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Postnatal depression: Dads experience it, too

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While recent research shows that rates of mental health issues in fathers is not necessarily greater than at other times in their life, the risk of stress and anxiety increases directly following the birth of their child.
 
Dr Wendy Burton, GP and Chair of the RACGP Specific Interests Antenatal/Postnatal Care network, believes higher stress levels in the months after becoming a dad may exacerbate any underlying conditions.
 
‘If an expectant father has a pre-existing mental health condition, this will complicate the situation within the household,’ Dr Burton told newsGP.
 
‘If the mum develops postnatal depression, it increases the risk to the father of also developing it.’

Elizabeth Spry is a Victorian Intergenerational Health Cohort Studies (VIHCS) investigator and an author of ‘Preconception prediction of expectant fathers' mental health: 20-year cohort study from adolescence’. In her research Ms Spry found that two thirds of men who experienced antenatal depressive symptoms had a history of common mental health issues, such as anxiety or depression, before their partner’s pregnancy.

The VIHCS examined the mental health of 214 men over a 20-year two-generation study during their teenage and young-adult years, and then again during subsequent pregnancies of their partners, as part of the 2000 Stories longitudinal study.

Researcher Elizabeth Spry believes that early intervention to assess the mental health of fathers is significant in reducing issues during and after pregnancy.

‘We found that those who experienced mental health problems in both their teens and their 20s were the most vulnerable group in the transition to parenthood, with over a four-fold increase in the odds of having perinatal depressive symptoms compared to those with no prior history,’ Ms Spry told newsGP.

One of the objectives of the intergenerational studies was to shift some of the focus of parents’ mental health issues to the fathers, which, Ms Spry said, has until recently been a ‘neglected area’.

‘We focus a lot on mums’ mental health during pregnancy and after their child is born, but we often forget about dads,’ she said.

‘Yet many men also find becoming a parent a challenging time, and one in 10 expecting fathers experience mental health problems [that also] effects their partners and their children.
 
‘We wanted to understand who is more likely to find this transition difficult, to help policy-makers and clinicians to support those who need it the most.’
 
Ms Spry sees the role of GPs and other primary healthcare professionals supporting fathers’ wellbeing as twofold.
 
‘A first priority is early detection and intervention for teenagers as part of routine checks,’ she said.
 
‘We found that teenage boys who have mental health problems that resolve fairly quickly are less likely to experience similar mental health problems when they later become parents, compared with teenagers whose mental health problems go on for longer.
 
‘So intervening early to limit depressive episodes is very important.
 
‘A second opportunity presents at the point of pregnancy. Typically, women are seen by their GP or other primary healthcare professionals at some point in pregnancy, but fathers are often not.
 
‘Involving fathers at this point provides an opportunity for early screening and intervention where indicated.’
 
Dr Burton also emphasised the importance of early-intervention strategies and recommends GPs include all involved family members.
 
‘Acknowledge the impact of parenthood upon all parents, not simply the birth mother,’ she said.
 
‘Most attention is paid to mum and certainly there is a lot happening in her life; however, we need to support the family unit.
 
‘I encourage men to talk to other dads, to understand their own health needs while acknowledging the changes in the household and the difficulty of meeting the needs of everyone.’
 
The impacts of fathers’ mental health issues during and after pregnancy can extend to their partner, children and general family environment, according to Ms Spry.
 
‘Even after accounting for the role of maternal depression, fathers’ perinatal mental health problems have also been found to predict children’s emotional and behavioural problems in early childhood, and psychiatric disorder in mid-childhood,’ she said.

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antenatal depression men’s health mental health postnatal depression pregnancy

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