Supporting Fathers' Mental Health
There has been an increased focus on perinatal mental health for mothers in recent years, and it’s wonderful and long overdue. However, there remains a glaring lack of emphasis on fathers’ mental health awareness and interventions. If you are or know a new or expectant dad, here are some things to help improve mental health and wellbeing!
Men’s Mental Health
Earlier in this space I wrote about men’s mental health and our relative disconnection from mental health services overall. We men tend to seek help at about half the rate that women do, and we struggle with some mental health issues much more frequently than women do, such as substance use and serious mental illnesses. Thankfully, men’s mental health is an issue that is slowly gaining more awareness.
Another issue that is experiencing growing attention is perinatal mental health issues experienced by new fathers. Note that ‘perinatal’ means relating to the period of time around the birth of a child, generally including pregnancy and up to a year after birth.
Maternal mental health, and maternal postpartum depression specifically, is a driving force in discussions about perinatal mental health. Considering the importance that mothers play in raising children and the disproportionate amount of work that women tend to do with childrearing and household tasks generally, of course maternal mental health should be the first priority! And yet fathers and non-child-bearing partners of all genders need to be prioritized as well.
Note that my focus is on fathers in this piece, but it could and should be expanded to focus on all non-child-bearing parents of any gender. I’m centring fathers here because: (a) I’m a man and a father and will be speaking to my experience as a new parent; and (b) the research I found on this subject tends to focus on fathers specifically.
Fathers’ Mental Health
While perinatal mental health in general remains an area that requires greater investment in research and treatment, mental health challenges experienced by new fathers in particular are under-addressed. Here’s a brief snapshot of mental health issues encountered by some new fathers:
Roughly 10% of new fathers will experience postpartum depression (PPD) compared to 10-20% of new mothers
The number of fathers with PPD rises to 50% if their partner also has PPD
Up to 16% of new fathers will experience an anxiety disorder within a year after the birth, which may be comparable to rates in new mothers
These rates of illness are amplified for fathers who experience financial instability, have lower levels of completed education, and whose jobs require long hours of work
New fathers are less likely to have strong social support compared to mothers, are less likely to seek treatment for mental health issues, and are more likely to dismiss their issues as less important than mothers’ issues
In navigating the perinatal process, fathers have reported feeling ignored and invisible during healthcare interactions. Because fathers describe feeling unseen by the perinatal health system and believe the system only saw them as caregivers for mothers, fathers report the tendency to downplay their own struggles or to be unaware of their difficulties as being related to mental health (men also tend to have lower knowledge about health issues than women generally).
My Anxiety as a New Father
As a new father almost three years ago, I struggled with anxiety after my daughter was born in a way that I never had before. I’ve certainly had some social anxiety for much of my life, although it’s faded considerably as I’ve gotten older, but the intensity of worry and health anxiety that hit me after my daughter’s birth was something I wasn’t prepared for. Despite all that I know about how to help others with anxiety, I had real difficulty using those skills myself at times.
At its core, my anxiety was related to worries about dying or becoming disabled and subsequently impairing my daughter by being unable to be there for her. This led me to catastrophize some of the normal body sensations and thoughts that we all have sometimes. This created on-and-off panic for me that looked like periods of relative calm interspersed with periods of intense anxiety.
In reading the feedback that fathers provided in the research, I saw my own experience in the system echoed well. I also felt invisible most of the time with perinatal clinicians. Not only that, I regularly felt actively ignored, considering there were frequent occurrences in which I would pose a question to a clinician, and they would respond to my wife. There were some notable exceptions, like my daughter’s doctor who involved me in every conversation we had together and who probably spoke to me just as often as she did to my wife. The meetings with the family doctor were the first time that I truly felt like an equal partner in the eyes of perinatal clinicians.
How I Manage(d) My Anxiety
I returned to therapy, having been to therapy before and surely will be again, and worked on confronting my anxiety and mental avoidance through various forms of exposure. Exposure is scary, exhausting, and incredibly helpful! I also embraced mindfulness practices, particularly ‘mundane’ mindfulness in which we return our attention to the present moment as we go about our day, as opposed to undertaking formal sitting or walking meditations (I did those too, but less often).
