Perinatal Depression and Anxiety in Men – By Sofia Rallis

What is Perinatal Depression and Anxiety in Men?

Perinatal Depression and Anxiety (PNDA) in men refers to depression and anxiety experienced during pregnancy and/or the first year post-birth by prospective and/or new fathers. For many years, depression and anxiety in mothers only (and in particular maternal postnatal depression), was the sole point of focus when one considered mental health during the perinatal period. As a result, it can be surprising for people to find out that up to 1 in 20 men experience depression during their partner’s pregnancy (antenatal depression in men), and up to 1 in 10 new dads experience depression following the birth of their baby (postnatal depression in men). Anxiety is also believed to be just as prevalent, given that depression and anxiety often co-occur.

It is fairly common for both men and women to experience a certain level of distress as they adjust to their role as parents. The symptoms of clinical depression and anxiety however extend beyond this ‘normal’ adjustment and have a notable negative impact on one’s life and daily functioning. Furthermore, while men and women alike often find it challenging to openly discuss issues related to their mental health, men often find this process even more difficult. For example, it is not unusual to hear fathers say that they find it ‘hard to talk about’ how they are feeling and the issues they are struggling with, particularly as there is often a sense that it is their partner who ‘has done the hard work’ of going through the pregnancy and birth experience. This reluctance to speak about experiences such as depression and anxiety is often also further compounded by the fact that they are at odds with the view that can exist in popular culture of the perinatal period being a particularly ‘joy filled’ time. Various myths and expectations about what fatherhood will be like may also be in stark contrast to reality. New dads can often feel torn between the need to be present and productive at work while also being present and supportive for their partner and baby. This can contribute to an increased sense of stress, confusion, frustration and anxiety. For dads who are struggling during this time, reaching out for help can take a considerable amount of courage. As hard as this may be, it is one of the most important things a father can do to not only help himself, but also to help and support his family at the same time.

Symptoms of Perinatal Depression and Anxiety in Men

In some men the symptoms of PNDA may present in a similar manner to those in women. In others, certain differences may be noted. Some of the most common symptoms of PNDA in men include:

  • Increased irritability, anger or moodiness
  • Loss of interest in things/activities that were previously enjoyable
  • Feeling constantly tired or exhausted
  • Ongoing headache and/or other increased physical stress symptoms (e.g. muscle tension)
  • Changes in appetite
  • Sleep disturbances (unrelated to baby’s sleep)
  • Emotional withdrawal from one’s partner, baby, family, friends
  • Persistent fear of looking after the baby
  • Not wanting to communicate with one’s partner, family and friends
  • Feeling isolated
  • Increased use of alcohol and/or drugs as a means of ‘escaping’ or coping
  • Thoughts of escaping or harming oneself/others

One can see from the list above that certain symptoms of PNDA overlap with some ‘typical’ perinatal experiences (e.g., sleep disturbances; feelings of fatigue) which can make it difficult to identify. In turn, careful assessment is always needed to differentiate between possible causes. It is strongly encouraged that individuals speak with an appropriately trained health professional if such symptoms are present and impacting on their life.

 Risk factors for Perinatal Depression and Anxiety in Men

There is no single definitive cause of PNDA in men (just like in women). It is usually a number of contributing factors that increase the likelihood of PNDA developing in dads according to current research. For instance, we know that for men in particular the perinatal period is often a time where increased financial pressure is experienced, as couples/families often make the transition from a dual income household, to a single or reduced income, even if only for a limited time. This financial strain coupled with the general demands associated with parenthood can also contribute to a increased sense of social isolation as individuals and couples may be less engaged in previously enjoyed activities. Many men also find themselves in a situation where their partner is struggling with the transition to parenthood and/or are experiencing PNDA. Not only is this a challenging situation to deal with in its own right, but can also impact on their own emotional wellbeing.

Some of the other most common contributing factors to PNDA in men include:

  • a past history of depression and/or anxiety
  • a family history of depression, anxiety and/or other mental health difficulties
  • complications during partners pregnancy
  • Infertility issues and/or previous pregnancy losses
  • the presence of significant life events and stressors, particularly in the preceding 12 months (e.g., death of a loved one, unemployment, moving house, major illness)
  • presence of relationship/marital difficulties
  • lack of practical, financial, social and/or emotional support
  • having unrealistic/unmet expectations about parenthood

It is always important to remember that experiencing one or more of the above mentioned risk factors it does not mean that you are bound to struggle with PNDA. Instead, it is helpful to keep this information in mind; if you can relate to the above experiences/events, consider whether some additional support would be helpful for you at this time, and who is available to provide suitable assistance (e.g., partner, family, friends, and health professionals).

