To think men genuinely can suffer from PND?

[Inboxer]

My friend has received treatment for PND after her second child and thankfully is coming out of the worst of it now. However, her husband is now getting counselling for male post natal depression and her response to this was complete anger. She resents him claiming to have what she had which she claims was due to a hormonal imbalance and can't take him seriously.

I haven't said this to her but I think he may well be genuine and deserving of support. I don't know him ever so well but I find it entirely possible that he's feeling as sleep deprived, shell shocked, trapped and overwhelmed as she is. Yes it might not be hormonal but surely the huge upheaval that having a child brings could send either parent into depression? I know health visitors tend to look for it more in the mother and maybe this means men get overlooked. I know this couple have money worries too and that pressure must affect him too.

Am I being unreasonable to think his mental suffering could be as real as hers?

Chazzer - I'm not saying she's wrong - she might be right that it's not genuine. I think I just generally feel that mental health worries should always be taken seriously and it might be dangerous to dismiss it entirely.

Thanks BertieBotts for your honesty. I think you have hit the nail on the head there about it being important how we name mental illness. I think that perhaps it's because women have fought for do long to get PND recognised in themselves that we feel so strongly. The symptoms seem to be almost identical to the women's symptoms though.

Bertie

Male PND would be correct (by what you have posted) as is is depression after the birth of the child.
Its just not caused by an imbalance of hormones and I suspect that it is not what the DH has called ot but what the professionals have called it.

I find it interesting that two posters have admitted to seeing it as encroaching on female territory and being attention seeking. I think that's admirably honest of them to say that and it probably reflects the views of lots of women.

I think we'll see a rise in male depression following the arrival of a baby that correlates very strongly to a rise in the number of first-time fathers taking that role seriously and really entering in to the responsibility of it.

All too often, fathers have escaped some of the worst excesses of sleep deprivation because of the fact that only the mother can breast feed or that the father's need for sleep is prioritised as he has to go to work to keep the money coming in while the mother is on maternity leave.

In still far too many families there is a situation where the mother is the carer by default - she has to arrange for the father to be at home for her to go out and fulfil her hobbies while he assumes he is free to pursue his unless specifically asked to be at home with the DC.

Life tends to change much more for women than for men with the arrival of a baby and that's before we even consider the hormonal element of PND. There are other physiological differences too - due to pregnancy and breastfeeding, men don't tend to get that feeling of their body just not being theirs anymore and that everyone wants something from it - midwife, baby, even partner.

But with more and more men really getting involved, getting up in the night despite going to work the next day, using expressed milk to make sure they do their fair share of feeds, changing the nappies, doing their share of the housework, etc, often in addition to still having the responsibility of being the main or only breadwinner, the impact of a new baby on men can be just as profound as it is for a woman, and TBH they wouldn't be human if they weren't left reeling from it, and in some cases thoroughly depressed from the overnight loss of freedom and sleep and the seemingly never-ending roundabout of nappy changes, feeding, winding, domestic drudgery and lifelong responsibility.

It's not a competition.

I wonder if there should be just one term that encompasses all depression caused by the birth of a child or whether as women we want a clear distinction between the chemical and situational roots of depression. Would this then mean that one is still taken more seriously than the other?

no, a catch all description doesn't work. You don't treat chemically based depression in the same way as you treat situational depression.

I think the solutions are very different depending on the cause but I also think it can get complicated for women because often PND is compounded by 'normal' depression. The link between mothers suffering PND and a lack of adequate support is huge.

It's already not taken seriously enough. I think that's the crux of it, and why it's so offensive that somebody would appropriate that and make it about men when women have struggled, and continue to struggle, to get PND recognised, talked about and dealt with.

Of course the state of mental health provision in general is dire but it's a kick in the teeth to grab the name and - yes, I suppose, the attention, that women have been trying to tell people about for decades. It's a bit like the thing where funding for female victims of DV is being funnelled into refuges for men. Yes they do need them too, but stop taking resources away from women to do so!

