Post-natal depression isn't just suffered by women who have given birth. It can also affect new dads, adoptive parents and IVF parents. It's important to recognise the signs and get help, writes Anna Whyte.

Evan Hutchinson knew he had hit rock bottom when he was found hiding under his bed for four hours.

A "heavy cloud" had been hanging over him since the birth of his first child three months earlier. Welcoming a child into the world is usually a joyous occasion, but adjusting to life as a father left him feeling anxious, depressed, exhausted and isolated.

"I felt broken," he says. "If I wasn't angry, I was tired. You could sleep for 12 hours and wake up even more tired.

"I would get paid, go to the supermarket, buy my daughter what she needed for the week, maybe a pack of noodles for me, and I went straight back home as fast as I could. I didn't want to be seen, I didn't want to interact. After the three months, I thought I was a basket case.

Advertisement

"The worst I got was when I was found underneath my bed with a blanket on me, just staring at the bottom of the mattress. They reckon I was in the room for about four hours."

He decided to get counselling and was shocked when the counsellor told him he had post-natal depression. He was unaware up to that point that such a condition could affect men. The weight he had been carrying for months lifted once he accepted the diagnosis.

"The problem was still there but that heavy cloud was removed by just simply putting a name to it," he said.

The hardest part was explaining it to his friends and family - some of whom did not understand or made jokes about it.

"That male mentality needs to be changed," he said.

Mr Hutchinson, a fourth generation butcher, decided he wanted to show other men who may be experiencing what he did, that there was help out there.

"As a male, when those feelings are creeping in, we're sweeping it under the carpet.
"If it had been a common topic I wouldn't have gotten so deep, there would be groups I could go to, counselling services," he said.

He wants the topic of post-natal depression in men to be a subject to be brought up without taboo.

Advertisement

"My goal is that it is as if you were talking about rugby. Or sitting in the pub, old Fred has had a bit of a bad week, he can open up to his mate, just natural, no stigma, just a natural conversation males can have."

He said it was important for men to know the warning signs for post-natal depression in their partner, as well as themselves. Mr Hutchinson created the Facebook page as a place fathers could share their experiences.

"It doesn't make you damaged, it doesn't make you any less of a person."

Mental Health Foundation chief executive Shaun Robinson said post-natal depression, or paternal depression, could affect anyone, but it was more common in men who had been depressed before, or if their partners were experiencing depression.

"Becoming a father brings with it new pressures and responsibilities and some men may find their new role difficult to cope with and may experience depression, which is often called post-natal depression," he said.

EXPERT: Mental Health Foundation chief executive Shaun Robinson said post-natal depression could affect anyone
EXPERT: Mental Health Foundation chief executive Shaun Robinson said post-natal depression could affect anyone

"According to postnataldistress.co.nz, 10 per cent of New Zealand fathers experience post-natal depression ... In general, studies have shown that one in 10 dads has post-natal depression and fathers appear to be more likely to suffer from depression three to six months after their baby is born," he said.

Mr Robinson said men who had experienced post-natal depression, "may find themselves unable to relate to their baby, and may lose interest in their usual activities, have a decrease in appetite, feel irritable or angry for no reason, have trouble sleeping and more".

Mr Hutchinson's partner, Nicole Hunt, gave birth to Laila seven months ago, and when she began to feel a little bit more than the baby blues, Mr Hutchinson, with his previous experience of post-natal depression, could see the signs in her.

"I remember anxiety. I'd hear Laila cry and almost panic," Ms Hunt said.

"I knew I was feeling tired, but then Evan kept saying, 'no, no, I think we should tell the midwife'. "I was fortunate he was at home to help me."

She said she benefited from being proactive about what she was feeling.

"If you can recognise it, you can change it."

Father and Child Trust Support worker Brendon Smith. PHOTO/SUPPLIED
Father and Child Trust Support worker Brendon Smith. PHOTO/SUPPLIED

Father and Child Trust Support worker Brendon Smith said he had provided support to "quite a few" fathers with post-natal depression.

The trust was founded by a group of dads in 1997 to provide fathers with help, information and support, and it has visited Tauranga for training exercises.

"We quickly realised ... a lot of dads that wanted that chat with somebody who had been through what they were going through, they were probably going through a bit of post-natal adjustment, post-natal depression, or they were the at home dad."

Mr Smith began his involvement with Father and Child after his second child.

"I ended up staying home with the kids, bit of a shock at the time, we'd just had our second kid ... but I went into a bit of a slump for a year or so trying to figure out what I was doing, and I didn't expect it to be that hard."

He said fathers seeing their partner going through post-natal depression could also be a contributing factor.

