, with pharmacological treatment we were able to manage it before it became a fully established depressive episode," said Dr Delipalas.

Daddy blues

The symptoms of paternal post natal depression are different to the normal "daddy blues" of feeling low or a little bit stressed.

Any father suffering from long-term, persistent depression, feelings of worthlessness, anger, decreased libido and a tendency to indulge in risky behaviour such as substance abuse could be struggling with PND.

In these situations, professional help should be sought, either from a psychologist or perhaps from a psychiatrist, depending on the severity of the illness.

Men should be encouraged to speak out, as sometimes just to be heard is very therapeutic, said Dr Delipalas.

Mr Palfry said he has now learned not to be ashamed of his feelings.

"I had a few problems last year, and I reached out to so many people. I just poured my heart out to anyone who would listen, even my work colleagues," he said.

"There are also lots of organisations, such as the National Childbirth Trust - a UK charity for parents, or even your local doctor who will give you the help you need."

In the UAE most mental health services are provided by private clinics, although during the pandemic the government set up the UAE mental health support line which can be reached by dialling 800-HOPE or 800 4673.

Updated: September 30, 2021, 1:16 PM