Perinatal anxiety & perinatal depression in men: Therapist’s guide

Summary: Perinatal depression and anxiety aren’t exclusive to mothers; fathers can also experience these struggles. Therapists play a key role in understanding symptoms and providing assistance. By recognising the unique challenges fathers face during the perinatal phase, we can help guide men through this transition, promoting better mental health and stronger family dynamics.  

Becoming a parent is a life-changing experience, and while much attention is often given to the mother’s mental health during pregnancy and the postpartum period, let’s not forget the dads! Reseach suggests Around 1 in 10 expecting or new fathers experience perinatal depression and anxiety. Perinatal anxiety and depression not only impact women; men can also find themselves navigating emotional highs and lows during this thrilling (and sometimes overwhelming) period. But here’s the catch: these conditions in men are often overlooked because they might not manifest in the “typical” manner. Men need to recognise, understand, and address their mental health issues. Let’s explore what’s happening in the minds of expectant or new fathers and how we can best support them through perinatal anxiety and depression. 

What is perinatal anxiety?

Symptoms of perinatal anxiety

• Excessive worry 
• Sleep disturbances 
• Restlessness 
• Difficulty concentrating 
• Irritability 
• Avoidance behaviours 
• Overprotectiveness 
• Negative thinking 
• Panic attacks 
• Changes in appetite 
• Increased heart rate 
• Dizziness 
• Muscle tension 
• Nausea 
• Stomach problems 
• Tightness in the chest 

Also read: Perinatal depression: Symptoms, risks and treatment

What is perinatal depression?

Symptoms of perinatal depression

• Excessive worry 
• Irritability 
• Anger 
• Unexplained aches 
• Digestive issues 
• Fatigue or low energy 
• Changes in appetite 
• Sleep disturbances  
• Feelings of guilt or worthlessness 
• Trouble concentrating 
• Thoughts of self-harm 
• Persistent sadness 
• Difficulty bonding with the baby 
• Feeling lonely 
• Changes in sex drive 

What can increase a dad’s risk of developing perinatal mental illness

• A personal or family history of mental health conditions (originally "issues") 
• Significant stress from work or home 
• Financial strain 
• Insufficient social support 
• Relationship challenges 
• Feelings of being excluded from the parenting experience 
• Difficulty adapting to new roles 

Also read: Can men get postnatal depression? How to spot it?

Factors affecting paternal perinatal mental health

1. Emotional transition to fatherhood: The transition to parenthood can bring about excitement but also anxiety, self-doubt, and a sense of inadequacy. Managing the emotional demands of caring for a newborn can influence mental well-being. 
2. Changes in relationships: Stress or diminished intimacy with a partner, particularly when both are fatigued or overwhelmed, can amplify emotional strain. Additionally, if the mother is dealing with perinatal mental health challenges, it may further increase the father's vulnerability. 
3. Financial and occupational stress: Concerns regarding finances, job stability, or balancing work with parenting can create significant stress for new fathers, potentially leading to feelings of pressure and burnout. 
4. Lack of social support: Many fathers may feel excluded from postnatal support systems or unsupported by health professionals. Insufficient social or professional backing can intensify mental health struggles related to feelings of isolation. 
5. Personal or family mental health background: A previous experience of depression, anxiety, or trauma may emerge or worsen during the perinatal period.  Early recognition and  early intervention can help prevent further deterioration. 

Risk factors for paternal perinatal stress, anxiety and depression

1. Individual mental health background: A previous experience of depression, anxiety, or trauma raises the probability of encountering mental health challenges during the perinatal period. 
2. Sleep deprivation: Persistent lack of sleep due to nighttime parenting responsibilities can significantly affect mood and cognitive abilities, potentially leading to heightened stress and emotional exhaustion. 
3. Relationship struggles: Disagreements, ineffective communication, or feeling detached from a partner, especially during or following pregnancy, can elevate stress levels and the risk of depression. 
4. Financial strain: New financial obligations or concerns about job security can contribute to feelings of inadequacy, anxiety, and helplessness. 
5. Insufficient social support: Experiencing isolation or lacking close relationships with friends, family, or peers can worsen symptoms and make coping with stress more challenging.
6. Partner's mental health challenges: If a partner is dealing with perinatal anxiety or depression, it increases the emotional load on the father and raises his own risk of developing similar issues. 

What to do

If you’re a new father feeling stressed, anxious, or down, it’s essential to realise that you’re not alone and there are resources available. Start by recognising your feelings and confiding in someone you trust, such as your partner, a friend, or a family member. Having open discussions can lighten the burden of what you’re experiencing. Pursuing professional assistance is a crucial step. A qualified therapist, general practitioner, or mental health expert can evaluate your situation and suggest an appropriate Mental Health Treatment Plan (MHTP). This plan may involve therapy sessions, medication if necessary, and access to resources like support groups or counselling. In certain areas, an MHTP might also make you eligible for subsidised mental health care services. 

Engaging in simple daily activities exercise like sufficient sleep, nutritious eating, and time for yourself, can also enhance resilience. Seeking help early can significantly impact your well-being and your role as a father. 

Supporting fathers through perinatal anxiety and depression is just as important as supporting mothers. By identifying the symptoms and offering the right tools and empathy, we can help new dads navigate this challenging time with confidence. After all, mental health is important for everyone in the family, because a happy dad means a happy family!