Postnatal is a type of depression that may parents experience after having a baby.

It's a common problem and can affect more than 1 in every 10 women within a year of giving birth. It also affects us dads! We might not expect it, but it typically hits hardest 6-12 months after baby arrives.

Postnatal depression can start at any point in the first year after baby arrives. In men it is less likely to be diagnosed because the symptoms can align themselves to a diagnosis of depression. Many women do not realise they have it because it can develop slowly. It's fair to say that men are less inclined to seek support which can result in the diagnosis going undiagnosed or ignored completely. A lack of early support and resources can also hinder early identification for both mum and dad.

Dads with a partner suffering from PND are more likely to experience it.

Did you know that the number of dads who become depressed in the first year after becoming a dad is double that of men experiencing depression in the general population? If you or your partner is experiencing emotional or mental health difficulties then you or partner are more likely to experience challenges.

If your partner is depressed, between 24-50% of you will experience depression yourselves. Why? In the early days you're both thrown in at deep end, the pressure is relentless and there is no let up and no escape! That monumental shift in your circumstances, mixed with hormonal changes experienced by mum can lead to her suffering from PND which in turn can put your partnership under intense pressure.

The negative behaviours attached to her PND can spill out into the relationship and can have a knock on effect to your own health and well-being. This can result in you feeling under increasing pressure whilst trying to balance the demands of work, baby and your partner's wellbeing! Ultimately her happiness, energy and confidence will be under threat, and this in turn can push those feelings onto you. You're exposed to a complex mental health issue and whilst she's clearly struggling she may not outwardly want to open up and discuss it with you. Under intense pressure you'll do everything in your power to understand what she's been exposed to and at the same time you'll ignore your own feelings. As the stress increases you might to start to experience feelings of anxiety and depression and start to close yourself off in the hope that it'll pass if you grit your teeth and ignore it.

PND. The warning signs

PND in dads? Is that really a thing? I know what you're thinking….. Isn't the struggle and exhaustion just part of being a parent? The honest answer is yes! But when does it become more than just adapting to fatherhood? Am I really at risk?

My own experience points to a fine line between the early pressures of fatherhood and PND, and it's a line that you can cross without even knowing you've crossed it. Remember; it's not just the arrival of your baby that can push you over the edge! It could be something you've buried or ignored that might just raise its ugly head as you're trying to adjust to this monumental shift in the world around you.

PND aside, the pressures on fathers today are different to those older generations experienced. In a lot of cases it’s the lack of resources, education, the shifting dynamic of the family unit and dare I say it, a lack of preparation that can catch us out!

Our failure to mentally prepare for the seismic shift in our everyday environment can result is us feeling overwhelmed. By our very nature we're problem solvers but facing up to the challenges alone and with limited knowledge and support we overlook the symptoms or ignore them completely. We recognise the struggle and internally we accept it hoping it'll pass. One of the biggest challenges facing many men is articulating what it is they're feeling. I ignored it, concealed it and pushed on because I believed it would pass. What I failed to appreciate was that it does pass, but when you're least expecting it, the emotion will creep up on you and bite you hard.

Often undiagnosed what should I be looking out for?

Think back to your own experience.

Parenthood is thrust upon you both! Labour starts and you're already both on the backfoot. A prolonged labour can leave you both feeling wiped out and a problematic labour can leave your nerves frayed and in a state of heightened anxiety. It's clear from discussions with dads who witnessed traumatic births or had to make decisions under intense pressure that you’re close to the edge and you don't have time to process the enormity of the decisions you're forced to make. In the moment, you make the right decision but it can leave you exhausted and facing an uphill battle. There is a real fear that you might just lose everything you've worked for and everything you love!

Dads often report having nowhere to turn in that moment or the moments after it. Their nerves are frayed and in the moment they have to internalise all the emotion attached to that event. Dads are often left to sit with the enormity of the decision with no aftercare offered and nobody checking in. It's fear that pushes you through but at no point do you pause to collect your thoughts, process what just happened or seek support. Your attention is diverted to the recovery of your partner and the wellbeing of your new arrival.

Faced with the realities of early parenting some of this stuff is going to go unnoticed. You might feel a little off but I suspect you'll gloss over it! I know I did. Your first mistake is believing that prioritising everything else is the right thing to do and that your health can wait. In many cases she's not seeing it either and because you're both distracted you'll put it down to adjusting. The thing is if, you put it off for too long it will catch you out.

