When Steve Wright became a dad, the UK was about to enter its first lockdown. He’d recently quit his job so he could take some time out to spend with his newborn son. What followed, however, was a crash course in the brutality of postnatal mental ill-health.
“Essentially I had a breakdown,” says Wright. “This experience was completely alien to me. I had a complete mental collapse. I didn’t feel like I could pick my baby up without dropping him. I honestly believed at times I was going to hurt him. Thankfully, I never did. I think it was just my brain playing tricks on me, saying I was going to fuck this up.”
Wright is one of a growing number of men sharing their experiences of mental health struggles during the postnatal period, defined broadly as the time from conception until a baby turns one. Recent research by the Colorado School of Public Health, studying data across a 25-year period from 1995 to 2020, found that 11 per cent of new dads struggle with anxiety.
Dr Daniel Singley, a clinical psychologist and founder of the Center for Men’s Excellence in San Diego, says that one in ten men can suffer from some kind of postnatal mental health issue, ranging from anxiety to depression or psychosis. Worryingly, that rises to one in two when their partner is also struggling.
“We’re socialised to think of fathers as protectors and providers, and to sacrifice and be there for others,” says Dr Singley. “But taken to the extreme, that means, ‘I deny what’s going on with me and I stuff it down’, sometimes to the point of getting to suicidality or acting out with rageful, agitated depression and harming others.”
Finding help for male postnatal depression
“Postnatal mental health is significant in fathers, and we know from suicide rates being higher in men that it can escalate very quickly,” says Annie Belasco, who runs PANDAS, the Pre and Postnatal Depression Advice and Support charity. “We saw a rise in our calls from men between March 2020 and March 2021 of 240 per cent.”
PANDAS is one of a number of outreach services that is working hard to address this growing crisis among fathers, and help bring it to the attention of new parents and busy healthcare services.
One of its volunteers is Ben Taylor, who serves in the Army Air Corps. Taylor’s wife gave birth to their son in October 2020, and in the weeks that followed, Ben found himself struggling. “It was quite a traumatic birth,” he explains. “I didn’t want to admit that I was suffering, because I wasn’t the one who had given birth.”
However, during a regular check-up with their health visitor, he opened up about how he was feeling: “I’m normally quite a confident person, being from the military, but when she asked, ‘Are you ok?’ I couldn’t look her in the eye as I replied, ‘No.’”
The health visitor ran through a series of questions about postnatal depression and told him he should seek help, signposting Taylor to PANDAS, where he spoke with two volunteers working specifically with men, one of them ex-military. They helped Taylor understand what he was going through and normalise it.
“I’ve not been diagnosed with PTSD, but there were tell-tale signs of that,” he says. “I was really struggling, I couldn’t sleep, and I thought, Well if I can’t sleep, I might as well work out. I was training four or five times a day, at least an hour at a time.”
Through speaking with other dads in PANDAS’ private Facebook group, Taylor was able to start feeling better and see that other men were going through the same thing. Now, he helps run the group, which has over 600 members – although many choose not to engage, opting instead, says Taylor, to find help by simply knowing others are dealing with similar issues.
Tackling outdated ideas
For Steve Wright, the issues with his mental health during the postnatal period came back to notions that are old-fashioned, but still powerful. “I’m not about keeping my feelings inside,” he says, “but that whole stereotype of being the one that steps up and provides kicked in big time. I just felt utterly useless.”
Rosey Adams, who set up #pndhour on Twitter to help highlight the issue of postnatal depression and ill health, agrees. “The stigma that’s attached to men’s mental health is even bigger than women’s, especially when you become a dad,” she says. “There’s a lot of pressure to hold it all together.”
Wright says that while the midwives who came to see him and his family were helpful – suggesting he contact his GP for support – doctors tended to focus on his partner and their baby, rather than hearing what he was saying about his own mental health.
It was at this point he began searching the internet and came across Dad Matters, a pioneering service that helps train staff in maternity services in how to help dads who are struggling. It’s linked with the NHS across Greater Manchester and is currently expanding to more sites around the UK. Its staff replied to him within 15 minutes of his initial message, sent late on a Friday evening, and set up calls the following week to give him the support he needed.
“There are lots of campaigns around male mental health, but in the postnatal period there’s not a lot of support,” says Kieran Anders, Dad Matters’ project manager. “There’s a lot of focus on mum, and dads want everybody to focus on
mum, but dads get missed, partly because the services are so focused on the outcomes for mum and baby.”
Anders says that, thanks to an innovation grant, he and his team have been able to develop universal and targeted approaches to help dads understand their mental health better both before and after their baby is born. Flyers and banner posters at booking appointments and scans highlight the service, while health visitors and midwives are aware of their work. There’s also one-to-one peer support, wider support groups and a growing focus on babies’ mental health, with the aim of shifting the idea of divided male and female services towards a more holistic offering.
That is something Dr Singley also feels passionate about. “We can’t all of a sudden rework society and change gender norms,” he says. “What I think is likely to be a huge step forward in the field is to stop looking at it as maternal mental health and start calling it parental postnatal mental health.”
Getting dads talking
One major issue is the difficulty dads have in coming forward. “Dads and men wait quite a long time before they access support and step into that arena of clinical care,” says Anders. “A lot of the dads won’t present in the postnatal period, they’ll present when their kids are two or three, maybe older, and so that skews the data.”
That often means men have reached crisis point, having struggled to see the early signs of postnatal depression, anxiety or PTSD. Speaking of clients who come to his clinic, Dr Singley says, “They tend to do it really late, so they’re very depressed or have suffered with significant anxiety for months and months.”
Breaking this cycle is challenging and requires a greater understanding of the symptoms, helping men detect when they have an issue, as well as offering the services they need from the start of the postnatal period.
Jenn Leifermann, PhD, Professor at the Colorado School of Public Health, whose research has helped shine a light on the scale of the problem, says more help is needed: “Young parents need additional support in their environment. They are at greater risk of anxiety and there are programmes and policies needed to help these folks.”
She points towards men being more involved in baby check-ups and exploring other risk factors, such as economic deprivation and a past history of poor mental health.
Reaching out and getting that help isn’t easy. But with services like PANDAS, #pndhour and Dad Matters, the options are improving, especially as the people working and volunteering have all-important lived experience.
“Part of the reason I volunteer is because if I can just help one person,” says Taylor, “or at least the thought of helping one person – that’s going to get me through this.”
Words: Joe Minihane