Focus

Fathers on the sidelines

Depression can strike new dads – but where can they turn?

By Diana Ballon

Adrian* can still picture a photo taken of his wife and twin boys within 24 hours of their birth. “I can see a person who’s completely shell-shocked,” he says, referring to his wife. “I think we both felt exactly the same way.”

Seven years later, Adrian is a successful corporate consultant in Toronto. His two boys are thriving, and his wife happily divides her time between a part-time career and caring for her children.

But Adrian can still recall how he felt in those early days like they were yesterday. It was “like someone has pushed you to the bottom of a well and there’s no way out,” he says. “We had two kids, and all they did was scream, so there was no relief physically or psychologically.”

At the time, neither Adrian nor his wife allowed themselves to think they were depressed. But she was. And so was he.

What Adrian experienced was the male version of postpartum depression, a phenomenon that has until recently been exclusively associated with the depression experienced by about one in eight new mothers in the year following childbirth.

This male depression – also referred to as paternal postnatal depression (PPND) – has garnered less attention than its female counterpart, despite research indicating that a smaller, but by no means insignificant percentage of new fathers also get depressed. According to a 2008 article in the Journal of Child Psychology and Psychiatry, about 10 per cent of fathers have depressive symptoms when the child is nine months, compared to 14 per cent of mothers.

This phenomenon reflects those darker times that parents are still reticent to talk about. They’re about exhaustion, and about the tumultuous feelings and upheaval that accompany the entrance of a new person into the home and the couple relationship. “‘Postpartum’ is a term premised on the act of giving birth,” says Adrian. “But what about the stuff that has nothing to do with giving birth – the spectrum of feelings that both men and women can have after the birth of a child that have nothing to do with hormones?”

While both men and women can struggle as new parents, men’s concerns are often less noticeable; they garner less attention; and fathers get less support. This is partly because PPND doesn’t have the same hormonal basis as depression in birth mothers, so psychiatrists may not see it as a diagnosable disorder, says Hiltrud Dawson, a health promotion consultant for Best Start Resource Centre in Toronto.

But others say PPND does indeed exist. Postpartum in fathers is “rarely talked about as a real phenomenon,” says David Sheftel, the provincial co-ordinator of the Father Involvement Network of British Columbia. Sheftel surmises that the slow change to acknowledge men with PPND is in part due to the fact that men don’t tend to ask for support, so funders and service providers don’t always recognize the value of providing support for fathers.

Depression in dads may also be less apparent. Unlike the depression that new mothers experience, the effects are less dramatic for men – “more of a slow burn,” says Dr. Bill Watson, a Toronto family physician who has run parenting groups and groups for fathers. Parent educator Brian Russell, who works out of the LAMP Early Years Centre in Toronto, agrees. The depression tends not to hit fathers until close to a year after their child’s birth, he says. Fathers have had to keep it together for their partner in those early days; then “they kind of fall apart.”

There may also be a less benign reason for overlooking fathers’ needs postpartum. Even if a father seems depressed, others simply may not have much tolerance for it. As one Toronto mother says when asked if new dads get depressed, “Of course they do…. I do have sympathy for men who experience depression after the baby is born, but my sympathy is short-lived. New fathers have to talk about the difficulties of parenting, but then they should get on with the diapering and laundry.”

“It’s a real double standard,” says Sheftel. Men are being told they should express their fears and be vulnerable, but at the same time, society still expects them to be strong and to provide financially. They are expected to do their fair share of the housework, and they are supposed to be the rock, no matter how scared or vulnerable they may feel. So new fathers may feel shame about acknowledging their feelings. And for women, “it can be hard to hear those feelings,” Sheftel says.

Community services need to shift their focus from helping and supporting mothers, to helping parents, regardless of their gender, so they can be good parents and find happiness in their own right.

Watson says that when he first started running parenting groups in the 1980s, men were reluctant to talk about their issues in the presence of their female partners. So he created separate groups for fathers only, with quite a different result. The men wouldn’t stop talking, he says. They had so many feelings, and were desperate to speak about them.

Unfortunately, for the few fathers who do get heard, many more will never attend a fathers’ group. Adrian says he confided in no one except his wife in those early days. He felt overwhelmed by the lack of help (both sets of parents live far away). He resented having to be the sole financial provider in a job he didn’t like. And he felt guilty that he couldn’t afford to pay for more help in the home. He also hated having to live up to his wife’s image of an idyllic childhood. And like so many new parents, he was exhausted. “I went from being a sound sleeper to always being in a state of alert, constantly jumping up in the night [whether to real cries or imaginary ones]. It was constant; there was no respite.”

For fathers, depression may show up in subtler ways than a classic depression. They may start to avoid the family, perhaps by working later, or by seeming more remote when they are with their family, says Russell. They may not pick up the baby’s cues. And if their partner is depressed – one of the main predictors for PPND – they may feel inadequate to help her or the baby. They have a lot of responsibility, and they get to a point when they feel like they’re doing everything wrong, says Russell.

An added complication to men taking more domestic responsibility is that “some women are reluctant to give up caregiving roles,” says Sheftel. A 2010 article in Personal Relationships describes how, despite the dramatic rise of mothers in the workplace, many before their child is one year old, employed mothers are ambivalent about their male partners being involved in housework and childcare. Those who saw their partners as “skillful caregivers” actually felt less competent themselves, reflecting “socially constructed ideals of motherhood.”

There is also a catch-22. Feminism is encouraging women that they can do everything men can do in their careers, but there is no equivalent when it comes to acknowledging men’s capabilities in the home with their children, says Sheftel. Men are often portrayed as incompetent in the domestic world, and many end up feeling that way. The reality is that many haven’t had good role models for the nurturing father, and they’re less likely to have babysat as teenagers, so they don’t always know what to do. But this doesn’t mean they’re any less committed or that they can’t make important contributions to parenting, Sheftel says.

Another reality is that when new fathers do reach out, many feel alienated by what they find. A 2009 issue of the Journal of Advanced Nursing revealed how women-only online forums provide much-needed support to mothers, but that they can marginalize fathers by not involving them in child-rearing discussions.

At family service agencies, the reading material in waiting room tends to be women’s magazines, and most staff are women, says Sheftel. And organized activities, such as “Movies for Mommies,” exclude men by their title alone. Ultimately, “dad watches from the sidelines,” says Sheftel.

Public health programs do need to emphasize support for women in the prenatal and postpartum periods, as these are the times when women can be particularly isolated, says Dawson, but that doesn’t mean ignoring the needs of expectant and new fathers.

For now, this support is mainly relegated to fathers’ and men’s groups; however, the message is slowly seeping into prenatal classes and other family-based services that men also need help. Community services need to shift their focus from helping and supporting mothers, to helping parents, regardless of their gender, so they can be good parents and find happiness in their own right.

For Adrian, it’s been an upward battle. It has left “a permanent scar,” he says. “I’m no longer carefree as I used to be. Anxiety has become a permanent state.”

Was it shame, I ask, about the depression? No, not really, he says. “It was more bafflement. I didn’t know myself anymore.”