Let's be frank for a moment… You prioritising everything else and ignoring your own health could have short term and longer term consequences not just on you but on the family unit too.

Ok, let's look at the common symptoms:

Tiredness

You can put it down to adapting to having a screaming baby but sleep deprivation can push to your limits and that's why this sign is often missed. We each adapt and cope differently to a world without sleep and depending on baby's needs (Bottle, Breast, Colic, Reflux, tongue tie, Appetite) good sleep is likely to be a thing of the past. That said are you contributing to poor sleep?

If you're in an agitated state or prone to thinking things through as you attempt to get off to sleep both could be a sign of PND. It's been shown that how you process stress can have a profound effect on your ability to shut off and get to sleep. If you're prone to going to bed later to get 'down time', this too will be having an impact and not to mention the constant interruption of your sleep as baby starts to adapt to a life away from mummy.

In my own experience Max pushed us to our limits! He was a light sleeper and a hell of a screamer! But I was before he arrived, already in trouble. I'd not been sleeping, not eating well and exercise had gone out of the window. I was up and out early every morning. I also found that once awake I was awake……. And once the brain started to whir away and I started to think it was hard to switch off and get back to sleep. So, whilst baby contributes to sleep deprivation you too will be having an impact on the quality of your sleep and that's where you'll get caught out. Let's face it tiredness can have a massive impact on your ability to get the basics right.

Trouble focusing.

Ahh it can't be…. Surely that's just me trying to adapt to my new role as a father. Maybe, but I know from my own experience I was thrown back into work after Paternity leave during the early onslaught of COVID and protecting the bottom line and reducing the commercial impact of COVID on my employer was my first priority. With COVID looming on the horizon my employer made the right decision to send me home before Max arrived. It was the right thing to do but at that point I was already under pressure …… With no end in sight and a lack of government clarity I put the trouble focusing down to the pressures at work.

I found that I was walking round in an ever darkening cloud. It wasn't necessarily fatherhood related it just felt like there was no time to catch my breath. You try desperately to stay on top of it all, but it saps your energy leaving you questioning your decision making and losing your train of thought. At times I felt like I was running on empty! You could ask me a question and whilst my brain fired and was ready to respond my mouth just wouldn't keep up. I'd cease midsentence and try to reconnect the dots.

In both roles (professional and parental) we want to be seen as competent and questioning even basic knowledge can knock your confidence even if you're a seasoned pro! In parental terms you start to believe you lack the basic competence to perform the role your partner and kids need. I could go as far as to say people start to question whether you're listening, and that's a poor place to be in when your partner needs you. She needs to be heard and you want to solve the problem but if you're not able to focus - Where do you start?

Reflecting back and honestly speaking, basic tasks took me longer to do and I even second guessed my knowledge on things I'd worked my whole career on.

Regulating emotions and your emotional response.

Were you a patient person before becoming a dad? What set you off before? Is it still setting you off now? Or has your tolerance disappeared? Are you quick to snap back? Easily angered? Quick to verbalise your frustration and do you feel guilty at your lack of control? How you managed your emotional responses before baby arrived can have a direct impact on how you regulate now.

One the biggest challenges facing any parent is that we're forced to relinquish control. What worked before is unlikely to work now and the relentlessness of it all can force you backwards. The approach you take to managing stress, anxiety, unhappiness, anger and frustration can lead you to question your value, the contribution you make and whether you're good enough to give them what they need.

You might hide behind a mask of solitude and start to push those closest to you away. There were times with our youngest when I struggled to bond. I wasn't mummy and he was happy to express that through the art of shrill screaming! Already under pressure it feels like you've hit an immovable object, the climb is getting steeper and you feel underprepared for the challenges ahead. We have a converted loft - It's not only unbearably hot in the summer but year round the sound reverberates off the pitch in the roof and it can feel like it's literally punching through your eardrum!

Anxiety can lead to irrational responses and therefore understanding any changes in your reaction to the sensory overload that is having kids should be managed carefully. If a response feels off I urge you not to sit back and wait for your secondary response. It might be too late and a failure to interrupt the pattern may lead you to programming a new response, one you'll later need to spend time and effort unpicking.

