Men can get it too

AT LEAST one in 10 fathers suffers from depression after his baby has been born, according to a recent study on post natal depression in fathers. In their paper (soon to be published in the International Review of Psychiatry), Dr Clive Ballard, psychiatrist at Newcastle General Hospital, Newcastle upon Tyne and Dr Rachel Davies, psychiatrist at Whitechurch Hospital, Cardiff, found that depression among fathers is associated with having depressed partners, having an unsupportive relationship and being unemployed.

Other recent studies on the subject in Britain have found up to 50 per cent of fathers suffer from some form of post natal depression if their partners have been diagnosed with post natal depression.

Such figures may seem startling to those who understand, post natal depression to bed caused by the huge hormonal changes experienced by the mother after childbirth. However, many experts now link post natal depression in women and, men to a much wider set of causal factors.

"There is overwhelming pressure on men to be present at the delivery. When they see at first hand the pain that they have indirectly inflicted on their partners, this can cause an acute stress reaction in some men. There is an increased risk of a man suffering from this reaction if the delivery is traumatic," says Dr John Sheehan, psychiatrist at the Rotunda Hospital, Dublin.

"Another risk factor in male post natal depression is whether he is included in the family unit after delivery. Usually a very close mother/baby bond develops after the birth and if the man was somewhat dependent on the woman beforehand, he can feel very excluded. This sense of exclusion can also lead to an extra marital affair," continues Dr Sheehan.

Speaking about their experiences of post natal depression, male sufferers also cited confusion about their new role (breadwinner or involved parent?) as one of the causes of their depression.

Some admitted that they found it easier to withdraw into their work given there was little help they could offer when their partner was breastfeeding the baby. Yet, this withdrawal made them feel guilty and anxious. The fact that their own fathers had been distant and uninvolved with them as children, provided them with no role models.

In their study, Dr Ballard and Dr Davies also note that the additional demands of child care occur at a time when less emotional support is given to the father by his partner and more support is expected by the mother. This happens at a time when there are also additional financial burdens and increased restrictions on the couple's lifestyle.

Dr Ballard and Dr Davies believe that fathers have less opportunity to prepare for this experience than mothers. For this reason, he suggests pre and post natal services should be directed towards the whole family.

Mary Pigot, chairperson of the Post Natal Distress Association of Ireland and author of the book, Coping with Post Natal Depression, says that the support group - has not, as yet, come across male post natal depression. "But, if you look at men suffering because their partners have post natal depression, it is understandable," she says.

"Men are also not as inclined to confide in others about their problems, so difficult as it may be for women to get support for" post natal depression, it is even more difficult for men. I'd love to see a support group for partners of women suffering from post natal depression," she adds.

In terms of symptoms, Dr Sheehan believes male post natal depression is more like a stress reaction than depression per se. "The symptoms include temporary mood disturbances, withdrawal, a sense of guilt and impotence. The latter can be linked to seeing the agony his partner has gone through at delivery," he says. There is no known male equivalent to the most severe form of female postnatal depression, puerperal psychosis.

ALTHOUGH there has been no recent research into the effect depressed fathers have on their babies, some studies have looked at their impact on children. Children with two depressed parents have much greater adjustment difficulties than children whose mother alone suffers from postnatal depression. Such children are also believed to be more self critical and have more difficulty making friends.

Dr Sheehan believes that increased awareness of male postnatal depression is the first step to treatment. "Up to 50 per cent of post natal depression in women goes undiagnosed so we have a long way to go to recognise that men can have psychological reactions to childbirth as well. Men are also far more reluctant to come forward and look for help."

A psychotherapeutic or counselling approach to the problem is considered a more appropriate treatment than drugs.

. Coping With Post Natal Depression by Mary Pigot (Columba Press, £5.99) will be published this month. All royalties from the book will go to the Post Natal Distress Association of Ireland, Carmichael House, North Brunswick Street, Dublin 7. Tel: 01 8727172.