Treatment and Support Options

Pregnancy and the postnatal period are both characterised by a significant number of physical, emotional, and psychosocial changes not only for women, but also their partners. When one considers the changes that often occur during this time within the couple relationship, the family structure, along with the occupational, financial, and individual ‘role’ changes, it is understandable that a significant number of both men and women find this period challenging. In some instances drawing on support from partners, family and friends (where available), and making time for some basic self-care may be all the support that’s needed. In other cases, formal assistance from a health professional may be required. Fortunately, anxiety and depression respond very well to appropriate treatment. With a range of different treatments options available, the decision on which one to undertake should be done in consultation with an appropriately trained health professional (e.g., GP, child and family health nurse, psychologist, psychiatrist). This will allow an informed decision to be made based on the unique set of circumstances of each individual and family. Some of the most effective treatment options include:

Psychological treatments:

Cognitive behaviour therapy (CBT) for anxiety/depression, including mindfulness based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and schema therapy.

  • Interpersonal psychotherapy (IPT) for depression/anxiety,
  • Psychodynamic therapy,
  • Couples counselling

Pharmacological treatments:

Medication: medication for depression and anxiety may need to be considered either as a stand-alone treatment, or in combination with psychotherapy, in cases where symptoms are severe, or where other comorbid or complex issues are present. In such instances, involving a psychiatrist and/or GP is recommended.

Summary:

Perinatal depression and anxiety affects both men and women. It can affect anyone regardless of gender, age or cultural background. In recent years we have come to understand how important it is to broaden the scope of perinatal mental health to include fathers as well as mothers. Most dads want to be present and have a desire to support and ‘hold the family together’. Perinatal depression and anxiety often interferes with this desire, given how difficult it makes it for individuals to function effectively both at home and at work.

Given the impact that perinatal depression and anxiety can have, particularly when left untreated, a better understanding of these experiences, along with pathways to support accurate identification and treatment is essential. If you or someone you care about is a new dad and struggling, don’t hesitate to reach out for support. It is important to remember that PNDA is a condition that is temporary and treatable. As hard as it may be to take the first step, reach out for some help. You can start by speaking to your partner, a trusted friend, family member or health professional. Reaching out for support is not a sign of weakness; quite the opposite, it is a sign of strength and evidence of wanting to do what’s best for your family. The demands of parenthood are varied and complex, so we all need some extra support at times. Try to remember that looking after yourself is also looking after your family!

Written by Sofia Rallis

References and sources for additional information:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC: Author.
  • Austin M-P., Highet N., and the Expert Working Group (2017). Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline. Melbourne: Centre of Perinatal Excellence.
  • (2011). Clinical practice guidelines for depression and related disorders – anxiety, bipolar disorder and puerperal psychosis – in the perinatal period. A guideline for primary care health professionals. Melbourne: beyondblue: The national depression initiative.
  • Beyondblue (2012).Managing mental health conditions during pregnancy and early parenthood: A guide for women and their families
  • How is dad going? http://www.howisdadgoing.org.au
  • The fathering project: http://thefatheringproject.org
  • SMS4dads: https://www.sms4dads.com/Resources
  • PANDA (2012).Perinatal anxiety and depression in men factsheet: https://www.panda.org.au/images/resources/Resources-Factsheets/Perinatal-Anxiety-and-Depression-in-Men.pdf

Disclaimer:

Please note that the information provided in this article, and any associated references, is general and is not intended to be therapeutic in nature. If you feel that you would benefit from additional information, support and/or require urgent assistance please contact your GP, or one of the following services in your state.

Crisis and Support Services

National Services:

Lifeline

13 11 14 (24 hours a day, 7 days a week)

www.lifeline.org.au

Perinatal Anxiety and Depression Australia (PANDA)

1300 726 306 (Monday-Friday 9am – 7.30pm (AEST / ADST)

www.panda.org.au

Pregnancy, Birth and Baby Helpline
1800 882 436

https://www.pregnancybirthbaby.org.au

MensLine

1300 78 99 78

www.mensline.org.au

Suicide Call Back Service

1300 659 467 (24 hours a day, 7 days a week)

www.suicidecallbackservice.org.au

Additional State Based Services:
Victoria:
Maternal and Child Health Line 24 hours a day, 7 days a week 13 22 29
Parentline VIC 8am to 12am Monday to Friday, 10am to 10pm weekends 13 22 89

NEW SOUTH WALES:
Karitane Careline 24 hours a day, 7 days a week 1300 227 464
Parentline NSW 24 hours a day, 7 days a week 1300 130 052

ACT:
healthdirect Australia 24 hours a day, 7 days a week 1800 022 222
Parentline ACT 9am – 9om Monday to Friday (except public holidays) (02) 6287 3833

QUEENSLAND:
Child Health Line 24 hours a day, 7 days a week 13 43 25 84
Parentline QLD & NT 8am to 10pm, seven days a week 1300 30 1300

SOUTH AUSTRALIA:
Child and Youth Health Service 9am – 4.30pm Monday to Friday 1300 733 606
Parent Helpline SA 24 hours a day, seven days a week 1300 364 100

WESTERN AUSTRALIA:
healthdirect Australia 24 hours a day, 7 days a week 1800 022 222
Parent Help Centre WA 24 hours a day, 7 days a week 1800 654 432

NORTHERN TERRITORY:
healthdirect Australia 24 hours a day, 7 days a week 1800 022 222
Parentline QLD & NT 8am to 10pm, seven days a week 1300 30 1300

TASMANIA:
Parenting Line TAS 24 hours a day, 7 days a week 1300 808 178

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