I had severe PND, two years of treatment.
I think it was incredibly tough for dh, and he suffered distress as a result of my illness as well as all the stresses and strains of having a young baby.

However, I really resent calling depression at this time PND for men. I absolutely HATE it. I think men absolutely can have severe depression too in the year after a child is born and it is serious and worthy of treatment, but I cannot conceive why it needs to be called PND.

The social context of depression after childbirth is entirely different for women and men. Usually, men aren't expected when severely unwell to continue to function. I knew SO MANY women who were at the point of suicide who were still frowned upon for being "lazy" and "not getting a grip" and such like, and whose partners and mothers told them they needed not to be so "self indulgent" and that they didn't have a "choice" or couldn't "afford" to be unwell. Even women who had been hospitalised - still told by apparently caring family members that they needed to get to grips with the housework. This is unlikely to happen to men.

Women have to cope with hormonal shifts, breastfeeding or not, body image changes, a body returning to a pre-pregnancy state, a society that judges every SINGLE choice the woman makes etc. You are KIDDING me that this doesn't make PND an entirely different experience to the depression that may be experienced by men in the months or years after having children.

PND remains THE leading cause of mortality in women in the year after childbirth. Is this true for men? Hmmmm, didn't think so. I think it's appropriation.

In any case, PND isn't even recommended as a label - the diagnostic label you get from a psychiatrist is just major depression etc. So screw calling it PND. Until men bear and deliver children, let's just call it DEPRESSION. I've every sympathy for any person experiencing depression at any point of life, but it is just insensitive in the extreme to the woman who had PND in this case.

I don't think men are taking resources away from women, men are far less likely to seek help with depression and access talking therapies far less than women. Men are also nearly 3 times more likely to end their own lives.

I think one of the reasons women commit suicide less than men is because of their caring responsibilities - they often use them as a reason to keep going just a little longer because they don't want to leave their children motherless. By the same token, there's some evidence to suggest that women access help precisely because they feel they owe it to their nearest and dearest to "get a grip" and carry on with their responsibilities and recognise that they need external help to do that.

There's a rather bitter-tasting irony there in the context of this discussion I think.

Bertie has summed up my feelings on this issue perfectly.

I'm not sure the difference between chemical and situational is always that clear cut. I was very low and teary the first five months of being a new mum then as my baby started sleeping better things started to improve but was that because I had less sleep deprivation or because my hormones had readjusted? I think it's not always so clear cut.

I just wonder whether the idea that recognising men's issues somehow takes recognition away from women might end up limiting our understanding of male mental illness. Is it helpful to anyone to see certain problems as "belonging" to women?

Again, I have every support for men getting help with depression at any point of their life and for this to be taken seriously.

I just don't see why we need to say men have a postnatal mental illness, when they haven't been through pregnancy or childbirth. Particularly given the fact that NICE guidance on ante- and postnatal depression advises against using the label of PND for WOMEN, so why would it apply to men?

Fair dues to any man seeking help for depression. I'm just not keen on it being called PND.

Mental health services are also far less geared up for treating men, my local area has specialist women's counselling services and various women's only groups with no parallel provision for men. Talking therapy services are also mainly staffed with women and this can be a barrier to access for some men. I think society does tend to socialise women to be interdependent and ask for help more and for men to be stoical. I believe the main reason male suicide rates are higher though is that men choose more lethal methods.

All that may be true, ILove, but why do we need to use the term PND for men? What's to be gained? Also, there are many, many areas where women with children are not supported in terms of PND and there's insane levels of stigma about it in many communities and cultures. It's not exactly an easy experience for women, either, and I do think the social context does have an influence on the course of PND for many, many women - that women's issues do often overlap with the causes of PND. Very many women I knew with PND could not access talking therapy at all because of childcare issues, for example. I think mostly every vulnerable group will have access issues, but in what way does describing male PND support male access to therapies?

What Bertie has said exactly. How is their relationship apart from this Inboxer? That might give some clues as to the levels of resentment your friend is feeling?

