Angry and Overwhelmed: The Men Who Experience Postnatal Depression

With its mixture of sleep deprivation and endless domestic chores, parenting was tough on both of them. However, increased professional responsibilities saw it take a unique toll on Israel, who found himself becoming increasingly overwhelmed and further behind in work. Within weeks of the birth of their son, cracks in his psyche started to show. Not wanting to burden his wife, however, he stayed quiet. "But the cracks started becoming fractures and then fault-lines," Israel says. "I was angry at everything, and felt overwhelmed, sad, and hopeless most of the time."

When he finally consulted a psychologist, he was diagnosed with general depression, but little changed. It wasn't until his wife began to fear Israel might self-harm that the couple starting looking into the root of the problem on a deeper level, and Israel was eventually diagnosed with postnatal depression (PND), a condition typically associated with new mothers.

Once dismissed as "the baby blues," PND, also known as postpartum depression, is now firmly established as a mental health condition, and recognized as equal in severity to other depressive illnesses. According to the Centers for Disease Control, 11 to 20 percent of women who give birth each year have symptoms, and are more likely to suffer from the condition due to their more direct experiences of childbirth and primary care. But research also suggests that some new fathers—estimates vary between four and ten percent—also experience depression after the birth of a child.

Social expectations and stigma have seen these men's experiences remain somewhat hidden, but PND in men has actually been on researchers' radars for almost a decade, says Anna Machin, who led a study on the issue in 2015 at Oxford University. "Many men find it difficult to admit they have had PND because they often get a poor reaction [to claiming they are suffering from it]," says Machin. "There is a general attitude of 'Pull yourself together.'"

"In men, PND is as real and as distressing as in women," Machin explains. "[Men] tend to not be interested in looking after themselves or joining in social interaction. They gain little joy from life. It often impacts negatively on sleep and appetite. They may have thoughts about self-harm. In severe cases, they may have made plans about killing themselves."

Similarly, a recent study from the University of Auckland identified symptoms of paternal PND in around four percent of 3,500 New Zealand fathers. "Increasingly, we are becoming aware of the influence that fathers have on their children's psychosocial and cognitive development," the report reads. "Given the potential for paternal depression to have direct and indirect effects on children, it is important that we recognise and treat symptoms among fathers early"

PND in women is generally linked to the act of giving birth—compounded by factors around individual psychology, hormone levels, and external circumstances—but the causal factors in men seem to be more elusive. "We don't know precisely why some men suffer and others don't," says Machin. "There may in fact be a hormonal component, as in women, because becoming a father leads to a drop in testosterone—a protective factor against depression in men and women."

Men are often reluctant to come forward with their suffering because they have not themselves endured the physical and psychological trials of pregnancy. As Terri Smith, CEO of support network Perinatal Anxiety and Depression Australia notes, "It can often be difficult for expecting or new dads to seek support.One of the things we hear a lot from dads is that they feel guilty about their feelings of depression or anxiety when their partner has been through all the physical process."

But Smith emphasizes that PND is a serious condition that requires treatment, and men who suffer from it are often unable to control their feelings. These dynamics can manifest in extreme anxiety, frustration and aggression, and cause men to withdraw from family and/or self-medicate with alcohol or drugs. "They want to be there to support their partner rather than needing help themselves. But no one can help being sick—and this is an illness," says Smith.

However, some have raised the question of whether "medicalizing" apparent mood disorders among new fathers is like to be helpful—for families themselves, or for others in the general population with serious mental health problems. After all, where can you draw the line between an illness, and the turbulent array of anxieties, frustrations, fears, and identity crises that the experience of parenthood can evoke?

When coupled with inevitable pressures of sleep-deprivation, curtailed freedom and (often) relationship strains, it seems unsurprising that new parents—mothers and fathers—may begin to crack.

"Some studies claim that PND effects up to 90 percent of women, when what they are actually just describing is the condition of being a mother," says Ellie Lee, Director of the Centre for Parenting Culture Studies at the University of Kent, who has conducted extensive research into the social dimensions of parenting. "There is a quite legitimate and very important perception that women—and men—are finding the demands of parenthood more and more difficult, but they are trying to bring that problem to light by calling it an illness, and that is the part I am very concerned about."

As Lee notes, the current approach to this issue contrasts starkly with the way problems around parenthood were talked about during the 1970s by feminists, who widely opposed the medical labelling of what was considered a social problem: "It now appears to be a situation where something completely essential to the human race is making vast swathes of the population completely ill," she says.

"So are all these people supposed to end up in a psychiatric hospital, or a GP's office?" she adds, noting some of the problems with the self-reporting research model adopted in studies on PND. "The solution is always posed as an interaction with the medical establishment, which is obviously absurd."

A more constructive approach, Lee suggests, might be found through broader discussion and critical questioning of the huge demands and expectations placed on new parents—as well as more direct input from the psychiatric field itself, which has remained largely on the periphery of discussions of PND.

"One of things that underlies these problems is the way in which we now think about parents as the 'inputs' and the child as their 'output,' so people always feel like they are being assessed. It is very anti-human." she explains. "Somehow, our culture has decided that the best thing to do is make men and women totally worried about whether they are up to the task of looking after their baby. And then we add insult to injury by telling them they have a mental illness?"

Whether or not a medicalized approach to PND is the most useful (and opinions, even among experts, will always differ), experiences like Israel's highlight the need for more frank discussion about the psychological trials of parenting. "We lie to ourselves about our feelings all the time," Israel says. "If we males were more honest about our own feelings, like: 'I feel overwhelmed. I'm not coping,' then I'm sure we'd have many more productive conversations about our own mental health."

*Names have been changed to protect anonymity.