Tuesday, January 26, 2016

Research: One out of 10 fathers experiences Postpartum depression

Postpartum depression affects one in 10 fathers

We don’t often hear about it, but fathers also suffer from postpartum depression, but talking about it can help

Billy Monk’s second child, an eight-pound, four-ounce boy named Conway with a mop of strawberry-blond hair, was born in the spring of 2014.

Soon after, the Burlington dad was hit by an overwhelming feeling: He wanted to run away from everything in his life. At his job as a software developer, Billy kept his head down, avoiding coworkers as much as possible. He tried to steer clear of neighbours while walking his dog. And friends? Billy stopped hanging out with them altogether. “I just wanted to be alone,” he recalls.

Back at home, where Billy couldn’t escape, life became a mess. “I would have these outbursts where I would more or less say, ‘Everything’s terrible, I’m unhappy, everything sucks, I don’t see the point in anything,’ ” he says.

It was a similar feeling to what he’d experienced after the birth of his older son, Nolan, but much more severe. The major eye-opener, according to his wife Danielle, was some silly disagreement where Billy just flipped. “He started yelling about how this isn’t his life,” she says.

It was totally out of character. Billy — a hip-looking 31-year-old with colourful tattoos and a red-tinged beard — is a loving father, an optimist and “the most wonderful person,” as Danielle, 27, puts it.

But at the time, he was likely dealing with a condition people rarely talk about in men: Postpartum depression. 

While depression in women during and after pregnancy has long been discussed in parenting classes and media coverage, dads with the so-called “baby blues” are often left in the dark. And that’s a problem. PPD hits moms more often — up to 20 per cent of women who give birth every year have postpartum depression symptoms, according to the Centers for Disease Control — but a surprising number of men deal with it, too.

One 2010 American study, looking at data involving more than 28,000 men, found 10 per cent of new dads have postpartum depression. And, as a recent Canadian study shows, plenty of fathers experience depression before the baby is born as well. Led by a team from the Research Institute of the McGill University Health Centre, the Quebec-based research found around 13 per cent of expectant dads dealt with symptoms of depression during their partner’s pregnancy.

Other studies coming out of Europe and Australia have signalled similar rates of 10 to 14 per cent, says senior author Dr. Deborah Da Costa.

But dads often don’t hear about it. “When we would walk into clinics or prenatal classes, men were shocked that we would want to talk to them,” Da Costa says.

On top of that, experts say men are less likely to talk about their feelings than women, leading to a lack of understanding and awareness about depression in dads. While moms may be more inclined to show their sadness and stress outwardly by crying, dads tend to express it in different ways — often through anger — and may also self-medicate with alcohol, detach from family life and, as in Billy’s case, lash out at their partner.

Bernadette Kint, manager for healthy families with Toronto Public Health, says dads coping with depression can become hypercritical of themselves and others, and can sometimes resort to escapist behaviour like watching television for hours on end or staying out as late as possible.

If it goes unaddressed, depression can have a host of negative implications for child development, bonding between the dad and kids, and the relationship between the parents, says Brian Russell, provincial co-ordinator for Dad Central Ontario.

The good news? Men, just like women, can eventually overcome depression as a new parent — with some help.

Any dads struggling with depression symptoms should connect with their family doctor to get a referral for specialized treatment, says child psychiatrist Dr. Andrew Howlett, who runs the Fathers’ Mental Health Program at St. Joseph’s Health Centre in Toronto.

“Major depressive episodes without treatment can last months, with gradual improvements over time,” Howlett says. But for dads who do go through treatment, things can start to improve after just a few sessions.

Men also need to be open about what they’re going through — even if talking about their feelings is a bit foreign to them — and ask for help from their support network. “Whether it’s their own parents, siblings or friends, they’ve got to be able to talk with other people,” says Russell.

Communication between both partners is key as well, since each parent may go through a bout of depression, with the periods sometimes overlapping. That was the case for the Monks, with Billy’s depression spanning the first three or so months after each child’s birth, and Danielle’s following after.
Billy finally sought out help in the months after Conway’s birth — after urging from Danielle — and started opening up to others about his experience at a fathers group in Mimico.

“That was a big help,” he says. “In these groups, you’ll find people in a very similar situation to you. They’re a lot more likely to open up to you in a situation like that than someone would be in the office.”

Looking back on the parenting classes they took together before having kids, Billy says he never learned about PPD in men. The classes just stuck to the ABCs of being a parent, like how to change a diaper. “It didn’t broach the subject of the emotions — it did for women, but not for men,” he recalls.

Canadian researchers like Howlett and Da Costa are hoping to change things.

On Father’s Day in 2014, Howlett launched the Fathers Mental Health Network with fellow Toronto psychiatrist Dr. Benjamin Rosen. The network’s website is meant to be a mental-health information tool for both doctors and patients, linking dads to community resources, treatment programs and depression screening tools. 

Da Costa is also developing an upcoming website for dads, based on research that revealed many men aren’t satisfied with the information available for parents online since it’s usually tailored to moms.

Now armed with knowledge about the impact of depression, the Monks regularly go to counselling together and Danielle is on medication to help with her PPD symptoms. And, with baby number three on the way, they also have plans in place to exercise, watch their alcohol intake and maintain a healthy diet in hopes of staying healthy as parents in a growing family.

Despite the dark moments, Danielle says the experience brought their family closer together. “Every moment that we’re able to, we’re together and doing things and supporting each other. I feel so much pride looking at our family and what we’ve overcome, and how we’ve bonded as a result.”

As for Billy, who eventually overcame his PPD, he’s relishing every beautiful moment with his growing kids. “There’s no part of being a father that I don’t like,” he says.


Dads Get Sad Too: Depressive Symptoms and Associated Factors in Expectant First-Time Fathers

This cross-sectional study aims to determine the prevalence and determinants of depressive symptoms in first-time expectant fathers during their partner’s third trimester of pregnancy. As part of a prospective study examining depressive symptoms in men over the first postnatal year, 622 men (mean age = 34.3 years, ±5.0 years) completed standardized online self-report questionnaires measuring depressed mood, physical activity, sleep quality, social support, marital adjustment, life events, financial stress, and demographics during their partner’s third trimester of pregnancy. The Edinburgh Depression Scale was used to assess depressed mood. Partners also completed the Edinburgh Depression Scale in the third trimester. The results revealed that 13.3% of expectant fathers exhibited elevated levels of depressive symptoms during their partner’s third trimester of pregnancy. Significant independent factors associated with antenatal depressive symptoms in men were poorer sleep quality, family history of psychological difficulties, lower perceived social support, poorer marital satisfaction, more stressful life events in the preceding 6 months, greater number of financial stressors, and elevated maternal antenatal depressive symptoms. These findings highlight the importance of including fathers in the screening and early prevention efforts targeting depression during the transition to parenthood, which to date have largely focused only on women. Strategies to promote better sleep, manage stress, and mobilize social support may be important areas to address in interventions tailored to new fathers at risk for depression during the transition to parenthood.                   

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