That neat paragraph makes it seem like my anxiety management was streamlined and simple and it wasn’t! I had on-and-off issues with anxiety for perhaps two years until I more strongly embraced mindfulness and ongoing exposure as a way of life rather than time-limited exercises I did during a treatment program. I kept trying to get myself back to who I was before my daughter was born and would inevitably become disheartened when the anxiety returned because I thought I would never go back to who I was. And of course I couldn’t go back to being that person! You can’t have a child and be the same person you were before, both for better and for worse. It’s taken time for me to truly accept that, and it’s been immeasurably helpful that I finally have.
Instead of trying to talk myself out of my anxiety or distract myself from it, I now sit with it when it arises. I try and breathe into it and welcome it as an opportunity to increase my resilience.
How to Support New Fathers
There are both individual and systemic adjustments that should be made to bring increased awareness to new fathers’ mental health issues and to enhance treatment options available to new fathers. I found very few dedicated resources to fathers’ mental health when I was searching for services for myself, and I’m a professional who knows how to navigate the mental health system. Imagine the difficulties faced by a new dad with limited mental health awareness and no idea where to turn! We need to do a better job as a system to build awareness and provide opportunities for support among expectant and new dads.
If you’re a new or expectant father, here are some ideas for you:
Read up on mental health issues throughout the pregnancy, both for your own benefit and to increase your awareness of issues your partner might experience. Learn about depression, anxiety disorders, OCD, and psychosis in particular, the warning signs and symptoms of these issues, and possible interventions. You don’t have to become an expert but at least learn the basics.
Seek practical and emotional support from friends and family. Have conversations with friends with kids about how they felt throughout the birth process and afterwards. Normalize the fact that struggling throughout parenthood is to be expected and that these struggles can sometimes feel insurmountable.
Ask questions of your health team. Ask the midwives, doctors, doulas, and whoever else to talk about possible mental health issues and ways to manage these. Put mental health issues on the table if your clinicians don’t, though hopefully they will.
Use research-based skills to manage difficulties. I’ve written other posts about the strategies to help manage depression and anxiety. I’ve also written about men’s mental health issues specifically.
If you’re a clinician who works with new or expectant fathers, here are some ideas for you:
A key consideration for health professionals and the healthcare system broadly is to acknowledge explicitly that fathers (and non-birthing partners of all genders) may struggle before, during, and after the birth. Professionals should make explicit inquiries about how fathers are doing, assess where fathers are struggling, and recommend professional supports as needed.
Work throughout the prenatal period to normalize mental health difficulties among expectant and new parents. Some fathers have reported that they felt blindsided by later mental health challenges because they hadn’t been informed of these possibilities during pregnancy. Since the issue was never raised by their health providers, fathers understandably assumed they would not encounter mental health challenges. The gap between expectations and reality was then particularly jarring.
While centring fathers as worthy recipients of attention and care, also highlight the importance of fathers’ mental health support for the benefit of their families. Men may have an easier time accessing mental health services if treatment is framed as being beneficial for the wellbeing of loved ones rather than solely for personal benefit.
Be conscious of gender stereotypes regarding men. On average, clinicians provide less thorough explanations and empathy in healthcare appointments for male patients compared to female ones. Challenge yourself to provide the same level of care to men and folx of all genders.
Mental health issues can affect anyone before, during, and after the birth of children. These are incredibly stressful events, and incredibly wonderful ones too, that throw us into a dramatically different phase of life. The perinatal health system must highlight the possibilities of mental health issues for all folx at these times. We need to prioritize a focus on increasing mental health literacy at an individual and systemic level to support the holistic physical and mental wellness for all parents.
Disclaimer: This post is intended for educational purposes only and is not a substitute for psychotherapy. The information provided is general and may not be appropriate for your particular mental health needs. Always consult a qualified health professional to discuss your personal needs and goals.