80% of men will become fathers and for the vast majority, while the journey will have its difficulties and stresses, overall they will look back on the early years of their fathering as a time suffused with joy and pride. But for a minority of men becoming a father is not quite the bed of roses they may have envisaged. Because these men, the 10% of fathers, will suffer from paternal perinatal depression.
Perinatal depression is an illness which can strike at any time from the point of conception up to two years after birth. Today most of us are clued up on the risk to mothers of this debilitating condition and I can remember being closely monitored by midwives and health visitors for any signs when I had my children. But it is only in recent years that those of us who make it our work to study fathers have become aware that the perinatal period is a time of huge mental vulnerability for dads as well.
“I mean I was signed off recently for stress which was a new thing for me, never been signed off before. It was probably my fault as well because I got a new job as she was born, so a new job, a new baby….. A lot of responsibility added on at work, a lot at home so it all mingled into one…..anxiety and depression. It all stemmed from stress because I took on too much. I couldn’t remember what I was supposed to do at work, I couldn’t remember where I was supposed to be. Just a complete nightmare for a time.” Colin
Colin is a father who took part in one of my very first fatherhood studies 6 years ago. He was a first-time dad, speaking here when his daughter was 6 months old. His story is now very familiar to me. A dad who had taken on board the message that fathers need to be hands on with their children; to be present, nurturing and caring alongside mum for the good of the child and family. Colin aspired to be the gold standard dad that so many young fathers want to be today. Further, in a world where the hospital support provided to a mum has diminished drastically in the last 30 years and many of us no longer live within striking distance of our extended family, he took on the care of his wife and child pretty much immediately after birth. He took his two weeks paternity leave – vital as his wife had been left seriously ill by the birth – but at the end of this time he had had to return to work as the family’s primary wage earner. He was forced to leave behind a wife and child who very much still needed him to earn the money which, in a world where any form of extended paternity leave is only paid at the statutory minimum, was vital to his family. For Colin the pressures of work stress, guilt and worry at leaving his wife to cope and a sense of failure because he felt he wasn’t being the dad he wanted to be led to a period of perinatal depression. But for Colin there was no monitoring from midwives or health visitors, no support groups or counselling service. Eventually Colin did get some help from his GP but if he had been offered the sort of early monitoring and diagnosis that his wife would have had access to he and his family may not have ended up in “a complete nightmare”.
Why does all this matter? After all, it is women who give birth and generally still bear the burden of childcare. Shouldn’t these fathers just “man-up” and accept their responsibilities? It matters because, regardless of the impact on the man, the family is the environment in which a child develops their sense of the world and how to act within it. We now know that children who are raised by fathers who have perinatal depression have a greater risk of developing behavioural problems and exhibiting language delay as young children and, as with any child who is raised by a depressed parent, are at greater risk of suffering from poor mental health and exhibiting anti-social behaviour and addiction as adults. This is a tragedy for the man, his child and our society.
It is also a tragedy that we know how to monitor and diagnose these men and we are starting to understand what we can do to help them but we are still not getting our message through to those who can change health and social care policy. Many of the solutions cost little if any money – baby massage, online social support groups and making information and support available at gyms, pubs and sports clubs – but at present it is only activists and charities that are working to provide these sources of help and support. We may be doing much better at dealing with the fallout from maternal perinatal depression but by failing to actively diagnose and support fathers with the condition we are still leaving the children of these families incredibly vulnerable. Paternal perinatal depression is a silent mental health crisis that has consequences for us all. It’s time we started listening.