One of the most vivid memories I have from the first weeks after my son’s birth is of walking in on my husband sitting on the bed, rocking our newborn to and fro while singing nursery rhymes. At first glance, it was the picture of new fatherhood; but on second glance, the baby was crying hysterically, and both of them had large, hot tears streaming down their cheeks.

It’s not something we ever talk about, but new fatherhood can be just as challenging as new motherhood. Men, too, have to go through that head-spinning identity switch from man to father. There’s pressure on men to provide financially, as well as emotionally, and there’s little room for a new father who is struggling to ask for support – after all, he’s not the one who’s just been through childbirth.

 While mothers understandably tend to hog the headlines when it comes to postpartum depression, there’s a growing awareness of how it can affect dads too. A new poll by the Priory clinic found that 39% of men experience ‘some anxieties’ after having children; one in ten men say they have ‘negative thoughts’; while one in 15 said they believed they were suffering of Paternal Postnatal Depression (PPND).

“New fathers can become overwhelmed by their additional responsibilities and the fundamental change in family dynamics, which often includes managing on a reduced family income, but their own emotional support is regarded as secondary,” says Maartje Suijskens, a psychologist at the Priory Wellbeing Centre in Dubai. “Yet, as with women, men can also be vulnerable to depression during this new, sleep-deprived chapter in their lives.” 

The situation can be even more acute for new fathers in the UAE, continues Suijskens: “The pressure on expat fathers can be just as significant if not higher,” she says. “The increase in pressure comes from simply being an expat, which is living in a location that is geographically distant from your family, friends and well-known support systems. This increases the pressure on the spouse to be the sole provider, not only financially, but also emotionally. Providing this support can be overwhelming and increase the risk of developing PPND.”

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How it’s different from maternal postnatal depression

For any mother who has ever experienced the depths of postnatal depression, the idea that men are now staking a claim to postnatal depression too might seem a bit rich, considering that they don’t go through the hormonal haywire of pregnancy or birth.

But although it may not be at the same level, new fathers also go through hormonal changes, Suijskens points out: “New research from the University of Michigan (2015) shows that just as new mothers experience hormonal changes, new fathers’ hormones shift too.

“Their testosterone levels go down and their estrogen levels go up. Their increased levels of estrogen make them feel more emotional than usual and low levels of testosterone are associated with depression in men.”

It’s true that post-natal depression usually looks different for men and women, continues Suijskens. “New fathers often exhibit less sadness, crying, and outward emotional symptoms that are more commonly identified in new mothers. New fathers with PPND may notice a change in their concentration levels and feel less motivated at work. Furthermore, they may exhibit risk-taking behaviours, irritability, anger, verbal outbursts and violent behaviour.”

Studies have shown that new fathers are also more likely to suffer from delayed depression than mothers, commonly three to six months after their baby is born, and often when the mother has recovered from delivery and is going back to work. 

Although there is no specific diagnostic coding that separates postpartum depression from regular depression, “the stressor for paternal postnatal depression is specific,” says Suijskens. “The depressed feelings are related to the event of becoming a father and the depressed or angry feelings can be directed towards the child, therefore early assessment and treatment is extremely important.”

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The stigma

In the Priory’s poll, two in five men (42%) who experienced depression or anxieties after the birth of their baby did not seek help, saying they were too embarrassed and ‘thought they should be happy’.

Nearly 70% of men said they felt there was still a stigma around postnatal depression, and that society might view those who suffered from it as ‘inadequate’ parents.

Meanwhile nearly half of men and women (47%) said there was not enough support for new fathers experiencing difficulties adjusting to parenthood, and nearly 80% of men and women said fathers were ‘forgotten’ in discussions about PND.

This social expectation that men should just be able to get on with it is certainly no less in the UAE, says Suijskens: “Among many cultures in this region, showing emotion or exhibiting feelings of anxiety or despair is still regarded as a sign of weakness by many men, who feel family needs should come above their own. As a result, they refuse to recognise when they may need help, which can only have negative consequences.”

What makes the situation even worse in the UAE is the fact that most health insurance companies do  not cover depression or mental health in any form for either women or men, which contributes to the mistaken perception that depression is not a valid illness.

“Most insurance companies either do not cover mental health at all or they will provide partial coverage for selected diagnosis as well as selected treatment,” says Suijskens.

“This negatively impacts not only the ability for people to obtain quality treatment for their diagnosis but also significantly contributes to the negative stigma and misperceptions around mental health.”

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Why it’s important to talk about

According to researchers, paternal postnatal depression (PPND) affects around one in 10 fathers, and its effects on the dad can be as devastating as that suffered by women.

Just as postnatal depression in the mother can impact a baby’s development, research shows that postnatal depression in fathers can do so too.

“Postpartum parental depression is a complex and challenging disorder and its effects can be far-reaching,” says Suijskens. “It can have a serious effect on parent-infant interaction and bonding during the first year of life, and can contribute to a child’s emotional, behavioural, cognitive and interpersonal problems in later life.

“It is vital that doctors and psychologists work together to ensure new parents leave the hospital better informed about the emotional impact of having a new baby, and the support that is available.

“Our research suggests that the number of fathers who experience anxiety and depression is greatly underestimated. New fathers might be aware of the fact they are not feeling well, but they will not link it to possible post-natal depression. Hopefully by raising awareness we can encourage this situation to change.”

 Maartje Suijskens strongly advocates an open and supportive relationship between partners: “Becoming a parent is a life-changing experience and so will naturally have its challenges.  After the baby is born, it’s important both parents communicate with each other, as well as with family and friends, and share any concerns. The worst thing new parents can do is to bottle up their emotions and hope they will go away. You’re more likely to get a clearer perspective and the support you need to feel better if you talk to a professional.”

If you have serious depression you may:

  • feel exhausted and anxious
  • be obsessed with finances
  • begin to withdraw from your family
  • be irritable or intolerant
  • sleep badly.

The Priory Welbeing Centre in Dubai’s Healthcare City organises interactive group sessions for new dads who need support and guidance with the transition into fatherhood.

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