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HEALTH / The cradle of men's misery: New research shows that fathers may also suffer from post-natal depression. Kay Marles uncovers a darker side of the happy event

Kay Marles
Sunday 20 March 1994 00:02 GMT
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TWO MONTHS after his first child was born, Stephen began an affair with another woman and moved out overnight after five years of marriage. Abdi, a father for the third time, started to become violent weeks after his daughter was born and smashed up the furniture in her room. Three days after his wife came home from hospital, Nick couldn't move - he had severe backache and lay in bed, immobile, for the first three weeks of his son's life.

Coincidence? Bad luck? Situations that would have happened anyway? Or are these all examples of a medical condition, related to the arrival of a child?

We know that at least 10 per cent of women experience some form of post-natal depression more serious than the baby blues, but what about men? Is it possible that the birth of a child can make them depressed or cause them suddenly to behave in an uncharacteristic way?

Dr Simon Lovestone of the Maudsley Institute of Psychiatry believes there is hard evidence to show that a significant number of men experience some degree of depression after the birth of a child. Last year, while conducting a study on women suffering from post-natal depression, and the rarer and more serious post-natal psychosis, he discovered that almost 50 per cent of the partners of these women hadsome kind of clinically apparent depression or mental illness themselves.

Some of the illnesses were prompted by the men's partners being in hospital, and in many cases their health improved as the women's did. 'The men's illnesses seemed to be linked to those of the women,' Dr Lovestone says.

More interesting still were the results of a questionnaire given to the partners of those women in the control group who had shown no signs of post-natal depression. The men were asked questions relating to their mood changes, such as whether they were feeling unusually miserable, or finding it hard to concentrate, whether they were having difficulties eating and sleeping.

Twenty-five per cent of the respondents claimed they were, therefore scoring highly. 'We would have expected about 5 per cent to score highly,' Dr Lovestone says, 'but what we found indicated that among a significant number of men there is a very high rate of distress and probable depression after childbirth.' The implications for the family, and for the men's ability to become satisfactory parents, is now likely to be the subject of future research.

Since he has been attending births at home, Dr Michel Odent, the natural birth guru, has become more aware of problems men face after childbirth. 'With the experience of home birth,' he says, 'you continue to visit the parents after the birth and so you see what is happening. Very often the woman is in the kitchen, active and alert and the man is lying in bed. One actually said to me that her husband felt terribly drained.'

Drained? Isn't this the person who should be sending proud photographs to all the relatives, filling out the birth announcement cards and managing the household for a while?

Of course, the majority of men do experience the joy of having a child and the unique happiness of holding their own baby. Many feel great fulfilment; but it is becoming clear that some experience something traumatically different, which can make them want to hide under the duvet all day or run off into the arms of another woman.

'We do have clients coming in with tiny babies,' says Renate Olins of London Marriage Guidance. 'The reality of childbirth is often so different from the expectations. A lot of issues can close in on a man when a baby comes, real anxieties about employment, a sense of being burdened, the illusion of being able to have it all being shattered. Sometimes men take flight in behaviour that is quite uncharacteristic of them and quite destructive.'

One of the issues that may have clouded discussion of men and post- natal depression up to now is the belief that post-natal depression is all the fault of hormones, so men can't possibly experience it. But while experts agree that there may well be some links between hormonal imbalance and post-natal psychosis, in the case of post-natal depression this is not proven.

'There is no established link,' says Professor John Cox of Keele University, 'but that does not mean that hormones are not the cause of some depressions. They may be, but there are other major factors too.'

One of the difficulties is that birth signifies the enforced ending of a dream. You can't fantasise any longer about parenthood; reality, often harsh, begins with that first cry.

'No one is ever adequately prepared for birth,' says the clinical psychologist Dorothy Rowe. 'It's a tremendous shock. Everything changes. You lose all the things you took for granted.'

But there are experiences some men find especially difficult, such as the sudden sense of serious responsibility. At Relate, where they find many marital problems can be traced back to the birth of a child, fathers can have particular difficulties if they are immature themselves. 'Sometimes the responsibility of a new child feels very difficult to cope with for fathers,' says Relate's spokeswoman, Zelda West-Meads. 'They may have wanted it, now they feel weighed down.'

One of Abdi's needs was to spend more time with his family and new child at home, and a reluctance to go back into the outside world and work. (There is as yet no statutory provision for paternity leave in this country, so partners take time off out of their annual leave.) For Stephen, the experience of seeing his wife give birth left him frightened and alone with no one to talk to.

'Men don't talk about these things,' says David Thomas, author of Not Guilty: In Defence of the Modern Man. 'There are no formal or informal networks such as women may form through organisations like the National Childbirth Trust or with their friends. Men's magazines tend to concentrate on high-earning bachelors, not on men's emotional issues.'

A man may find his emotions being stirred up quite out of his control. He may suddenly feel intensely jealous or displaced. He may feel rejected and lonely. He may feel he has lost his wife's love. None of these are excuses for violent, destructive or hurtful behaviour, but they are nevertheless real reactions that no one can accurately predict. The pressure on men to share the experience of childbirth and the tasks of child-rearing can also lead to difficulties that may not have been sufficiently addressed.

'The emphasis today on the man being at the birth and sharing the experience, and the sense that it will make the links between the couple stronger, is nothing but doctrine and theory,' Dr Odent says. 'In practice some men find it traumatic, and there is nowhere for all their emotions to go.'

'Many men experience an extreme reaction to the birth of a child,' says Dr Emanuel Lewis of the Tavistock Psychotherapy Clinic in north London, 'but they tend to show it in different ways. They may turn to drink, or violence, or rush off and have an affair. They might even leave home.'

Psychologist Dorothy Rowe says: 'If a man is unhappy and has a sense of having lost control of his life, he may feel he must do something about it. He may feel that in order to regain control over his life, he must act. He may go out and buy something they can't afford, or he may race off with someone else.'

Friends and family react quite differently to men and women in the post-natal period. Because people know that some women suffer from post-natal depression they may consider that as the cause of a problem. They are unlikely to do the same for men. 'I have several male friends who acted extremely strangely when their children were born,' says David Thomas. 'But we tend to say, 'Oh, he's just being a bastard.' Given the same circumstances with a woman, we'd probably say there must be something wrong with her.'

The difficulty lies in part with the way men deal with depression: it is hard to feel compassion and understanding for someone, man or woman, when their actions appear cowardly or leave a trail of bitter hurt in their wake. But just as it is inappropriate to suggest to a depressed woman that she take some pills and pull herself together, this is likely to be unsuitable for men too.

The concept of men being depressed after childbirth is unlikely to be widely accepted for some time. But the results of Dr Lovestone's findings are beginning to filter through. At the Maudsley Institute, and increasingly at other centres of psychiatry, the emphasis is moving towards treating whole families rather than just the woman, and men are increasingly being asked to talk about their own feelings. As with women, getting help through some kind of talking therapy can often be the first and most effective step in dealing with unwieldy emotions. -

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