Dads get sad too

Viren Swami is Professor of Social Psychology at Anglia Ruskin University and will be speaking about post-natal depression and dads at this year’s Cambridge Festival of Ideas. It is something he has personal experience of. As workingmums.co.uk and workingdads.co.uk hold a roundtable with employers today on support for and engagement with dads, Professor Swami talks about a subject that has not received much attention.

Question: How would you define postnatal depression?

Professor Swami: The period after the birth of a child can be very stressful. For some new parents, this can sometimes cause extreme psychological distress and mental health problems, which include conditions like postnatal anxiety and postnatal depression. Postnatal depression is a depressive disorder that occurs after the birth of a child, sometimes up to a year after delivery, though it is most commonly diagnosed within the first three months after birth. Postnatal depression affects parents in different ways, but it is more than simply feeling unhappy, tired or fed up after the birth of a child. Symptoms of postnatal depression can include long-lasting feelings of unhappiness and hopelessness, a loss of interest in the things that were previously enjoyed and having suicidal thoughts as well as physical symptoms like feeling constantly tired, sleeping badly and having no appetite.

Q: Is it the same in men as in women?

Professor Swami: Until relatively recently, postnatal mental health was viewed as an issue primarily or only affecting new mothers. We now know that the transition to parenthood can trigger mental health problems in fathers too. That includes postnatal depression, which affects about 8-11% of new fathers – compared to between 6-13% of new mothers. While the symptoms of postnatal depression are similar in father and mothers, men sometimes experience and understand psychological distress differently from women. For example, women tend to internalise depressive symptoms, whereas men externalise the experience – through anger, isolation, blaming others and risk-taking.

Q: Have you had personal experience of it?

Professor Swami: I struggled with my mental health after the birth of my son two years ago and was later diagnosed with postnatal depression. I’ve written about my experiences elsewhere, partly as an attempt to understand what I was going through. As a social psychologist, I’ve also begun to research societal understandings of postnatal depression.

Q: What causes postnatal depression?

Professor Swami: There isn’t a single cause of postnatal depression. Instead, researchers talk about a “multifactorial aetiology”, which simply means there are multiple factors and experiences that need to be considered. In both women and men, risk factors include a previous history of mental illness, a genetic predisposition to mental illness, demographic factors (such as young age and low socioeconomic states) and social factors, including a lack of support from others, marital conflict and a partner experiencing psychological distress. Neurobiological changes – such as changes in levels of oestrogen, testosterone and prolactin – are also important, but in contrast to the popular belief that this only affects women, there is evidence that men also experience marked neurobiological changes both during and after their partners’ pregnancy. Some factors may be more common in men and exacerbate risk factors, such as their relatively speedier return to work.

Q: What are the consequences of postnatal depression?

Professor Swami: The most obvious consequence is the impact of parents themselves, most notably in terms of everyday psychological functioning, elevated risk of self-harm and suicide and poorer relationship quality. Postnatal depression also negatively impacts parent-child attachment, reducing participation in child-rearing and enrichment activities – such as reading and singing with a child – and increasing the use of physical discipline. Postnatal depression also has longer-term impacts on child development, including increased risk of behavioural and emotional difficulties. All of this places a heavy financial burden on healthcare systems: it has been estimated that every mother affected by postnatal depression costs the UK economy about £74,000, with the bulk of the costs relating to adverse impacts on children.

Q: How difficult is it for men to admit they are struggling after the birth of their child?

Professor Swami: Even in the face of extreme psychological distress, many men can find it difficult to admit that they are struggling and to ask for help. This might be because they have internalised a common myth: that only women can be affected by postnatal depression. Instead, new fathers may articulate their distress as being caused by stressors that are common to most new parents, such as a lack of sleep or tiredness and instead passively cope with their condition – effectively waiting for things to improve on their own. Some men may also feel ashamed to admit that they are struggling, either because they believe that “good” fathers are strong, tough, and resilient or because they should just “suck it up” and support their partners.

Q: To what degree do healthcare professionals recognise postnatal depression in fathers?

Professor Swami: Postnatal mental healthcare in the UK remains heavily focused on the well-being of mothers and there is very little clinical guidance for assessing and supporting at-risk fathers. In addition, healthcare professionals who come into contact with new fathers – GPs, midwives, and health visitors, for example – often do not have the relevant training or work time to address the mental health of new fathers. This can make it even more difficult for new fathers to ask for help, resulting in them feeling abandoned, helpless and invisible.

Q: What can be done to support dads, given mums may be having their own issues with adapting to life after birth and recovering from the birth?

Professor Swami: I don’t think it does any good to see fathers as separate to the family unit and deserving of special or different attention compared to mothers. Instead, we need to consider postnatal mental health in terms of the family unit, for which the mental health of both parents is vital. This means that both mothers and fathers should be routinely screened for psychological distress after the birth of a child and afforded appropriate healthcare should they need it. The form of that healthcare may vary depending on the severity of symptoms and the specific needs of parents, but considering the mental health of the family as a whole is vital. More generally, there needs to better societal awareness of the psychological distress that some fathers experience after the birth of a child.

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