"He wasn't expecting it to be that hard, or for his wife to be upset all the time, and that's sort of stage one of some dads going into depression. Some guys it's the fact that some mums have been through that, and when it's come right, that's when the dads collapse - might just run out of puff."

He estimated he had given support to 20 or 30 men with post-natal depression over the last 10 years, but thought there were many more out there.

Mr Smith said it was unlikely a lot of men would want to talk to their friends about what they were going through.

"It's not something dad wants to tell anyone, there is a combination of denial and pride going on.

"A very small number of them find out about us, and out of the ones who get told they should ring me ... roughly half of them never call me."

When Mr Smith does get in contact, usually they need to ask the fathers about their families before they open up.

"It's just understanding, and reinforcement that they're doing the right thing. It could be just hard, they've got a lot on. Some guys just [need a] pat on the back, say hang in there and love your partner."

He said he wished fathers would, and were encouraged, to take a more active part in the birthing process.

"Don't forget the dads. They might warn you of what is going on with the mother, and maybe the dad might need help himself."

Tauranga Hospital perinatal infant mental health registered nurse Robyn Matthews said there was no statistics on men with postnatal depression collected regionally.

"However, anecdotally we are aware of many dads who become depressed."

She said the reasons could be varied, but one of the main issues was feeling helpless with not knowing how to help their partner when they had post or antenatal depression or distress.

"Often men feel helpless and often think they are failing in their 'expected' role. Both parents are required to adjust to their new role, and this can be a difficult transition for some. Particularly older professional parents who have had a good income from two working adults, that reduces to one."

She said IVF parents were at risk of postnatal depression too.

"Again due to the arduous task of becoming pregnant, and then their idealisation or fantasy of being a parent is often not realised."

Ms Matthews said one of the major triggers was sleep deprivation for both parents.
Plunket media manager Serene Ambler said those suffering would get better gradually with the correct help.

"The important thing to know is no matter how long you've been feeling depressed, it's never too late to ask for help. These feelings are not here to stay," she said.

She said fathers could get support through talking with other dads about shared experiences, through a family doctor or Plunket nurse, follow-up parenting education courses and Dad's local support groups.

Ministry of Health senior media advisor Erina O'Donohue said the Ministry of Health did not collect data on the number of men with postnatal depression, or how many men had developed depression after becoming a dad.

What causes postnatal distress?

Registered psychotherapist of Auckland's Postnatal Distress Centre Susan Goldstiver said hormonal changes were an aspect of postnatal depression.

"It is only one of many risk factors."

She said it was not just women who had given birth who experienced post-natal depression.

"Ten per cent of men are experiencing PND, and women who adopt babies are at risk ... In my experience, it's never just about hormones.

"It's situational factors, adjustments, difficulties, vulnerability to anxiety ... It's a huge adjustment, it's a time of transition. It also depends how solid the relationship is [and] what other environmental things are going on, finances, his past experiences of being a parent and any kind of abuse or relational trauma."

Plunket NZ media manager Serene Ambler said hormonal changes being the sole cause of postnatal depression was not correct.

"It's thought to be caused by a combination of many different factors."

She said there had been a range of research on post-natal depression and fathers, which found fathers were particularly prone if their partner was depressed, and also if one of the parents had already had a child or children from a previous relationship.

Other risk factors for PND in fathers include:

- Older age
- Being a first-time parent
- Having a small circle of friends
- Limited social interaction and support
- Limited education
- Concurrent stressful life events
- Quality of the relationship with wife or partner.

What to do

Tauranga Hospital's Robyn Matthews said communication, and talking about what parents were going through was the start of a healthy relationship and well-being.

"Remember dads, you do not have to 'solve it', you just have to be there. Listen, and ask what your partner might find helpful."

Often talking to a friend, a parent or a counsellor may help you work your way through this.

Keep seeing friends, ensure you exercise, and eat healthily."

"Alcohol and marijuana are depressants, so abstain from these."

Ms Matthews said parents benefited from having time out individually and together, to nurture their relationship and themselves.

"Get a baby sitter to have a good night sleep if you can, or in the weekend to catch up on sleep, or R&R."

And don't hesitate to talk to a health professional, she said. See your GP if you are experiencing:

- Low mood
- Poor sleep (particularly if you find it difficult getting off to sleep, or wake up outside of baby waking)
- Increased or reduced appetite ¦Feelings of sadness or anger
- Lack of pleasure, and have poor or low motivation
- Isolation from friends, family or work
- Feelings of anxiousness or a sense of dread
- Poor concentration - work is suffering
- If you are not able to meet the needs of or spend quality time with those you love.