Postnatal Depression in Men

Based on birth notification data, there were 625,008 live births in England and Wales in 2021. For the new parents, these births bring with them any number of emotions and feelings – love, joy, excitement, trepidation, nervousness, anxiety and, for some, depression.

According to the NHS, postnatal (also known as postpartum) depressions affect more than 1 in every 10 women in the UK within a year of giving birth. Interestingly, they also cite research that suggests a far less talked about fact, that up to 1 in 10 new fathers in the UK also become depressed after having a baby.

It is natural for a majority of mothers, and a number of fathers too, to experience a brief period of low mood, feeling emotional and tearful for around three to 10 days after giving birth. This is often referred to as the “baby blues”. It is quite normal to feel emotional and overwhelmed, as there are often lots of new demands to cope with and you may be getting little or no sleep, especially in the first few days.

The “baby blues” are usually only very temporary, lasting for the first few days after the birth and very soon things settle down.

Some of the signs and symptoms that you or someone you know might be experiencing the “baby blues” can include:

• Feeling overwhelmed.
• Anxiety.
• Sadness.
• Tearful and crying.
• Irritability.
• Mood swings.
• Reduced concentration.
• Loss of appetite.
• Trouble sleeping or disturbed sleep.

These feelings usually only last for no more than a few days and are generally quite manageable, particularly with support. However, for some mothers, the experience is much deeper and longer term, and they are experiencing maternal postnatal depression.

What is postnatal depression?

Postnatal depression usually develops within six weeks of giving birth, although it can arise at any time during the first year after giving birth, and the onset can be either gradual or it might be sudden. The range of postnatal depression symptoms can vary from being mild to being very severe.

Some of the signs and symptoms that you or someone you know might be experiencing postnatal depression include:

• A persistent feeling of sadness and low mood.
• A lack of enjoyment and a loss of interest in the wider world.
• A lack of energy and feeling tired all the time.
• Having trouble sleeping at night and feeling sleepy during the day.
• Having difficulty bonding with your baby.
• Withdrawing from contact with other people.
• Problems concentrating and making decisions.
• Frightening thoughts, for example, about harming your baby.

Other conditions that can occur following a baby’s birth can include:

• Anxiety.
• Panic attacks.
• Psychosis where a mother may start experiencing psychotic symptoms, such as paranoia, delusions or hallucinations.

Many women do not realise they have postnatal depression, because it can develop gradually or may feel that being depressed means they are a bad parent, so they don’t talk about it or look for medical help, but postnatal depression can happen to anyone.

UK singer Adele famously opened up about her own postnatal depression after she had her son, in an article in Vanity Fair. She admitted that she felt inadequate and thought she had made the worst decision of her life.

Vogue featured another mother who suffered postnatal depression, US tennis star Serena Williams, who commented: “I still don’t really like to say, ‘I have postpartum depression,’ because the word depression scares a lot of people,” she continued. “I often just call it ‘postpartum.’ Maybe I should say it, though. Maybe it will lessen the stigma a bit.”

Postnatal depression is most often associated with mothers following a baby’s birth; however, as we have seen from the statistics above, fathers can be affected by the condition too.

What is postnatal depression in men?

If postnatal depression in mothers is seldom openly discussed, particularly in the media, open discussion about postnatal depression in men is even rarer, although that is changing. Speaking to ITV’s This Morning programme, fireman Mike Simms commented on his experience of men’s postnatal depression saying that the experience came as a complete surprise and made it difficult for him to bond with his daughter.

“The birth came and I’m not going to say it was traumatic for me because for the lady it was horrendous. As I watched, I felt like it was my fault she was in pain. It was horrendous to watch.” He continued, “I thought I would feel a huge rush of emotion and this intense connection. But it was just like meeting any other person. I felt totally disconnected. I felt like there was something wrong.”

First-time fathers are particularly vulnerable to male postnatal depression and the peak time for it to develop is three to six months after the birth.

However, men can experience depression at any time, including during their partner’s pregnancy, before a baby is born. 2019 studies found that the highest risk of depression during pregnancy for expectant fathers occurred during the first three months of the pregnancy.

What are the signs and symptoms of postnatal depression in men?

Paternal postnatal depression is more than just the “baby blues” described above.

Some of the signs and symptoms that you or someone you know might be experiencing paternal postnatal depression include but are not limited to:

• Feeling sad and hopeless.
• Constant exhaustion or numbness.
• Not wanting to do anything.
• Feeling unable to cope.
• Feeling guilty for not being happy or for not coping.
• Worrying that you don’t love your baby enough.
• Being easily irritated.
• Anger, sudden outbursts, or violent behaviour.
• Crying or wanting to cry more than usual.
• Not wanting to eat or being unable to eat.
• Binge eating.
• Abusing alcohol and/or recreational or prescription drugs.
• Increase in impulsive or risk-taking behaviour.
• Finding it difficult to sleep.
• Lack of interest in your partner and/or baby.
• Withdrawing from relationships.
• Anxiety and/or panic attacks.
• Finding it difficult to make decisions.
• Working a lot more hours or a lot less.
• Having worrying thoughts about harming yourself or your baby.
• Thinking about death or suicidal thoughts.
• Physical symptoms such as headaches, muscle aches, stomach or digestion issues.
• Experiencing symptoms of obsessive-compulsive disorder.

