Fatherhood is the biggest challenge many men will experience in their adult lives. Mental health in men continues to be a taboo subject; there is a great deal of focus on men’s physical health but not enough on their emotional, psychological and mental wellbeing. Some people argue that this is not true, and that modern men are more open. This is valid, but so is the fact that 70–75% of suicides in the UK are men.¹
Not only does becoming a father represent major social, cultural and financial changes, but also men must deal with numerous physiological responses in their bodies in the months preceding childbirth. When his partner is pregnant, a man’s testosterone levels will decrease while other hormones increase – basically rewiring his brain to prepare him for fatherhood. These drastic physical changes continue through the first year of the child’s life. While they will better equip a man to take care of his baby, these significant transitions greatly increase his chances of developing clinical depression and mood disorders in the months surrounding childbirth – with a notable spike 3 to 6 months after the birth.
Numerous studies into depression in new fathers corroborate this. It is believed that 1 in 10 dads-to-be become depressed during their partner’s pregnancy, and 1 in 5 experience postnatal depression.² Traditionally, and understandably, there has always been a focus on the mother in the pre- and postnatal periods, but there is a severe lack of support networks for new fathers, who will be facing some of the same enormous challenges as their partners. Just like new mothers, new fathers suffer from sleep deprivation, money worries, changes in their relationship, and many other concerns. It is crucial to the maintenance of their mental health for fathers to be supported at this time. More education work and specialist outreach should be made available to encourage men to seek help for mental health problems.
If a father feels supported and emotionally healthy, this can benefit the whole family. Depression can put his relationship with the baby’s mother at risk, and it can also affect the relationship they have with their child. We all have a responsibility to look out for our partners during the wonderful yet challenging period of new parenthood. Just as we expect the father to care for the mother, so too should we expect mothers to watch out for the mental health of their partners, so that the whole family unit feels supported.
It is exceptionally important to be aware of the early symptoms of mental illness in fathers. One of the most significant signs and maybe also causes of depression in fathers is isolation – whether that be in family life, work or social situations. Sudden shifts away from family and friends can be indicative of mental health issues. When we socialise and spend time with people we are emotionally close to, we are ‘rewarded’ for this activity hormonally and neurologically. These rewards not only make us feel good, but also improve our physical health. Additionally, sharing worries reduces stress hormone production.
Substance abuse also denotes psychological issues – in particular regular and/or heavy drinking, due to its close integration with male culture. Another warning sign is a problem with anger management, which is very common in anxiety and depression and can lead to intimate partner domestic violence. It is important to seek help immediately if this is happening and ensure that partner and child are safe. That is the first priority.
Any of these may feed into difficulties with appetite, weight or sleep patterns – all of which can be detrimental to the father’s physical health. The link between psychological and physical health is an intimate one, and addressing physical health problems can be the first step in addressing mental health issues – especially for men who are more reluctant to admit mental illness.
It is now understood that physical illness produces low mood due to inactivity, and low mood produces less activity. Physical activity produces mood-improving reward chemicals in the brain. Outdoor sports are particularly rewarding: not only is the fresh air beneficial, but also nature has a soothing effect. Team sports can help with bonding socially, the positive approval achieved when winning together is great for morale and self-esteem, and they can also offer a support network for men to open up about their issues.
‘Behavioural activation’ activities such as going to a gym, walking and cycling are common treatments for anxiety and depression. Many GP surgeries now offer social prescribing to address common mental health problems, and this might include membership of a gym, joining a rambling group, and so on.³
The way treatments are labelled has an important impact on their uptake. For some men, maintaining the five-a-side footie on a Saturday is literally their therapy. It could very well these days be prescribed by a GP or a therapist, but if it’s already part of a man’s life then that’s helpful. We shouldn’t wait until we are mentally ill to get help. Let’s engage in a healthy lifestyle that reduces the possibility of we all have a responsibility to look out for our partners during the wonderful yet challenging period that accompanies pregnancy mental illness, and lessens its severity should it occur. We need to support each other by enabling each partner to have time out in a way that boosts his or her mental stability.
The difficulty men can have generally with discussing their mental health is well documented. This reluctance to engage with and address mental health issues extends into fatherhood, as many fathers adopt an attitude of acceptance towards their emerging mental difficulties. This not only fails to resolve the problem, but in fact worsens it. Poor mental health causes more difficulties in the day-to-day life of sufferers, which leads to worse mental health. Many people who are mentally ill are not even aware that they are ill. It is rare to be aware of one’s own depression, and even harder to recognise that it is a mental health condition.
The challenge is and has always been in getting men to seek help. Once they are over this threshold, they are generally very good at using the resources available. In the UK we have very good national services. Men can visit their GP and ask to be referred to local support services and talking treatments. It’s important in the conversation to dispel the myth of what talking therapy is. This area of help has come a long way since Sigmund Freud had people lie on a couch and free associate for years about their childhood. Modern talking therapies are much more about psycho-education (learning about the illness and why it happens) and practical changes to thinking and behaviour in order to get well and maintain this long-term. Modern therapies are time-limited and goal-oriented. Most people don’t need, want or benefit from long-term therapy approaches. Understanding this may be tremendously helpful for getting men in particular through the door into helping services.
What I think is needed is a focus for both men and women on the importance of mental health when they become parents. If each feels supported and has an outlet to talk and share feelings at this life-changing time, this will help them be aware of any larger problems and enable them to get help, for the benefit of the whole family.
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Noel McDermott is a psychotherapist with over 25 years of industry experience. Passionate about bringing high-quality care and support to vulnerable people, he is an advocate of community care and the power of a stepped care model within the community. mentalhealthworks.net
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References
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Illustration by Clare Wassermann
Published in issue 61. Accurate at the time this issue went to print.