Your approach to managing the stress of work can limit your progress. Anxiety for example will either move you forward or move you back in the workplace, but place too much emphasis on operating in a state of anxiety and you can burn out. If you're the mum in all of this watch out for your partner's approach to work life balance. He might have that deadline or want to work that extra shift to reduce the financial burden but question whether it's worth the longer term strain on his mental and physical health. He will plough on because he's seeking to support you and baby at any and all cost.

We often ignore the signs before we realise the impact they're having and we often struggle to articulate beyond the statement 'I'm tired or it's just been a long day'. Internally we're looking for solutions and we perceive our failure to solve the issue as a weakness and fear judgment or reprimand, when in fact it's ok to share the problem and work it through with others.

The shame will build over time and mounting feelings of inadequacy will leave you questioning your role and the impact you're having on your young family. That shame leads to hopelessness and we fear powerlessness. Your emotional responses if unchecked can damage your self-worth. So, if your day to day emotions feel off and have done for more than a week, seek support. There will be a point when it feels like the walls are closing in, but don't wait until the last minute. In my experience that's a tell-tale sign that something needs to change before you hit the bottom, and by waiting too long to engage the support you need, you risk hitting the bottom and losing everything you've built.

Isolation, the age of the father and the impact on first-time dads.

We adjust differently and that can cause conflict! Our bond is built over time; I remember feeling a disconnect with our youngest! He was so different to our eldest. He was attached to mummy and still is, whilst it didn't knock my confidence I felt that bonding was much harder. In fact it wasn't until we started to break the breastfeeding and sleep cycle that I was able to put Max to bed and even then he still fought me.

In the grips of PND or even just the adjustment to fatherhood, it's simple things like this that can knock your confidence and lead you to question your role. It often feels selfish to speak up on what one might perceive as trivial and that's why communication is key. It's not about being selfish, it's about honesty between you and your partner. You must learn to be more transparent but you must also learn to communicate with empathy no matter what pressure you both are under.

A major contributing factor to PND is isolation. Research has shown there to be a high correlation between a father developing PND if his partner has or has had PND. A father's concerns about his partners health and wellbeing are highly likely to have a detrimental impact on his own health. It might seem like an obvious statement to make but society is better equipped to support the mother. There are mother and baby groups, toddler groups all of which are incredibly daunting for fathers to attend.

In the dad space there is little to no local community. There is either a pop up group or nothing at all and as more dads want access to shared paternity leave the gap is there to be filled. In reality a father is left isolated and as he backs further away the risks of PND and depression can increase. The research also tells us that his partners PND brings disruption to their lives and their relationship. In order to protect the family unit the father retreats further and further from social activity. If she's coercing you into social situations and you're lacking optimism or positivity toward the situation I suspect the immediate reaction is for you to tell her to back off.

COVID forced a lot of us into our homes, with little break in the routine and our work life balance has come under immense pressure. Even though we're more present (If you're employer supports flexible working) the relentlessness of it can leave you reeling and behind the screen are your colleagues and managers really alive to the changes in your behaviour. Whilst there haven't been any extensive studies into the effects of working from home on new fathers I can guarantee you that he's feeling the strain. Ordinarily he'd have had space to decompress, but today he steps across the threshold and straight into the chaos of everyday life living with kids!

Both your friendship group and your social status within that group play a big part. Let's face it we don't all have kids at the same time. In fact of my core group of friends in a relationship I was the 2nd to last father in the group to have kids. Your connection as a group can remain largely unchanged, but frequency of catch ups diminishes over time and whilst catching up with colleagues is fun, we often pride ourselves on the character we play at work and so those around us don't see the truest version of who you really are.

I have an incredible group of pals but the challenge we've all faced is that we're spread far and wide and therefore getting together has been difficult. It doesn't mean we're any less closer it just means we have to make more effort but often for dads/men the relationship you're in can create distance and once fatherhood hits you have very little option but to turn inward.

The problem is that you are so focused on family, your partner and baby that stealing 5 minutes here and there to watch TV (with or without your partner) is now the only time you get to decompress. You'll lose touch with those closest to you if you don't put in the effort and whilst some friendships stand the test of time how often you communicate will play a big part in keeping your trusted counsel together. At times you will feel guilty because it will feel like a selfish act but without community and brotherhood you'll lose sight of the value you bring to others outside of your relationship and that can create friction internally as you wrestle with finding your place as a new father and it can create a conflict between you and your partner both leading to more time alone.