If you or a loved one experience some or all of these paternal postnatal anxiety or depression symptoms that intensify or last longer than two weeks, talk with your doctor or NHS 111 about possible treatment options.

Why men experience postnatal depression

Both parents’ mental health and wellbeing can become affected by the birth of a child as a birth is accompanied by all kinds of change. Fathers can become depressed for many of the same reasons as mothers; however, there may be other triggers too, including but not limited to:

• Feeling guilty about what their partner is going through.
• Having to take on extra responsibility.
• Changes to their routine and lifestyle.
• Increased financial pressure.
• Stress on the relationship, particularly if his partner is also suffering from postnatal depression.
• Feeling unsupported by their partners.
• Loss of sleep and sleep interruption leading to tiredness.
• Hormones – research has shown that fathers experience hormonal changes during and after their partner’s pregnancy, particularly declines in testosterone.
• Age – men who are under 25 are more likely to go through postnatal depression than their older counterparts.
• Personal or family history of depression.
• Difficulties adjusting to parenthood.

How is postnatal depression diagnosed for men?

Many midwives and health visitors have been trained to recognise postnatal depression and have techniques that can help. In recent years they have been made more aware of the issues concerning the fathers’ mental health during pregnancy and following the birth.

Midwives are well-positioned to initiate screening and outreach programmes for new fathers and to advocate for the inclusion of information about paternal postnatal depression into existing programmes.

However, it is unclear whether fathers suffering from the symptoms of postnatal depression in themselves are bringing their concerns to the attention of these medical professionals.

Any men who feel that they may be experiencing any of the symptoms highlighted above should contact their GP and emphasise that these symptoms are related to the birth of their child, or they can access NHS choices who have an online tool which can help in diagnosis.

According to a study published by the Journal for Mental Health involving cases of both maternal and paternal postnatal depression, those experiencing maternal postnatal depression symptoms were more likely to indicate that something was wrong (97.0%), compared to those with paternal postnatal depression symptoms (75.9%). And, that the symptoms were more readily recognised by professionals in maternal postnatal depression (90.1%) compared with only 46.3% in paternal postnatal depression.

Their conclusion being that: “There is a gender binary in symptom recognition of postnatal depression, which highlights the need for greater awareness of paternal postnatal depression.”

So men and/or their family and friends need to be aware that postnatal depression is just as likely to occur in men as it is in women and should you feel that something is not quite right, even if it is not a symptom on the list above, you should talk to someone about it.

How is postnatal depression treated for men?

The treatment of paternal postnatal depression is in its early stages. Currently, the majority of the options for treatment are the same as for maternal postnatal depression.

The three main types of treatment offered by the NHS are:

• Self-help – For example, talking to your family and friends about your feelings, making time to do things you enjoy, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet
• Psychological therapy – A GP may be able to recommend a self-help course or refer you for a course of therapy, such as cognitive behavioural therapy (CBT)
• Antidepressants – These may be recommended if your depression is more severe or other treatments have not helped

If your depression is severe, you can get help from mental health professionals. Their focus is on helping you to recover. You will have support from a team of community psychiatric nurses, psychologists or psychiatrists. They will provide more intensive talking therapies, such as psychotherapy, alongside medication and CBT.

Relationship counselling may also be useful and the introduction of paid paternity and shared parental leave can also help fathers to take time away from other commitments to adapt to all the changes during the postnatal period.

What support is available for men going through postnatal depression?

For men experiencing paternal postnatal depression, often the hardest part can be admitting to yourself how you are feeling, let alone letting others know what you are going through.

Your partner, friends, and/or family may already be very worried about you and they may be trying to find a way to talk to you about it, so try not to bottle everything up – talk to them. Although it may be difficult at first, you will be amazed at the relief you feel when you do start talking about how you are feeling.

Your loved ones can play an important part in helping you to recover by listening to you, and understanding how you feel. However, if you feel more comfortable talking to someone that you don’t know at first, there is plenty of help out there.

• If you live in England and are aged 18 or over, you can access NHS psychological therapies (IAPT) services.
• The National Childbirth Trust (NCT) offers online support for dads and a shared experiences helpline 0300 330 0700.
• The mental health charity Mind offers a postcode search to find support in your area, and you can also get help and information by phoning 0300 123 3393 or texting 86463.
• The Baby Centre offers a community  page to talk to other fathers.
• The PND Daddy runs a Twitter chat for dads who suffer from paternal postnatal depression and need support. Join in on Tuesdays 8pm–9pm using #PNDDaddies.
• ANDYSMANCLUB is a non-judgemental, talking group for men.
• DadsNet offers support and knowledge through a community of dads on practical parenting and fatherhood.
• SMS4dads gives dads information and connects them to online services by text. As well as this, every three weeks you get an interactive “How’s it going?” message. Although this is an Australian site, you could give it a try.

Other mental health organisations that specialise in providing help and support for men include:

• menshealthforum.org.uk.
• headsupguys.org.
• thecalmzone.net/help/get-help/.

Final thoughts

Having a baby is probably one of the biggest changes of your life and the transition from partner to parent can be challenging. You might also find that your transition to being a father is different from your partner’s transition to being a mother.

Many new parents say that they feel closer after the birth of their baby. But it is not unusual for even the strongest of relationships to feel the strain at times, particularly when both parents are drained by a lack of sleep. While it is normal to feel tired and anxious as a new parent, if you’ve been feeling really down and it is getting too much, then it is probably time to talk.