Mark Williams walks in the hills near his home in Wales as he tells about the night his wife gave birth. Both Mark and his partner Michelle were nervous first-time parents, and Michelle struggled through a difficult and painful 24-hour labor before it was decided she would need an emergency C-section. “I was very anxious and my wife was anxious,” he says. “We were both just shattered and then the doctors came rushing in, saying she needed this operation.” With a rising fear that he was going to lose both his wife and new child, Mark had his first-ever panic attack right there in the labor ward—an event that marked the beginning of a six-year downward spiral and a “torrent of negative emotions” that would leave him experiencing suicidal thoughts. It would only be later, looking back in retrospect, that Mark would diagnose himself with a condition long-recognized in mothers: postnatal depression.
Postnatal depression in new mothers is now a widely accepted mental health problem, but in recent years there’s been a rise in the number of studies of both pre- and postnatal depression in men. While it is believed to affect around 15 percent of women, research produced by the National Childbirth Trust (NCT) found that more than one in three new fathers are concerned about their mental health, and according to a 2010 meta-analysis published in the Journal of the American Medical Association, one in 10 men experience postpartum depression. And yet, as with so many other mental disorders, men are far less likely to speak to friends and relatives or seek medical support.
Mark says that he felt unable to discuss what he was going through with anyone: “I basically had six years of suffering in silence,” he says. “But I was always smiling, always going through the motions, even though I was also drinking a lot to cope with it all.” Part of the reason Mark says he felt compelled to try and carry on as normal was in order to support his wife, who suffered from severe postnatal depression in the years following the birth, and Mark left his job so he could be at home to look after both her and their new son, adding financial pressures to their already difficult situation.
Indeed, the worry of increased financial responsibility can be a contributing factor towards men becoming depressed after the birth of a child, as well as the new pressures that fatherhood brings and changes in relationships and lifestyle, all exacerbated by lack of sleep. However, Dr. Will Courtenay, a leading men's health expert and psychologist, says that there are also more specific things that make certain fathers more at risk. “In the cases where a baby is unplanned or unexpected, if the baby has health problems, or if the father is particularly young, those things can all make men more susceptible to pre- and postnatal depression,” he says. “And of course, for those with pre-existing mental health problems—whether they’ve been diagnosed or not—the arrival of a new child can act as a trigger.” In Mark’s case, he had underlying but undiagnosed ADHD, which became worse after the birth of his son. “My mind was just always on the ball and was constantly racing through all the worst-case scenarios,” says Mark. “To cope with this, I drank. It was a way of self-medicating.”
However, not everyone is convinced. In 2012, Guardian columnist Barbara Ellen wrote a piece in which she voiced the opinion that the idea of men experiencing PND “cheapened” the long battle women have gone through to have postnatal depression recognized as a condition in the first place. “Can't females have anything just for themselves, without men barging in,” she wrote. “Not even a foul, debilitating condition directly related to the physical act of pregnancy and childbirth?”
Sarah Mcmullen, who leads the research team at the National Childbirth Trust, says that it’s these kinds of responses that make men reluctant to speak out. “There’s a huge stigma associated with it—both with postnatal depression and just with men and mental health in general,” she says. “We’ve heard from men who have tried to share what they’re feeling but have come up against a negative response. But these feelings are real and we really need to open up the conversation about it in order to help.” Mcmullen says that the vital first step is for health services to recognize the issue in order to offer the appropriate services when needed. “Right now with perinatal care, there’s a real focus on the baby and it having the best start in life,” says Mcmullen. “But it’s so important that we recognize that both mom and dad’s mental wellbeing is crucial to the outcome of the baby, too.”
After having a complete breakdown in 2011, Mark was recommended to see a counsellor and sought treatment for both his depression and ADHD. Having begun his recovery, Mark’s focus then turned to what he could do to help other fathers who were going through similar difficulties. He founded the support service Fathers Reaching Out with the aim of not only promoting awareness about paternal mental health but also to campaign for better support for parents in general. He echoes Mcmullen’s argument that health services need to be widened to the whole family: “What’s really important is that both parents are monitored in the lead up and after a birth,” he says. “I campaign for all parents, not just fathers.”