‘I Couldn’t Afford To Fall Apart’: Post-Natal Depression in Dads
Content warning: this story contains descriptions of birth trauma and mentions of suicidal ideation.
Nial Sands, his wife Danielle and their little boy Joe are nearing the end of their first family summer holiday in northern Italy. They’ve been riding gondolas in Venice, sailing on Lake Garda, and visiting Peppa Pig Land in the Gardaland amusement park.
But turn the clock back to March last year, and if someone told the young couple they had all this to look forward to, they simply wouldn’t have believed it.
Nial was in the bath when he was jolted by the sound of Danielle’s screams on 7 March 2023. She was haemorrhaging. It was two days before his wife was booked in for a C-section to deliver their first child. A panicked Nial drove her straight to Altnagelvin Hospital, one of the busiest hospitals in Northern Ireland.
‘Danielle was wheeled off and I was shitting myself, stood outside theatre in the corridor – nobody came anywhere near me,’ the 33-year-old recalls. He thought they’d lost Joe.
‘Then I heard a baby crying and all of a sudden Joe was brought out. I asked, “Is my wife OK?” and they said, “Hopefully.” Nobody could give me a straight answer. I was just left there. Joe was whisked off to the Neonatal Intensive Care Unit (NICU) and all these questions were fired at me about how I should feed him, and injections. I’m petrified, thinking, “How did he come so quick – and where’s my Danielle?”’
It Started With Anxiety...
Danielle and Nial were introduced to one another by a mutual friend, in Dormands Bar, Magherafelt, Northern Ireland, in 2013, when Danielle was 17 and Niall was 21. ‘I knew from the get-go that she was the one for me,’ Nial recalls.
In 2020, Danielle’s mum died suddenly of a brain tumour. Shortly after, the couple started making wedding plans, and within weeks of returning from their honeymoon in Nashville and Florida, they found out they were pregnant.
But things started to go ‘pear-shaped’, as Danielle puts it, when she was 20 weeks’ pregnant. The rest of her pregnancy was fraught with growth scans and blood-flow checks. Danielle was booked in for a C-section at 37 weeks. But, at 35 weeks, she was rushed in for an emergency C-section. After a brief stint in NICU, baby Joe – who, at just 3lbs 6oz, could fit into Nial’s hand – was sent home with his parents. Both mum and dad were terrified it was all too early.
‘The night Joe was leaving NICU, a nurse said: “I’d just fear for Danielle’s head” and I thought: “You could be right,”’ recalls Nial. ‘Then Danielle started dipping. And then she spiralled...’
Nial throws a loving glance in Danielle’s direction, as she charts her brutal descent into postnatal depression: ‘Nothing was right in my head. I wasn’t working... I was sure I couldn’t be a mummy to this baby, but if I couldn’t be a mummy, I’d lose my husband and what would I do then?’ she says Danielle.
Danielle’s midwife spotted the signs. Within days, the perinatal and crisis team swooped in and Danielle was diagnosed with severe postnatal depression (PND).
‘It started with anxiety and fear, but it became uncontrollable. I had five weeks of no sleep, thoughts whirring 24/7, not eating, not going to appointments... I’d no interest in anyone or anything,’ she says.
Nial left his job in logistics at a warehouse for four months to take care of mum and baby round the clock. ‘I never knew mental bad health could totally change a person,’ he says. ‘It was horrifying. She was a shell of herself. She kept saying she was fine, but she just couldn’t be a mummy. She had these intrusive thoughts. I’d heard of PND but never thought it could happen to us.
‘I tried to [support] Danielle as much as possible during the day, trying to convince her she could get better. I did everything at night, I was doing the feeds every two hours, changing Joe. Danielle couldn’t be left on her own. It wasn’t that I didn’t trust her with Joe, but I knew she didn’t even trust her own thoughts.’
Being bombarded with pictures of happy families on social media didn’t help. ‘The algorithms [showed me] loads of perfect families leaving the hospital, everyone happy. You wonder, why didn’t that happen to us? People offered to help, but I wanted to do everything myself and step up to the plate. There was pride there. I thought Joe didn’t have Danielle, as I knew her, so I wanted to give him everything.’
One in 10 New Dads
By June, Danielle made her first big breakthrough when she bundled up baby Joe and walked him into town in his pram for the first time. By late August, her combination of Cognitive Behavioural Therapy (CBT) and medication were starting to work.
But just as the old Danielle started to return, Nial’s own mental wellbeing worsened. ‘Before that I told everyone I was grand – I couldn’t afford to fall apart. But then the wheels came off,’ he says. ‘I was going to work but feeling anxious doing stuff I found easy before. I couldn’t concentrate. I started catastrophising. If I was on the forklift, I thought: “This will fall and hit someone and I might kill them.” I always thought of the worst-case scenario; in my car, I thought I’d crash it.
‘I was so angry that Danielle had to go through so much, losing her mummy, too. And I was obsessing over what I’d missed, and angry that I felt it should have been prevented. We could have lost Danielle and lost the baby and I felt that could have been prevented.’