Age plays a big part!

It's likely to be a maturity thing with PND predominantly found in dads aged 30 years of age or younger. There are likely to be multiple factors contributing to this.

1. Some might say we're still finding our feet in our late teens and mid to late 20s.

2. A young fathers education and understanding of the impact of baby's arrival and access to key support networks like NCT.

3. Education, your upbringing and social and economic pressures.

4. The status of the relationship between mother and father.

5. It's more socially acceptable to approach difficult subjects like anxiety and depression. It's more widely spoken about in the workplace environment.

6. Maturing financial pressures! The cost of living, increasing exposure and access to debt and potentially University loan(s) cost.

All of this can contribute to feelings of loneliness and desperation leading to a lack of social interaction, a lack of interest in the things that make you smile, and isolating from your partner.

Emotional connection with your partner and a loss of passion and communication in the relationship.

She's exhausted and you are too. The melting pot of factors outlined result in a mounting pressure on you as a couple.

Her pregnancy experience, life experiences, family unit, support and her own health and wellbeing and adjustment to motherhood all play a big part. Remember if she's a career mum she's putting her life on hold temporarily which in itself creates stress and uncertainty.

You adapt at a different pace and her experience of birth and the hormonal changes her body goes through lead to a disconnect between the two of you. A lack of understanding about the way in which fatherhood impacts you can create more noise than is necessary. So if you're a new dad it's time to reach out and find the right support networks.

The lack of intimacy and time for it can rock even the strongest of foundations. In your world, the complexity attached to adjusting to fatherhood and the pressures that come with it can have a knock on effect to you and her.

Do you create time for one another? Do you talk, or is the communication in the relationship strained? Trust me, if I had a £1 for every time I started a conversation only to be interrupted by 'Dad, can you…." or "Dad, did you know……" I'd be working less and enjoying more family time.

In basic terms how you conduct yourself (health and well-being) is a bigger obstacle to intimacy than baby brain, breastfeeding or hormones! By retreating into yourself and failing to look after yourself you're creating a barrier to the intimacy you crave. How you communicate is put under intense scrutiny and with conflict arising we often ignore the thoughts and feelings of others in favour for our own. That approach can lead to feelings of judgment or a perceived lack of sensitivity on your part which in turn draws the battle line on topics like intimacy and connection.

In conclusion

PND is real. There is a lack of support for new fathers and left to muddle through we tend to ignore the signs and sacrifice our short and mid-term health because we think it's the right thing to do.

There is a gap in data which will inevitably lead to a lack of funding, but there is a lack of education in this space too. Employers rightly focus on wellbeing and drive mental health initiatives but are we overlooking the case that 80% of men will become fathers and for every 1 million fathers we expect to see between 30,000 and 100,000 cases of PND.

There is responsibility resting at the feet of fathers too. I personally chose to ignore the signs until it was nearly too late and I'm privileged to be in a position where my partner refused to give up despite my behaviour. I am one of many who attended NCT courses and was prepared for the practicalities of parenting, but I wasn't ready for the mental challenges and that's where we get caught out. Against a backdrop of exhaustion, sleep deprivation contributes to poor decision making. But I also think it's our ingrained stubbornness that leads to that feeling of isolation, overwhelm, inadequacy and powerlessness. Underfunded and unsupported, Dads need your help and they need you to listen without judgment.

Remember: Encouragement is key but applying stress to the situation will not help him find his feet. He's calling out for someone to listen, his cues are not always going to be verbal but he will be behaving differently. He may have already accepted he has a problem but feels cornered, and with nowhere to turn he'll turn to behaviour that can contribute to both his downfall and the downfall of his relationship.

Yes the balance of everything we've talked about directly contributes to PND and the isolation and overwhelm you fear as a new parent. But all of the factors described have their place. It's not one thing or two things. There are different stages, a number of combinations and a multitude of pressures that can lead to PND.

My worry is that this topic isn't far enough up the chain of command to deliver real, sustained change and a preoccupied father's impact might not be measured today or even this year, it will be measured by the legacy he leaves and that legacy starts with his children.