New fathers: Don't let depression overshadow the joy of fatherhood

Understanding postpartum depression in men

Men may start to experience depression during the pregnancy, or it may begin after the birth.

As with depression in mothers, paternal depression often goes undiagnosed as it can mimic the usual stresses of having a new baby. Depression looks different from one man to the next, but here are some signs you may notice:

• Physical changes: Altered sleep patterns, appetite, and libido, as well as headaches, tiredness and physical pain
• Emotional changes: Low mood or motivation, no longer enjoying things that used to be enjoyable, a sense of overwhelm, and increased irritability, anxiety, anger, and cynicism
• Behavioural changes: Working more than usual, engaging in risk-taking behaviour, turning to drugs or alcohol more frequently, increased conflict or violence, and withdrawing from family and friends
• Changes to thinking: Negative, anxious or suicidal thoughts

You may think that only women are impacted by changing hormones during this time, but in fact men can also experience hormonal changes after the birth. Key hormones, such as testosterone, oestrogen, cortisol, vasopressin, and prolactin can change during this period and may contribute to the symptoms listed above.

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Causes of postpartum depression in new fathers

Some factors may increase the chance of experiencing depression as you transition to fatherhood, these include:

• A personal history of depression or anxiety
• Your partner is experiencing depression
• Difficulties in the couple relationship, or if the relationship has ended
• The pregnancy was unplanned
• Financial pressures
• You are under 25

These factors don’t necessarily cause depression; however they have been associated with increased risk of depression in new or expecting fathers.  

The transition to parenthood comes with many changes, including changes to sleep patterns (particularly if you have a baby with sleeping or settling difficulties), lifestyle, and increased pressure as you juggle parenthood, work, and other important parts of life. It also involves grappling with changes to your role in the family, especially if you are the stay-at-home parent.

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Whilst all families have differing roles and expectations regarding parenting, fathers today are generally expected to be more involved in the day-to-day caregiving of babies than in previous generations. This is an extremely positive development, as we know that fathers bring unique strengths in terms of attachment and development. Fathers, for example, tend to engage in more ‘rough and tumble’ play with their little ones, which assists with social development, problem-solving, and regulation of key emotions, like excitement. If the mother is experiencing maternal depression, a secure father-infant attachment can also help to buffer a baby against any interrupted attachment in those early days.  

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The impact of postpartum depression on family dynamics

If left untreated, paternal depression can place strain on your partner and effect your relationship. It may also impact the bond with your baby, with some fathers reporting that they found it very difficult to spend time with their little one when their depression was at its worst.  You might also find yourself withdrawing from other family and friends. It’s important to recognise the signs and seek help. The earlier treatment is sought, the better the outcomes for you and your family.

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Seeking help: It's okay to ask

Talk to those in your support network about what you’re experiencing. Like the changing role of fathers, attitudes around masculinity are also changing, as more men open up and seek help for their mental health. Unfortunately, stigma still exists, so it is important to identify those you feel comfortable and safe with. If you are in the hospital system, consider speaking to your midwife or obstetrician.  Alternatively, you can book an appointment with your GP – these conversations are confidential and a good place to start for resources and referral to specialised services, such as Gidget Foundation Australia.  

In addition to Gidget Foundation Australia, you can also contact one of the many services out there that offer information and support for mental health in the perinatal period:

• Gidget Foundation Australia — 1300 851 758 (Monday to Friday, 9am – 5pm) ‍
• PANDA (Perinatal Anxiety & Depression Australia) — 1300 726 306 (Monday to Friday, 9am - 7.30pm; Saturday, 9.00am – 4pm)
• ForWhen — 1300 24 23 22 (Monday to Friday, 9.00am to 4.30pm) ‍
• Beyond Blue — 1300 22 4636 (24/7) ‍
• Mensline —1300 78 99 78 (24/7)

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Treatment options for postpartum depression

The good news is that depression is treatable. There are a range of treatment options available, and the right one for you will depend on several factors, such as the severity of your depression, whether you are experiencing other mental health issues, your personal history, and your preferences.

If your symptoms are mild, then it may be sufficient to connect with your family and friends and make some changes to your lifestyle (for example, daily exercise, engaging in hobbies, maximising sleep, and reducing alcohol and drug use).

If your symptoms are more severe and impacting your ability to function in important areas of life, these steps are not enough. Seeking help is important, for your own recovery and the wellbeing of your family unit at this significant stage of life.

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Psychological therapy, such as Cognitive Behaviour Therapy (‘CBT’) or Interpersonal Therapy (‘IPT’) have been shown to be safe and effective interventions for mild to moderate depression. These generally involve meeting with a therapist, individually or in a group, and exploring ways to develop more helpful thoughts, actions and coping strategies to improve your mood.

Antidepressant medication is also available to either complement therapy, or as a stand-alone treatment. These tend to be prescribed when depression is moderate to severe. There are a range of safe and effective antidepressant medications available which your doctor will discuss with you if medication is indicated. It’s important to take medication regularly and as guided by your doctor to maximise its positive effect and reduce any associated risks.

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Tips for coping with postpartum depression  

Here are some general tips for managing stress and maintaining positive mental health during the perinatal period:

• Communicate openly with your partner, share your experiences and feelings to try and tackle challenges as a team, rather than on your own  
• Get some exercise or move your body each day. Get creative about how to achieve this, for example, take your baby for a walk in the pram, or walking/riding to work rather than driving
• Engage in incidental self-care if you aren’t able to carve out dedicated time for this in your day, for example, use commutes in the car to listen to podcasts or your favourite music, take your favourite cup of tea or coffee to enjoy for the ride; or do a short yoga video at home (YouTube has many great free offerings!)
• Maximise sleep. This can be a tricky in the postnatal period, but try to make sure you get at least one uninterrupted block of 4-5 hrs sleep each night (plus any more on top of that) Where that is not possible, try to rest where you can and know that your internal sleep mechanism will make up for any lost sleep the next night.
• Reach out to trusted friends and family, this can help to feel more connected and supported; more often than not, your loved ones want to support you where they can
• Try to reduce use of alcohol and other drugs. Although they may bring short term relief, they tend to create additional problems and increase your vulnerability to stress
• Think creatively about what might help to lighten the load at home, for example, do you have family or a babysitter who could watch baby for a couple of hours so you and your partner can rest or have some quality time together? Could you get a cleaner one day a week/fortnight to assist with maintaining the household? Could you sign up to a meal kit service to reduce the cooking load for a little while?
• Connect with other fathers in your area, engaging in father’s groups or online groups, such as Gidget Virtual Village for Dads. It can be helpful and validating to have people around who understand what you’re going through
• Try meditation (there are lots of free apps, such as Healthy Minds or Insight Timer), or even just take a few minutes each day to drop your shoulders, relax your face, and slow your breathing down. Reducing your physiological arousal levels can help you feel calmer and more able to cope with the day or night ahead.
• Be kind to yourself: being a father can be a tough gig; everyone faces a challenge at one point or another. Remind yourself that you’re learning too, and it’s okay to make mistakes.

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Conclusion

Paternal depression is much more common than you may think. Get to know the symptoms and seek help as early as possible to reduce the negative impact both on yourself and your family. Depression is treatable! There are evidence-based interventions available in many different forms. Be sure to contact a support service or your GP to find support in your area or online. Don’t underestimate how important you are, and the unique strengths you bring to your family. Treating your symptoms now will also allow you to enjoy fatherhood and reap the benefit of the many gifts it can bring!