New dads: Parental post partum depression (PPND)

Two weeks after his first child was born Michael started feeling more than a bit flat. He loved being a dad, but was worried about his ability to be a good father and making ends meet as the sole breadwinner. The sleepless nights began to take their toll. Michael couldn’t concentrate at work, and became moody and angry.

Michael is not alone. Parental post partum depression (PPND) can affect up to 10 per cent of new fathers, says the University of Adelaide’s Karina Bria, who has recently conducted a systematic review of international and national studies on men and post partum depression. She believes changes to lifestyle and increased responsibility for first-time fathers is often the catalyst – plus many men aren’t prepared for the dramatic changes parenthood brings. “The birth of a new baby is stressful for both parents,” says Karina.

Silent sufferers

If a new father is feeling anxious about the transition to fatherhood, chances are he’ll keep it to himself. This is because men find it difficult to talk about their feelings and, culturally, aren’t really encouraged to, says Karina. As a consequence many men suffer the effects of PPND in silence.

There’s also a greater risk of the father’s depression going unnoticed because the focus is on the mother and baby during the pregnancy, birth and in the weeks and months following the baby’s birth, according to Karina. Immediately after the birth, for instance, mothers are introduced to mothers’ groups, play groups, child health nurses, lactation consultants and midwives. Fathers, by comparison, are marginalised, albeit unintentionally.

“Women have many avenues to seek help, and they are also naturally going to talk to one another about parenting issues – men don’t as a rule,” Karina explains. “It’s not like a man is going to sit at the pub with his mates and say, ‘Ok guys let’s talk about nappy rash’.”

One solution is to include more gender- or father-specific information in antenatal classes, and to increase support networks for dads, Karina suggests. Men also need to be given more opportunities to learn some of the hands-on skills associated with parenthood, she says.

Men at risk

So what sort of man is more likely to fall victim to PPND? The answer, according to Karina, is men who:

• Are born worriers. Men with a predisposition to anxiety, or who’ve suffered depression in the past have an increased risk of PPND.

• Have a limited support network, or who are socially isolated from family and friends.

• Have a partner suffering from PPND. There’s definitely a strong link between the two, Karina says. In fact, according to some experts, this is the strongest predictor.

What are the symptoms?
Symptoms of PPND are very similar for men and women, says marriage and family therapist Micki Lavin-Pell. They include:

• Feelings of inadequacy.

• Loss of energy and concentration.

• Being unable to cope with normal day to day activities.

• Sleep disturbances.

• Loss or increase of appetite.

• Possible increase of alcohol consumption in men.

Men suffering from PPND are also likely to experience a feeling of disconnectedness from those around them, Micki says. “Some men describe it as a flood of overwhelming negative feelings – it’s being trapped, and feeling lost and alone in their situation.”

Although there are some parallels in the way men and women experience PPND, there are also marked differences. While women are often prone to bouts of tears, men are more likely to become angry. “If a man starts to feel sad and weepy, he often won’t allow himself to experience it – because of the stereotypes surrounding manhood and masculinity he feels he should be able to cope, so tries to ignore his feelings,” says Micki. “If his wife questions him about his changed behaviour, instead of admitting that he feels unhappy; he’ll often turn to defensive mode, and become angry.”

Broaching the subject

When a man suffers from PPND he is likely to feel anxious and confused about what is happening to him. He probably won’t want to talk, but don’t be afraid to broach the topic with him, says Karina. Be patient and reassuring, and encourage him to express what he is feeling. “Try to be vigilant and observant – if you notice mood swings and changes in behaviour, encourage him to get some help,” she adds. Sometimes all a man needs is someone to talk to, such as a health professional who can validate his feelings and offer guidance. It’s important that the mother has someone to talk to also, to share her own frustrations and fears.

Getting help

If you feel that you’re slipping into depression, it’s important to acknowledge your feelings – and also to know you are not alone.

“Admitting there might be a problem is a big step for some men, but dealing with it will not only benefit you, but your whole family,” says Karina.

✓ Ask your doctor for help.
✓ Call Mensline Australia on 1300 78 99 78.
✓ Visit www.beyondblue.org.au.

DON’T LET IT HAPPEN TO YOU

The good news is there are several positive, proactive measures men can take to minimise their risk of falling victim to PPND.

1. GET PREPARED
It’s important both partners have open, honest discussions well before the baby’s due date about your ideas, perceptions and fears about parenthood. Do you have concerns about becoming parents? How were you parented?
“When men and women become first-time parents, issues from their own childhood are likely to come to the surface,” says Micki Lavin-Pell. “It’s important to discuss how you feel about becoming parents.”
If there are unresolved issues from your childhood, Micki recommends talking with a family therapist.
It’s also a good idea to work on your relationship as a couple before baby comes along. “You need to work to build a strong, solid foundation together before becoming parents,” she says.

2. GET INFORMED
Stock up on parenting books, watch DVDs about parenting and birth, and go to antenatal check-ups and birthing classes together, where possible. Ask questions, get involved and share any concerns. Spend time with friends or relatives with young children and babies. Talk to them about their parenting experiences. Gain confidence in your parenting skills by putting your hand up and offering to feed or bath the baby.

3. GET CONNECTED
Build your support network. Stay in touch with your family and friends. Take time out to do things you love, such as playing sport to energise your mind, body and spirit. Once baby is born, arrange to have friends or family care for her every now and then so you and your partner can nurture your relationship with each other.