And I agree about chemical and situational difference. If you think about what happens to a woman when they have a child. They have to give birth, exhausting and painful, possibly traumatic. Possibly ongoing issues. Their life is turned upside down and they have a small being who is completely dependent on (mainly) them for life. They are sleep deprived and possibly isolated. Their normal support networks may not be there e.g. Work, friends without children, family. Their husband/partner may not be around much/at work/unhelpful. There is a correlation with PND and a lack of support for example. PND is not unsurprising given all that. I think doctors like to hang it on women and their hormones, but is there that much evidence of that?

But unless they are very very hands on most men won't have those experiences after the birth of their child.

duplodon, I've said up thread that I think applying a PND diagnosis to a man is a misappropriation of the term. My post about where resources were directed was in response to Bertie's statement that men were taking resources away from women and my post about reasons for access issues was in response to Pounding's post. I'm just a very slow (and easily distracted) typist so the thread had moved on a bit and my comments probably seemed quite random. Depression is awful and everyone needs timely access to appropriate treatments.

"Is it helpful to anyone to see certain problems as "belonging" to women?"

Keeping issues as women's is incredibly helpful for focusing attention. And also helping find solutions or directing resources. As Bertie pointed out women have fought long and hard to have PND recognised and now, as demonstrated by this thread it is being appropriated by men.

If we were in a society where women had equality I'd agree that it wasn't necessary. But we aren't and the hard-fought gains women have made are under constant threat of erosion (abortion, DV refuges to name a couple).

Sorry ILove, never saw that. I agree with what you're saying then, just feel discomfort with the postnatal prefix in this context.

i found the link Imbimba

here u go op, www.literallypr.com/public_relations/file/Olivia-Spencer---Sad-Dad.php

Personally, i think just because society and the medical profession have concentrated on womens mental period after birth does NOT mean men are not affected by it too. The only difference is that for women the hormones are involved also. Maybe they should rename it Post Birth Depression then men could be taken seriously too?

"womens mental health in the period after birth" is what i meant to write!

Why does a man's depression in the face of a major life change have to be related to childbirth at all? Why not just call it depression? It's really no different, NICE are clear on this. For the majority of women, there are additional physical and social challenges at this time that are NOT experienced by men. Breastfeeding, for example, is a major source of rumination and distress for women that men will NEVER EXPERIENCE.

I fully believe a man can experience depression triggered by becoming a father, having a child, change of relationship with his female partner, additional stresses and strains, worry about finances etc... but many of the most common themes of rumination and distress in PND are generally experienced either exclusively or far more frequently by women because of the differences in gender or sex role - ruminating about the birth experience, breastfeeding, body change, resentment about suddenly being expected to take full responsibility for housework, isolation on maternity leave, lack of support for the role of mother, being with a baby 100% of the time, 24-7. Having absolutely NO time away from the baby or young child is a very common experience for many, many women and complicates recovery for many women who get PND. There are very, very few men who would be in a situation where they had absolutely no time away from the needs of their young child across the 24 hours of the day.

In all my treatment (and I had a LOT) it was the woman-specific treatment I had a PND group that went the furthest towards making me feel normal again, because we had the opportunity to explore some of these themes which all of us, eight women in extraordinarily different circumstances, shared.

I just don't think it's appropriate to make male depression at this time of life about pregnancy or childbirth. PTSD after a traumatic childbirth is somewhat different, but again, there's no need to make the label about the birth - there's no implication that depression or PTSD are not serious or worthy of treatment by not calling them "post-natal".

Also, there is no man EVER who will have to face deciding about antidepressants in the context of conceiving, being pregnant or breastfeeding, let alone the judgement attached to it, or the hordes of people who "don't agree" with women treating depression medically and continuing breastfeeding. That alone really changes things for women during this period of life and perinatal mental health services develop high degrees of specialism in medicating pregnant and breastfeeding women because it's a major consideration in treatment that wouldn't exist for men at this time of life.

Huge numbers of these services have been rationalised and cut back as it is, they don't need to provide for men too. It would be unlikely a man would ever need a father and baby unit, for example. That in itself explains why it IS different for women at this point.