Although the couple didn’t know it at the time, Nial – like an estimated one in 10-15 new fathers in the UK – was also suffering from PND.
‘I closed up – I didn’t want people to know. I didn’t want Danielle to feel guilty. I was petrified I’d set her back,’ he says. ‘I tried to hide it but she knew.’
Danielle confided in her perinatal team that Nial was struggling and they signposted him to a support group for new dads called Dad’s Voice. But still, nobody mentioned PND.
Building Support Systems
This lack of awareness is why Irene Petersen, Professor of Epidemiology and Health Informatics at University College London (UCL), wants to see routine postnatal healthcare appointments for men after childbirth.
‘You could argue that it’s a good idea for men to have a discussion at that point, particularly first-time fathers,’ she says. ‘This is not new – we’ve known [about male postnatal depression] for a while. We did a study more than 10 years ago where we demonstrated that fathers were likely to develop PND, so it’s not a new thing. Although it takes a while to penetrate society.’
According to a study of more than 3,000 families in Bristol, almost one in 20 new dads suffered depression in the weeks after the child was born. And groundbreaking research last year led by Prof Petersen, examining the medical records of 90,000 new dads, found that those with a recent history of antidepressant use were more than 30 times more likely to be prescribed antidepressants in the first year after childbirth. Those who’d had treatment more than a year before childbirth were seven times more likely, and 2% of those with no prior depressive episodes were prescribed antidepressants.
‘Having a child can be one of the happiest periods of your lives, but sometimes it is not,’ she continues. ‘It can be so hard to admit that to yourself, family and friends, and men feel they have to be there for their partner. Some people feel it’s a weakness to admit it, but you can argue it’s a strength as that’s the best thing for your family. GPs are there to help new fathers.’
She points out that her study was based on medical records, ‘so we don’t know how many men remain untreated. But it’s important for men to speak to their family GP . It’s a good idea to seek help and find out about opportunities, not just pharmaceutical treatment. It could be a counselling referral.’
And while men are often involved in antenatal classes, she believes it could be very helpful to set up postnatal classes too, through which they can ‘speak to other men and recognise they’re not the only one’.
Help is Out There
As Nial suffered in silence, Danielle made the decision to contact Dad’s Voice organiser Darren Beggs, who rang Nial and invited him out for a chat.
‘I met Darren first, and then the group came in. I sat there and listened,’ remembers Nial. ‘It was good to be in a room where people understood. I didn’t feel like I was on my own.’
Now every second Tuesday evening, between 8-15 new dads help themselves to tea and coffee and sit on the sofas in a community room in Ballymena. They recently had to move venue as word got out – more new dads kept turning up.
Mental health campaigner and author Mark Williams, who wrote Daddy Blues in 2018, founded International Fathers’ Mental Health Day and also runs the website Fathers Reaching Out. After his wife had a traumatic birth with their son Ethan in 2004, followed by PND, his panic attacks escalated into suicidal thoughts and postnatal depression, which he masked by drinking too much. He says men often attempt to conceal their true feelings, and cope by overworking, drinking too much or even using drugs.
‘What’s shocking is that one of the leading times for men to die by suicide is around the perinatal period,’ he says. ‘Dads with mental health problems during the perinatal period are up to 47 times more likely to be classed as a suicide risk than at any other time in their lives. There’s guilt, feelings of isolation, sleep deprivation, loneliness, like you’re not good enough, but dads mask a lot. It got worse in Covid: dads were left in carparks for days waiting to hear about the birth. We talk about equality – men need pathways of care too.’
Encouragingly, more and more new dads are refusing to suffer in silence. A private fathers’ Facebook group run by the PND charity Pandas has swelled to just under 1,000 members since starting in 2020.
Recently, dad-of-four Aled Vaughan-Edwards set up a support group, How’s Dad?, in north Wales, after coming close to ending his life following the birth of his daughter. Like many others, Vaughan-Edwards had never heard of male PND before experiencing it firsthand.
‘I’m in a much better place now,’ he says. ‘I’ve had different therapies, which have allowed me to break down the walls, show my emotions and express them more freely. I want to help other men realise they’re not alone.’
Nial had one-to-one counselling and was started on antidepressants by his GP. But he is at pains to stress how transformative revamping his physical health has also been on his journey to recovery.
‘I started working on myself, focused on my physical health, working with an amazing personal trainer, Paul Reynolds – not just looking at my mental health,’ he says. ‘I started at the gym, eating well, taking vitamins, running. I’ve never felt better in myself.’
Now he wants to help other men get better, too. ‘I started sharing my feelings on Instagram – I set up a page called That’s Mental... I had dads coming to me saying they felt it too, but felt ashamed.’
Now, just like the Danielle, Nial barely recognises his old self.
‘I want to tell dads out there, don’t be ashamed, get rid of the stigma. There’s a bravado around men and they don’t know who to talk to, or feel they can’t. But things can get better – just look at our story.’
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